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Prisca Smith | Scrubs Magazine
about 4 years ago
I am a "seasoned" RN having worked 16yrs on med/surg floors. A few years ago I had a challenge with a physician who had a history of not being very compassionate with patients who were nearing their end of life... things like pain management and comfrot measure in general. He had verbalized on more than one occasion that it was not money well spent. One day I had one of his patients whose family was having great difficulty with the end time transition for this patient. The patient was a DNR and on a morphine drip at 1mg/hr and O2 via cannula for comfort. The family asked if there was more we could do for comfort as the patient was very restless. I asked the Doc if we could turn the drip up a little and he countered with, " SURE... turn it up to 10 mg and take away the O2... that should make them more relaxed!" I was shocked and told him so and was met with, "You want to make this patient comfy?? Then this should do it!' He then left the station. The "order" was so completely absurd that I didn't write it as I thought he was simply being rude. I told my charge RN about the incident and she said not to worry and she got orders from another Doc on the case for more reasonable pain management orders and we left the O2 on as it was (O2 sats were acceptable).
The next day another nurse had that patient and I heard the original Doc bellow about "Why weren't my orders written down and carried out??". I came around the end of the chart files and faced him and told him that they were so far offbase that I was sure he had to have been joking and that we sought other recourse. He blew up at me, of course... in front of every RN at the station and within earshot of patients and visitors as well. I simply told him that taking away O2 from my expiring patient and giving them a dose of morphine that would take them out almost immediately was not in my patient's nor their family's best interest and that would have nothing to do with patient assisted death. He stormed out of the station and I stood there trembling and light-headed... and then everyone who had heard the exchange came and hugged me and told me they wished they ahd my "guts". I was about to fall over from the stress of it all... I told my charge RN what had happened... I wrote the offending Doc up and he was called on the carpet in the end. My charge RN came and told me she was proud of me for being a very good advocate for the patient and the family as well. The patient passed later the next day... peacefully and quietly... and the family was grateful for the care she received and for helping them through a tough time in a graceful manner.
That Doc wouldn't talk to me for a very long time... and when he finally did he kept things strictly limited to business at hand and never crossed me up again.
I came out stronger in spirit for having gone through that battle... stronger as an advocate for my patients (for those who are not able to speak for themselves or for their families who do not know how to articulate their needs in a sometimes scary medical environment and situation)... and stronger in my convictions that EVERYONE needsto be able to accept correction at one point or another (myself included).
I hope that new grads are always able to look to us "seasoned" RN's for guidance and ancouragement... and just pick our brains and hearts for the tools that help make their careers more fulfilling... maybe save them a few heartaches along the way.
As a "Lifer" you must continue to learn and remake yourslef. As a hospital nurse for 20 yrs things have changed and I can no longer work in hospitals I have had 3 back surgeries, chronic pain and cannot stand for any extended period of time. I finally left the hospital "kicking & screaming"" and went to phone coaching. I spent 8 months and found that telephone coaching was not my thing. I did learn a huge amount about communication, motivating people to good health care goals, etc. It was a very valueable experience. In an interview I can speak about staging people's willingness to change, goal setting ,etc. It has made me more marketable. If you must leave the hopital you must review your assess because there is a huge wealth of info due to simply being a nurse for 20 yrs.
over 4 years ago
Great article. I would consider myself a long time nurse. I have been in management and currently am staffing. However, I am very entrepreneural, and my plan is to be self supporting as a nurse entrepreneur...
Experience in the area of Work is always essential to gain confidence in rendering services and meeting the needs of individuals
One has to take care of themselves also., then only they are able to take care of others effectively., Basic Personal care like rest, relaxation, nutrition, air etc., are very much needed to have sound mind in a sound body
Education & Experience always makes the Professional to be confident in their Professional life
Advocation is always beneficial
Admitting our own mistakes is always beneficial either in personal & Professional life., Though at that moment it may be embarassing, but it will give calm mind, the person will not have any inhibitions or hesitations to interact further., moreover for their genuine nature they will be appreciated
Effective Therapeutic Communication skills always needed in all Professional activities. Concise, brief, accurate communication is very much needed., It helps the Nurses in our Interactions
"Experience makes men Perfect" yes i.e., true., It gives very confidence in all walks of life
Excellent article. There is always things to learn from "lifers" to a "newbee" I have been in nursing for over 32 years. I have seen so much change since being a grad. to now a "Lifer". I can no longer do bedside nursing so I now am a Nursing Supervisor. I advise any nurse to always feel challenged and continue learning. If not it is time to move on to another challenge. There is are always areas of nursing to seek our new challenges and learning.
I really enjoyed reading this article. I have been nursing for 15 years. Only 15, wow. Anyway, nursing is really getting me down, I am thinking of moving on, which is sad because I never wanted to be anything else but a nurse. My mom is a nurse and my hero, but I may not make it to retirement as a nurse. I find the changes in nursing to be innovative in some areas, and down trodding in others. Sad!
The article brought out some great points. I have been a nurse for 32 years in a hospital, wow the changes. I miss actually taking care of the patients. With management changing policies daily , so much more computer documentation and demands of families of the patient it is hard to actually take care of the patient. Working 12 hours shift is the worst thing our hospital has gone, I have begged for an 8 hour shift, they will not give. The shifts are exhausting because it is not just 12 hours, many times ther is a need to stay over to chart. Nursing is very rewarding in many ways but the menta and physical stress is more than I can handle. I never can take a break at work and many times not a lunch . I think our profession needs an over haul. Many say why don't you change jobs , I checked other , but with so much to loose such retirement large cut it pay it would be difficult. I wish the new nurses the best and hope for changes.
This article is one huge "DUH". You get these qualities from experience; it doesn't take advice from a "lifer" to point this out.
Thanks for the wisdom! I love reading about this stuff. Maybe I'll be a step ahead when I hit the floors for the first time in January. :)
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