I was having a normal day at work yesterday...the usual getting all gowned up for a Cdiff patient and bringing 25 out the 26 supplies I needed into the room. Weaned off some pressers only to have to put them back on again. Seeing a dear patient that isn't making progress. It was sort of getting me down for a few hours.
Then my patients wife came in to visit. She shared her husbands story with me and it almost brought me to tears, as a nurse and a normal human :)
Her husband suffered multiple medical problems in the last year putting him in the hospital, where he then suffered from several heart attacks and strokes. Everyone wrote him off. He had a stage 4 pressure ulcer you could stick your fist in. He was sent to hospice to ease him from the pain of what he was going through.
Then...
He didn't get worse. He got better bit by bit. His wife was there, turning him, dressing his wound, applying Dakins solution (which is pretty much just bleach), toileting him for weeks. He was moved out of hospice into a rehab and was transferred to us for heart surgery. When I saw him yesterday, we got him out of bed and he popped right up like he didn't spend the last year almost on his death bed. His pressure ulcer? Healed. Completely. We transferred him out of the ICU yesterday. His wife showed me her catalog of iPhone pictures from the last 11 months showing his acute decline and steady and slow progress back to a strong, independent man. Back to his wife of over 30 years.
Those kind of stories make me come back for more, day after day, week after week. Even though we are understaffed every day and night, even though we trudge through hospital politics sometimes just to care for our patients. Even though sometimes you feel like you aren't making a difference for anyone, anywhere sometimes. It makes me proud to put those scrubs on and introduce myself as the nurse to my patients every morning.
Wednesday, December 10, 2014
Wednesday, December 3, 2014
Something about why I like being a NURSE
Why didn't you go to medical school? You are too smart to be a nurse. Did you need training to become a nurse? When are you done with school?
I know, we've all heard these things. Sometimes you get a patient that you really bond with and they appreciate your hard work and attention to detail and to them. You've finally found the one, you think. Their family brings in Donut Holes. It's true love. And then they ask why you didn't want to become a doctor. Your heart rips open. Another patient who doesn't understand the line between medicine and nursing. But why would they? My favorite part about rounds is when a large group of doctors comes to tell the patient that 'we' extubated you, 'we' titrated your drips, 'we' got you out of bed, 'we' fed you a heart healthy diet... I'm sorry but when I explain your heart surgery to you, I don't say 'we' carefully sawed your sternum open, 'we' stopped your heart, 'we' carefully cut through layers of tissue, 'we' bypassed your arteries, 'we' sewed your sternum back together.... I give credit where credit is due...mostly because I'm not a surgeon.
That is a rant I didn't meant to take us on.
What I meant to say is that, why can't we change the fact that people ask these questions? I'm getting my Master's degree in Nursing and I've been asked more than a few times why I'm not just going to go to medical school. Because I'm a nurse. The Growth and Development of Nurse Leaders by Angela Barron McBride is a book I was forced to read during my leadership class and I've now revisited to help me answer those questions. She literally says "Nurses have long known what they do, and, if anything, have been annoyed that others didn't understand what they did.' Is that not how we all feel? Did this woman read my mind? She goes on to say that if we want others to understand what we do, we have to name it. And we can't just name it nursing because if everything we do is just 'nursing'. Why? Because then Florence Nightingale just continues to be the woman who put cool cloths on fevered heads, not the woman who wrote over 200 books, created the first school to train nurses, and was inducted into the Royal Statistical Society for her work with nursing statistics, showing infection rates and treatment effectiveness.
What might be a surprise to some people is that what we do all day is not ask for permission to perform our nursing duties from a doctor.
We give a detailed head to toe report to each other twice a day (or more sometimes), introduce our patients to the new nurses, comb through electronic medical records for all the details. We decide on our daily tasks early. Dressing changes, neuro checks, clapping on someones back every hour to help them expectorate some sputum, increasing their levophed, standing them up or rolling them over every two hours so they don't get skin breakdown, hanging IV bags of antibiotics, electrolytes, nutrition, vasopressors, vasodilators, vasowhosiwhatsits, decreasing their levophed, suctioning out their stomach contents because they aren't digesting, measuring those stomach contents, deciding to either throw them away or put them back in....taking out central lines, putting IV lines back in, measuring urine in foley bags, taking foleys out, putting foleys back in, increasing their levophed, adding continuous sedation, holding them back when they try to take their endotracheal tubes out, increasing their sedation, increasing their levophed, change ventilator settings, drawing arterial blood gases, change vent settings, increase their levophed, decrease their sedation, draw more ABGs, change more vent settings, turn them and look at their butts, rub cream everywhere, decrease their sedation....aaanndddd chart it all hour by hour, minute by minute, task by task.
My favorite part about what we call nursing? Way deep down, I do really like to hold my patient's hand and coach them through a recovery and watching them as they overcome their pain. But don't tell any doctors that, I don't want anyone saying 'we' comforted you when the dilaudid just wasn't cutting it.
I know, we've all heard these things. Sometimes you get a patient that you really bond with and they appreciate your hard work and attention to detail and to them. You've finally found the one, you think. Their family brings in Donut Holes. It's true love. And then they ask why you didn't want to become a doctor. Your heart rips open. Another patient who doesn't understand the line between medicine and nursing. But why would they? My favorite part about rounds is when a large group of doctors comes to tell the patient that 'we' extubated you, 'we' titrated your drips, 'we' got you out of bed, 'we' fed you a heart healthy diet... I'm sorry but when I explain your heart surgery to you, I don't say 'we' carefully sawed your sternum open, 'we' stopped your heart, 'we' carefully cut through layers of tissue, 'we' bypassed your arteries, 'we' sewed your sternum back together.... I give credit where credit is due...mostly because I'm not a surgeon.
That is a rant I didn't meant to take us on.
What I meant to say is that, why can't we change the fact that people ask these questions? I'm getting my Master's degree in Nursing and I've been asked more than a few times why I'm not just going to go to medical school. Because I'm a nurse. The Growth and Development of Nurse Leaders by Angela Barron McBride is a book I was forced to read during my leadership class and I've now revisited to help me answer those questions. She literally says "Nurses have long known what they do, and, if anything, have been annoyed that others didn't understand what they did.' Is that not how we all feel? Did this woman read my mind? She goes on to say that if we want others to understand what we do, we have to name it. And we can't just name it nursing because if everything we do is just 'nursing'. Why? Because then Florence Nightingale just continues to be the woman who put cool cloths on fevered heads, not the woman who wrote over 200 books, created the first school to train nurses, and was inducted into the Royal Statistical Society for her work with nursing statistics, showing infection rates and treatment effectiveness.
What might be a surprise to some people is that what we do all day is not ask for permission to perform our nursing duties from a doctor.
We give a detailed head to toe report to each other twice a day (or more sometimes), introduce our patients to the new nurses, comb through electronic medical records for all the details. We decide on our daily tasks early. Dressing changes, neuro checks, clapping on someones back every hour to help them expectorate some sputum, increasing their levophed, standing them up or rolling them over every two hours so they don't get skin breakdown, hanging IV bags of antibiotics, electrolytes, nutrition, vasopressors, vasodilators, vasowhosiwhatsits, decreasing their levophed, suctioning out their stomach contents because they aren't digesting, measuring those stomach contents, deciding to either throw them away or put them back in....taking out central lines, putting IV lines back in, measuring urine in foley bags, taking foleys out, putting foleys back in, increasing their levophed, adding continuous sedation, holding them back when they try to take their endotracheal tubes out, increasing their sedation, increasing their levophed, change ventilator settings, drawing arterial blood gases, change vent settings, increase their levophed, decrease their sedation, draw more ABGs, change more vent settings, turn them and look at their butts, rub cream everywhere, decrease their sedation....aaanndddd chart it all hour by hour, minute by minute, task by task.
My favorite part about what we call nursing? Way deep down, I do really like to hold my patient's hand and coach them through a recovery and watching them as they overcome their pain. But don't tell any doctors that, I don't want anyone saying 'we' comforted you when the dilaudid just wasn't cutting it.
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