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.
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