I have a question that I am sure many can help with. Many hands make light work. It is clear that the public and legislators both need to understand what it is that professional nurses do. What they understand it that we pass meds, we do procedures, we deal with physicians and so on. What they do not understand is the why of what we do. Much like we had to learn in nursing school, the why is the most important part of what you are doing. I am asking that each of you that respond to this post take just one thing that you do in a daily routine and describe it as if you were teaching someone, and that someone has absolutely no idea as to what it is that nurses actually do. Most of Joe Public would fit that description. The subject to choose from is many. Let me start though with the easiest,
I pass meds. It is up to me to look over the med list of every one of my patients, understand what they do and why my patient is taking it. Depending on the type of medication I may need to check blood pressure and heart rate before giving my patient those meds. And if the blood pressure or heart rate is outside of the range of where they should be for those medications then I must decide if I should hold those meds or not. I must look for drug interactions. I need to access if a patient is on the appropriate dose and type of pain medication based on my assessment of the patient. If my patient is on antibiotics with little result, then I need to see if a culture and sensitivity has been done on the offending bacteria, to assess whether the appropriate antibiotic is being used. If my patient has been on long term antibiotic use I need to look in their mouths and see if any thrush has developed. With very long term use of antibiotics a yeast infection of the blood may occur. I need to be aware of that and on the lookout for symptoms. I need to look for drug interactions and appropriate dosages. I need to be aware of my patients allergies to any medications. I need to know if my patient is able to swallow their meds, if they need to be crushed and put down a tube in either their nose or their stomach, do they need their meds in applesauce or something like that. Any medications that my patient is on that I am not familiar with I must look it up so I am fully aware what it is that I am giving to my patient and why. If I see anything that gives me pause I need to go back into the chart and check the original order, and depending on what I find I may need to discuss my patients meds with the pharmacist and the physician. I know many drugs by heart, with normal dosages and uses, however new drugs come out all the time and I must never take for granted the knowledge that I have. I must also know that what is "normal" dosages may not be appropriate for the patient whose liver or kidneys are compromised. I must know the side effects of the drugs my patient is on so I know to look for those side effects just in case. When I go into a patients room I need to explain to the patient what it is they are taking and why. If the patient is unable to understand what I am teaching, then it is up to me to make sure that responsible family understand what their loved one is taking and why. I must also chart any education that I give to patient or family. All medications must be signed off as given right after the patient takes their meds. Failure on my part to do so may result in a patient getting an additional dose if for any reason I need to leave the floor and another nurse watches over my group of patients. I must do this for each and every one of my patients. Legally I have a half an hour before and a half an hour after the times set for medications to make sure all of my patients receive their meds. The first med pass of the day is usually the heaviest, if I find any problems and need to clarify anything with the physician it takes precious time to do so given my legal window of time to work with. Some physicians I page will call back in a timely fashion, some will need to be paged several times before I get a response, some will get nasty with me for questioning an order, some will hang up if I do not get to the phone quickly enough, and some but by no means the majority will call back in a timely fashion, will wait for me to get to the phone and be pleasant and educational when I speak to them. While I am doing all my med pass I am likely going to be interrupted by aides who are requesting my assistance to toilet someone or turn someone. I may be interrupted by a physician doing early rounds with questions as to how their patient is doing, I may be interrupted by a family member calling to see how their loved one is, I may need to attend to a patient who needs a nurse NOW. I need to know who needs a blood sugar taken before breakfast so I get an appropriate reading and make sure I am there to take the blood sugar before they eat. I must give insulin based on the reading that the glucose monitor gives me. I may have a patient that is combative, and who will swing at me when I attempt to give medications. I may have a patient that refuses medications only to have a family member demand why mother is not getting her meds, accusing the nursing staff of being neglectful. The family member does not understand patient rights, nor do they believe that mom is refusing her medications. A family member may become angry and verbally abusive with me because of medications that the physician has ordered because" I told him I didn't want my dad taking a sleeping pill" not understanding the effects of sleep deprivation. For each of these problems I must have a ready intervention. Behavior management for the combative patient, as well as the ability to duck and dive quickly and in the right direction. For the family members I must do education so they understand what is going on with their loved ones and why. I need to do this in such a way that they understand, and without giving any offense to an already angry person. I am never to get angry back with a nasty family member or a patient, even if they are alert and understand what it is that they are doing. When communicating with any patient or family members I also have to remember that they do not understand medical terminology, and yet ensure they understand what I am explaining to them. Sometimes that is difficult. I need to do everything that I do during a med pass in about an hour to keep to my legal time frame. Please understand if I seem a little rushed and do not have any time to chat with you. I will try to fit that in later, if I can.
So who else is game here? We do alot of complaining that the public does not understand what we do. Take the time please, to pick just one thing out of your day and do what I have done. We need to learn how to educate the public. Only when we do so, maybe using what others post, will the public have even a glimmer of what it is that we do, why we are so important to the healthcare system, and why it is not appropriate for unlicensed personnel to be doing our jobs.
I thank anyone in advance who will do this.