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| No. 160 | 
Apr 27, 2008, 08:11 PM
 Re: Nurse sees worst, best of profession during daughter's ER visit
Wow. For me, this discussion boils down to how we choose to define competence in nursing. Ms. Madsen believes that comfort and caring define nursing, and that it's unique to nursing something that I vehemently disagree with. (Other professions care too). Unfortunately the general public shares her opinon and see nurses as unskilled caregivers whose main job is to hold hands and fluff pillows in between passing pills and waiting for the doctors to tell us what to do. The biggest disappointment here is that Ms. Madsen should know better. She is free to criticize the nursing care that was provided to her daughter and she is free to criticize it publicly as far as I'm concerned. If a nurse makes an error or is rude or fails to rescue a patient, she has every right to scream to the high heavens about it, but that is not what happened here. She was specific that they did their job quickly and efficiently only that they were "soulless", whatever that means.
As a profession we continue to struggle to define and redefine our profession and our professional image and to educate the public; columns like Ms. Madsen only serve to undercut that struggle. Yes kindness and comfort are important but their absence does not mean that the nurse is "incompetent".
This has become a debate in nursing although a quiet one. Do we want to continue to known as "beary nice" and the "heart of healthcare" "touching lives" or do we want to be "clinical leaders" who "save lives"? I know what I want. And the more we hear about medical errors, I bet I know what the public is going to want.
Like someone else wrote, I show I care by doing my job carefully, quickly and accurately. To me that is far more important than a pat on the shoulder. Too bad that's still not enough for her.
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Apr 27, 2008, 09:53 PM
Re: Nurse sees worst, best of profession during daughter's ER visit
Unfortunately, Ms Madsen does not come from a position of knowledge re: the battle zone in hospitals in this decade, or for that matter, any decade.
Her professional history can be viewed at Cox College website.
Sadly, this is another distanced nurse educator teaching our young nurses. I can only surmise from the article that these student nurses will be missing out on valuable lessons that come from experience from the true nurse educators that have been in the trenches.
| | No. 162 |
Apr 28, 2008, 07:51 AM
Re: Nurse sees worst, best of profession during daughter's ER visit
I sent Ms. Madsen an email which was basically my first 2 posts in this thread. Here is her reply. Dear [Workingforskies] Here’s some food for thought-you try and be in the same situation and let’s see how well you do. You go to the ER with a crying child, get ignored, observe things that you think are wrong around you and have no one, No one talk or try and communicate with you. You watch your daughter suffer. You watch nurses have time to do the things I talked about but don’t have time to reassess your daughter, even though her condition is deteriorating right before your eyes. You have a surgeon say that her appendix likely ruptured in the ER and see how well you handle it. You write something that was edited down from your original, placed in a national forum without your permission and let your thoughts, feelings and perceptions be batted around by strangers who know nothing about you, your daughter or the ER in which you were. Let’s see how your experience and heart hold up to people who give you absolutely no credit, assign the worst of all possible motives to you and instead of trying to support you, attack you in the most horrible ways. You think I threw nurses and nursing under the bus-try reading your “reply” back through my eyes and we’ll see who really got attacked here. You don’t like what I wrote-tough. Try and improve your own practice and leave mine alone.
My guess is that she does not now, nor ever will get it. | | No. 163 |
Apr 28, 2008, 01:15 PM
Re: Nurse sees worst, best of profession during daughter's ER visit Originally Posted by SharonH, RN  Wow. For me, this discussion boils down to how we choose to define competence in nursing. Ms. Madsen believes that comfort and caring define nursing, and that it's unique to nursing something that I vehemently disagree with. (Other professions care too). Unfortunately the general public shares her opinon and see nurses as unskilled caregivers whose main job is to hold hands and fluff pillows in between passing pills and waiting for the doctors to tell us what to do. The biggest disappointment here is that Ms. Madsen should know better. She is free to criticize the nursing care that was provided to her daughter and she is free to criticize it publicly as far as I'm concerned. If a nurse makes an error or is rude or fails to rescue a patient, she has every right to scream to the high heavens about it, but that is not what happened here. She was specific that they did their job quickly and efficiently only that they were "soulless", whatever that means.
As a profession we continue to struggle to define and redefine our profession and our professional image and to educate the public; columns like Ms. Madsen only serve to undercut that struggle. Yes kindness and comfort are important but their absence does not mean that the nurse is "incompetent".
This has become a debate in nursing although a quiet one. Do we want to continue to known as "beary nice" and the "heart of healthcare" "touching lives" or do we want to be "clinical leaders" who "save lives"? I know what I want. And the more we hear about medical errors, I bet I know what the public is going to want.
Like someone else wrote, I show I care by doing my job carefully, quickly and accurately. To me that is far more important than a pat on the shoulder. Too bad that's still not enough for her.
AWESOME post, Sharon.  | | No. 164 |
Apr 28, 2008, 05:19 PM
Re: Nurse sees worst, best of profession during daughter's ER visit I have a new passion for making sure none of "my" nurses ever act like the ones I observed in the ER. I have a new passion for teaching effective communication. And I have a new depth of love for my daughter and my family.
This was the ending in the article mentioned above. I was a wife and mother several years before I was a nurse -- although I always dreamed of someday becoming a nurse. When my children were of school age I started college and finally became a nurse. After four years of med-surg and floating to other other areas of my hospital ---I finally specialized in my true passion---Emergency Nursing---and began my career at a Level I Trauma Center at a Major Metropolitan Teaching Hospital. Needless to say, I've been on both ends of the stretcher many times as a nurse, patient, mother, spouse, and other family member. I agree with Professor Madson (the author) that good communication skills is extremely important to teach her nursing students. However, there are many other things about her experience that she should also teach her students. Our mistakes sometime teach us more than our successes.
1) Never Never rely on the inside of your wrist to determine temperature. Always use a thermometer. Low grade temps (early sign of appendicitis and other impending serious illnesses) cannot be assessed by "feel".
2) Always listen and take seriously what your child or patient tells you and don't just disregard it as whining.
3) Pain medication is contraindicated in undiagnosed abdominal pain.
4) Notify your Primary Care Physician Before the situation becomes Urgent because he/she will then be made aware and should conditions worsen -- he/she can have the patient brought to the hospital as a "Direct Admission" --thereby bypassing the extended wait in the ER. Many people today are without medical insurance and Family Physicians. This has caused ER's to become flooded with people in need of medical care and therefore has greatly increased the time pts. wait to be seen by physician.
5) "Nurses didn't care" If the Nsg. Skills were good--Eg: Pts. are being triaged within reasonable time of arrival, pts. in waiting room are being reevaluated periodically to assess for a change in triage category, and labs have been drawn & sent as per ER Policy ---then the nurses have cared greatly. They've maintained up-to-date assessment skills and have monitored each pt to note any changes --- which shows the emphasis is on saving & preserving life --- rather than pillow fluffing. The ER is not a controlled environment as she experienced when her daughter was post-op. Now that her daughter was safe, the Professor felt comfortable in her element of shouting orders to staff and performing her bedside Nsg. skills. The Fight or Flight atmosphere of the ER was no longer present.
I agree with many of you other nurses, who commented that she was probably trying to compensate for her own guilt of not recognizing the s/s of Appendicitis. I'm not trying to beat-up on her or put her down in any way. Hey, it happens --- we've all experienced guilt & anxiety when we failed to see s/s that should have been obvious to us ----especially when it involved a family member. Granted -- I agree-- the compassion and caring of the nurses might not have been visible to her that night. In an ideal world it would have--But maybe it was a Nightmare Night for the nurses in the ER that night. My point is, her nursing students could benefit from hearing about the mistakes she herself made that night (even though she's probably embarrassed). It's such a great Educational story for her to share with her students ---- that despite having an advanced degree in Nsg., she too is vulnerable -- and sometimes we make mistakes -- Serious Mistakes!  | | No. 166 |
Apr 29, 2008, 12:59 PM
Re: Nurse sees worst, best of profession during daughter's ER visit Originally Posted by SharonH, RN Wow. For me, this discussion boils down to how we choose to define competence in nursing. Ms. Madsen believes that comfort and caring define nursing, and that it's unique to nursing something that I vehemently disagree with. (Other professions care too). Unfortunately the general public shares her opinon and see nurses as unskilled caregivers whose main job is to hold hands and fluff pillows in between passing pills and waiting for the doctors to tell us what to do. The biggest disappointment here is that Ms. Madsen should know better. She is free to criticize the nursing care that was provided to her daughter and she is free to criticize it publicly as far as I'm concerned. If a nurse makes an error or is rude or fails to rescue a patient, she has every right to scream to the high heavens about it, but that is not what happened here. She was specific that they did their job quickly and efficiently only that they were "soulless", whatever that means.
As a profession we continue to struggle to define and redefine our profession and our professional image and to educate the public; columns like Ms. Madsen only serve to undercut that struggle. Yes kindness and comfort are important but their absence does not mean that the nurse is "incompetent".
This has become a debate in nursing although a quiet one. Do we want to continue to known as "beary nice" and the "heart of healthcare" "touching lives" or do we want to be "clinical leaders" who "save lives"? I know what I want. And the more we hear about medical errors, I bet I know what the public is going to want.
Like someone else wrote, I show I care by doing my job carefully, quickly and accurately. To me that is far more important than a pat on the shoulder. Too bad that's still not enough for her.
Ah Sharon  - I'm starting my RN-BSN program next week and have been doing reading for the 1st homework assignment for "Professional Nursing" and the first thing mentioned is that even though nursing has been considered a profession for many years, it is not a profession yet but an "emerging profession" and fails to meet all required criteria."
The #1 issue is the failure to have a standardized education for entry.
I have a feeling this will be a controversial class . . . . . 
As to the author - I do have some qualms about how negative this thread has become.
There is another thread about an RN's view of her recent hospital stay http://allnurses.com/forums/f8/suppo...ng-299503.html
. . . of course it isn't in a national magazine but it is critical of some of her nurses.
steph
| | No. 167 |
Apr 29, 2008, 02:49 PM
Re: Nurse sees worst, best of profession during daughter's ER visit Originally Posted by MAISY, RN-ER We know the system isn't great, but it's what we have to work with. As long as administration focus on keeping staff low, politicians keep cutting programs and hospital reimbursements, and hospitals keep closing. There will be no room at the inn.
I checked on the writer, and as I suspected ....she worked in L&D, Nursery, and finally as a lactation specialist prior to working as an assistant professor. None of these areas are crisis, all of them are usually happy areas, and areas where a nurse can spend time with their patients. It's expected, and supported by administration.
It's funny, I am currently taking a class with a professor working on her PhD-she worked pediatrics. She hasn't got a clue, and sometimes I am not sure she believes us when we relate stories. I count the hours while I sit in her "fantasy" nursing class, and thank GOD, it is almost over! I wonder if this is how Karen's students feel. She also writes a column....so shame on her. I agree with another poster....shadow an ER, PACU, Recovery, ICU or any other critical care nurse for several days-do what they do-get your hands dirty-see what it is all about before it ends up in a national magazine.
Maisy
Unfortunately, I do agree that the writer of the article could've used her experience to spot-light why it is that the general lay-person views nurses/nursing the way they do today (lack of time, poor staffing ratios, administrative issues, etc..)
I don't however, agree with all of the statements made by this pp. I have spent numerous hours doing a preceptorship in the ER and have a tremendous amount of respect for the nurses I worked with and the issues they face daily. I have previous experience working in a pediatric unit (we got med-surg dumping oops, over-flow) and now work in a women's hospital in L&D, Nursery and some NICU. We, unfortunately, are subject to the same undercuts by administration as the rest of our hospital system. We never have enough staff, are constantly getting called in for just a couple of hours and then sent home, etc, etc... We DO get critical situations just like any other area of the hospital. We DON'T get general trauma off of the street. I do think that a fetus with a heart rate in the 60's that warrants an emergent c-section, or a placental abruption is a crisis situation, as is a 28wk neonate just delivered that needs immediate intubation.
I was disappointed by the statements about the nursing staff in "Pediatrics, L&D, nursery, etc." This was kind of an undercut to me as a nurse who works/has worked in those areas. I hate that we as nurses can be more (or less) entitled to respect as nurses r/t the areas in which we choose to practice. JMHO  | | No. 169 |
Apr 29, 2008, 04:25 PM
Re: Nurse sees worst, best of profession during daughter's ER visit Originally Posted by sample24
I was disappointed by the statements about the nursing staff in "Pediatrics, L&D, nursery, etc." This was kind of an undercut to me as a nurse who works/has worked in those areas. I hate that we as nurses can be more (or less) entitled to respect as nurses r/t the areas in which we choose to practice. JMHO
i honestly don't think it was meant to undercut or diss these specialties.
rather, more of a reality check.
let's face it...
it's the specialties that usually dictate the atmosphere, pace and stress levels of a unit.
if a nurse is only accustomed to one type of pt population, then anything outside that norm can and will, throw some for a loop.
it has nothing to do with respect, or lack of.
but wouldn't it be obvious that medical priorities are just that?
and once those are fulfilled, then maybe we'll have time to get you that cup of ice water or meaningful hand squeeze.
leslie
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