Guilt

CHATSDALE · May 17, 2007

this is thin dangerous ice

telling the patient is always dangerous because you can alienate your staff workers and maybe they have had a reason for the care that was given

if this was a md eror go to your superior and show documentation about what happen..if this was another talk with them or if you feel this is not appropriate again refer to superior

talking with the patient/family is probably the worse action you can take, they will not be able to put this in perspective, if they are to be notified it would be best that it come from a person whose gets the bucks for this

CIRQL8 · May 17, 2007

If a patinet (or family member) complains of poor care, or an error, the best thing that you can do is tell them that you will IMMEDIATELY get the mamager of the unit there for them to speak with. DO NOT attempt to judge the care. You WILL place yourself in a very sticky situation. If it is after hours, call the house coordinator.

Use you best judgement. It may or may not be appropriate to say something like "I am sorry that you feel this way. We want you to feel that you have received the best care possible. I will get my manager for you to speak with." If that's too much for the situation, just say something like "I can't do anything for you myself about this, but I will get my manager for you to speak with just as soon as s/he is available." Then do it.

dekatn · May 17, 2007

Could you elaborate please, on what exactly you mean by "served well by the medical establishment"? Are you talking about lack of care by staff?

firstyearstudent · May 17, 2007

I guess I am thinking about any and all of it. From a patient who comes in fore minor surgery and ends up septic to knowing you partipated in harmful care (like after lobotomies were debunked) to med errors. Medical professionals aren't perfect. They're only doing the best they can.

One day I suspect someone I am caring for will be harmed more than they are helped, either from my direct act or indirectly. I'm wondering how I'll deal with that. Will I lie awake at night tossing and turning or will I shrug my shoulders and say, "Well, at least I tried to help."

Maybe I'll do both...

ZootRN · May 17, 2007

Being patient advocate, you can choose how to act. But feeling guilty? I refuse to take personal responsibility for everything that for whatever reason could go wrong. It's bad enough I have to be apologetic for dietary not serving dinner on time, or doctor being late with rounds, or just because bedside nurse is an easy target to put a blame on.

firstyearstudent · May 17, 2007

Being patient advocate, you can choose how to act. But feeling guilty? I refuse to take personal responsibility for everything that for whatever reason could go wrong. It's bad enough I have to be apologetic for dietary not serving dinner on time, or doctor being late with rounds, or just because bedside nurse is an easy target to put a blame on.

Good point!

Altra, BSN, RN · May 17, 2007

Being patient advocate, you can choose how to act. But feeling guilty? I refuse to take personal responsibility for everything that for whatever reason could go wrong.

Excellent point.

OP, is it possible (to use one of your examples) that someone could have minor surgery in which infection control was the best it could possibly be but develop sepsis anyway?

Beware of believing that you (or the "medical establishment" in general) are all powerful and can control all outcomes if you're just "good enough." That's dangerous arrogance.

RNperdiem, RN · May 17, 2007

No matter how good care we give, never forget that the human mortality is still 100%. Death has not become optional. When we think death is optional, then it becomes someone's "fault".

chadash · May 18, 2007

Why yes, yes I do.