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jegworld 759 Views

Joined: Sep 20, '05; Posts: 1 (100% Liked) ; Likes: 1

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    noyesno likes this.

    I have been an RN for over 40 years, and I can honestly say, each day I learn something new about myself and how best to care for patients and their families. My experiences have ranged from med-surg, ICU, ER, L&D, NICU, managed care for both insurance companies as well as UR in hospitals. The advent of managed care certainly changed the focus of my practice as an RN, although it has always been the patient first, paying claims is just another way of caring for the patient.

    I started during a time when sterilizing needles, directing teams and doing little patient care other than passing meds, starting IVs, and even getting up to give physicians my chair to today where the RN is running from one heavy duty assignment which could include hanging blood, telemetry, wound care, putting in foleys, and making sure the patient receives the right meds, doses etc. Forget when we used to be able to give back rubs for comfort, keep rooms clean, bathe patients daily with hair care and soft touch. Now, the RN is running, literally running from one high tech ordered procedure to another. Primary Care nursing, no longer allows for baths, hair care, personal touches such as keeping rooms uncluttered.

    Prioritizing is a difficult thing to the RN today. I have worked as a discharge planner/case manager in hospitals all over the country. Working as a travel RN in the capacity of Case Manager/Discharge Planner has allowed me to see that the RN is no longer in a position to take her time, listen to the patient or families, but must keep on moving.

    I am saddened by this situation, as I became a nurse to nuture, care for and advocate for patients. Who would consider a surgical patient who goes home in 3 days and NEVER showered or was bathed. This was the time I got to know the patient, their fears, their thoughts and wishes.

    Also because nursing has become one of the number one "jobs" with the teaching situation being saturated, I also find a good deal of nurses who just "do it for the money", which of course is a different world.

    I love being an RN, and love being involved in end of life discussions, discharge planning for the reality of the patient and their family, and being able to hold hands, assess their needs, and follow up with proper discharge plans and goals.

    I would not give up my experiences of assisting in a CHF patient who has reached the limit with active treatment transition to their plan for end of life. Or assist a Hindu family in having a ceremony in a hospital so that all could attend, but in a neutral environment. This has required a good deal of learning on my part, as culture changes have caused me to "research" mores and practices, and to integrate them in my thought and practice.

    Yes I am still learning, daily, I look into a patients eyes, they share their heart, their family shares the differences in their goals as opposed to the patient goals, and try to find a creative way to make all comfortable and often peaceful with the choices. This does not happen without actual touching, hand holding, and human interaction on a personal level. My life is better each day for these collaborations.

    As my mortality becomes more as more clear to me, I lose family members, and I am in the position where I am dependent on someone else to assist me with recognizing I am a nurse, but first a daughter, mother, aunt or cousin.

    Learning is what being a nurse is all about, and until my last breath, I hope to continue to do so.