monnie

Yes. If "coup de gras" is being used contextually as "the blow that terminates", then that is correct. Expediency of action is paramount in the medical field, even if said expediency involves a forced quickness of sound judgement. Unfortunately, rapidity at multi-tasking often comes only after repeat exposure, or more often, years of experience in the medical field. The human condition is vast, and not easily evaluated from strict empiricism. Experience has taught me the hard way, but it has taught me. And for that, I am grateful.

I am an LPN working in the state of Indiana. To my knowledge, scope of practice entails a hierarchy where we are accountable to our RN supervisors (which God knows are not always available). That being said, if an LPN is practicing nursing, and a situation arises where the patient's safety or health is in question, the order of operations is to first seek out the RN for advice, and second, call the MD in charge. BUT, of course, there's a million caveats to this process. Was the patient becoming critical, did an appropriate nursing measure effectively address the issue, was the patient alert and oriented enough to provide satisfactory and MEMORABLE feedback, and finally, was the RN, who is our supervisor, consulted regarding the change in condition? Nursing is a very, very difficult field, regardless of whether LPN/RN/CNA/NP or any other position which entails caring about another individual's health. We do not always do everything "Right"--especially considering that the field seems to be becoming more about CYA than caring for the individual at all levels-physical,emotional,social,mental,spiritual. I work semi-autonomously in the field of home health care, which is absolutely a double-edged sword. I have the luxury of providing 1:1 care, and who could ask for a better ratio then that? However, it is not a "clinical setting", to say the least. I must use my soundness of reasoning, fine-tuned problem solving skills, and the whole compendium of tools which God has given me to use in this field. My main hope and aspiration, other than to be a good mother, wife, daughter, is to "first, do no harm." Hope all turned out well.