Monday, January 26, 2009

When being a nurse counts.

I take pride in my work. Although being a nurse wasn’t originally my plan post-high school, I have found an area I like and I enjoy learning everything there is to know about emergency nursing.

The other day was a poignant experience for me- one that truly brought home how important advocacy and education is, and why nursing is a profession to be proud of.

I met a patient who had unfortunately fallen through the cracks of prenatal care. She didn’t have a family doctor, had gone to some prenatal ultrasounds through a walk-in clinic, but did not know how to access the results. Unfortunately, she was to be set up with a women’s health clinic, but in the hustle of a busy walk-in, nothing was set up and the patient was forgotten.

The patient was a young, first time mother, who didn’t know how to get access to prenatal care in the city. She came to emerg with abdominal pain. She was not bleeding, the baby was moving fine and the fetal heart rate was perfect. She was, however, terrified that she would lose the baby. With no family in the area and a laissez-faire boyfriend, she didn’t have much social support either.

I received her into my care at the beginning of my shift. The previous nurse pulled me aside and expressed her concern for this patient- not because the baby was in distress or because the mother was in trouble medically, but because of her concern over the lack of prenatal care and the lack of support this patient had received thus far.

The care and concern that this nurse had for my new patient blew my mind. Most of the Emergency nurses in my department aren’t known for wiping brows and hovering just in case the patient needed another glass of water or their pillow fluffed. They are known for being intelligent professionals, with a dedication for medical needs and providing specific nursing care. Our emerg nurses are at their best in a crisis- when a patient is coding, when the patient is obtunded and needing RSI*, or during STEMI’s*, CVA’s*, trauma, DKA*, etc. Although they do provide the pillow fluffing and water bearing for the patient when they can, most emerg nurses I know are fairly tough and aren’t the pillow fluffing type. ABC’s – that’s the motto.

This particular nurse is one of those tough nurses. She would tell you things as they were. However, now I can say she is also one of the best patient advocates I’ve ever seen.

Not only did she express her concern and have everything set up for the patient’s discharge, she also made sure I understood her concern, introduced me to her patient, and stayed later to follow up with things she had initiated. She wasn’t doing it because she thought that I wouldn’t do well for the patient (in fact she told patient that she would be in good hands) but because the nurse CARED. The emerg doctor who was seeing the patient also understood the gravity of the situation, but unfortunately did not have the time to manage the non-medical side of the patient.

Although this nurse didn’t have a lot of time either, she made it important to go back and reassure the patient, to provide her further instructions for prenatal care, to provide phone numbers for physicians accepting patients, and much more. The patient left the hospital less scared, and more hopeful for the care of the baby then when she came to emerg. She also had an ultrasound appointment, a women’s health appointment, and understood the importance of advocating for herself and knowing who to go to in the sometimes confusing healthcare environment. All because of this hard-edged, but amazing advocating nurse.

That is why I’m proud of this profession. This is why nurses are an important part of the health care system. This is whom I will strive to be.


*RSI- rapid sequence intubation
*STEMI- S-T Elevated Myocardial Infarction (heart attack… a bad one)
*CVA- Cerebral vascular accident (stroke)
*DKA (Diabetic ketoacidosis)

7 comments:

prnpenguin said...

That's the sort of thing that they can't teach you at uni...

Nice.

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