Sometimes I wipe bottoms, often I
give meds, but that isn't the extent of what I do.
Don't call me just a nurse
In the first year of my career as
a registered nurse, I continued my education, wrapping up my bachelor's degree
in nursing, not yet a requirement to work as an RN but a well-worth-it
continuation of a degree to make you a more well-rounded and, to be honest,
respected nurse.
One of the requirements for this
degree was a course called "Professional Issues and Trends." The
course explored the profession of nursing, barriers it is facing, and the way
that we, as nurses, can change that.
I learned many things in that
course, but the most important, the thing that has stuck with me the most, was
this:
A few days into the course, our
professor made one thing very clear: Each and every one of us, from that moment
on, needed to remove "just a nurse" from our vocabulary.
"Are you a doctor?"
"No, I'm just a nurse."
I have spent six years since
trying to avoid that phrase. More so, I have worked to avoid that feeling. I
work hard at what I do, but I am often aware that my friends and family have no
concept of what nursing is.
I don't bring you to your room at the doctor's
office, sit you on the table, and check your normal blood pressure, then go and
get the doctor. Instead, I am often in a room with a small child on a
ventilator, multiple intravenous medications infusing through central lines
keeping the vascular system constricted or dilated.
I monitor blood gases and
adjust ventilator settings accordingly. If the blood pressure goes too high, I
adjust the medications related to these values.
I keep my patient adequately
sedated and paralyzed, for their safety, without over-medicating them. It is
often my responsibility to determine this balance.
Recently, I had a nearly
2-year-old patient who pulled his own breathing tube out in the early morning.
We weren't sure whether he would do okay without it, so I monitored his
respiratory status closely all morning. By mid-afternoon, he seemed to be doing
well enough. By then his sedation had worn off and he had no interest in
staying in bed. Concerned that he would harm himself moving around through
multiple IV and arterial lines, plus a BiPap machine, and monitor leads, I
decided to hold him.
He had no family present but needed close to a dozen
IV medications over the next five hours. I collected them all and lined them on
his bed. I pulled his syringe pump that would be used for the medications off
of the IV pole and placed it on the bed in front of me. I lifted him out of bed
and onto my lap, into my arms. For five hours we rocked and I held him close.
He stared into my eyes, played with my hair with his one arm, tried to suck his
thumb through IV sites and arm boards. I gave his medications one by one until
the nurse who would relieve me for the oncoming shift came in.
I'm not just a nurse. I am a
nurse.
I can over the course of the
12-hours shift go from interpreting serial blood gases to comforting a sick
child while continuing to monitor vital signs, respiratory status, and
administer medications.
I am the eyes, hands, and feet of
the physician.
I am not their eye candy or
their inferior.
I don't stand up when they enter the room.
I don't follow their orders, I
discuss the pathophysiology of the patient's condition with them, and together
we make a plan.
Often the things I suggest are the
course of action we take and other times I learn something new I had not
understood from this doctor.
They don't talk down to me; we
discuss things together.
I had an experience this weekend,
one of the first of its kind for me, and I was surprised by how angry and
affected by it I was.
A friend cut their arm and hours
later still struggled to stop the bleeding. I assessed the wound and created a
pressure dressing out of the supplies you have available in a frat house
cottage.
I reluctantly informed the friend
that the wound would likely need a stitch or glue. It wasn't large, but it was
deep and wide and would likely heal poorly, if at all, and even if it didn't
become infected would leave a decent scar. I am not one to jump to big medical
interventions; if anything, I ride the line of noncompliant and under-concerned.
My opinion was shared but another
guest, a doctor, decided it would probably be fine with a Band-Aid and heal
without issues. He may be right, or I may be right.
But a close family friend who I
have known almost my entire life chimed in.
"No offense, Kateri," he
said, "But obviously we're going with the doctor over the nurse for this
one."
"You're just a nurse," he might as well have said, although he didn't.
I felt like I had been smacked in
the back by a two-by-four. My best friend knew this would be my reaction and
turned in horror as the color left my face and the posture left my
shoulders. Something inside of me sunk.
The following day I struggled to
understand why I was still upset. Surely he had no idea what his words had
meant, or how they felt. But over lunch the following day, as I discussed my
new job with my family, it became clear.
My job is so much, and so much of
it is misunderstood. And maybe this is no one's fault but my own. Sure, I'm a
nurse. Yup, some days are sad. Yeah, blood and poop don't bother me.
But that's all I say. I don't tell
you what I really do. And the media definitely doesn't either. Nurse friends,
help me out here.
Maybe it's time that we stop
pretending we are less than we are, that we do less than we do.
I came across the following blurb
this morning. I wrote it a few years ago for Nurse's Day, and it rings as true
today as it did then.
I may not be a doctor, but I am a
nurse. And if you are someone whose mind says "just a nurse" please,
go ahead and ask the nurse you know best what it is that they do. I think you
may be surprised.
I am a nurse.
I didn't become a nurse because I
couldn't cut it in med school or failed organic chemistry, but rather because I
chose this.
I work to maintain my patient's
dignity through intimate moments, difficult long term decisions, and
heartbreaking situations.
I share in the joy of newly-born
babies and miraculously-cured diseases.
I share in the heartbreak of a
child taken too soon, a disease too powerful, a life changed forever.
My patient is often an entire
family. I assess and advocate.
Sometimes I wipe bottoms, often I
give meds, but that isn't the extent of what I do.
There are people above me, and
people below. I work closely with both; without them, I could not do what I do
well.
I chose this profession and love
almost every minute of it. I know I am not alone, and I appreciate all of the
nurses who work alongside me. Many of them have shaped me into the nurse I am.
Someday I will shape others into the nurse they will be.
This wasn't my plan B.
It was my plan A, and I
would gladly choose it again.
NB I totaly agree and I'm so
glad someone wrote this down for me.
Gavi Mensch
Nederland BV, 14-9-2013
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