So many times I tell myself that I had done everything within the scope of my practice. Yet if I had stuck to the limits of my scope, the woman could have died. Since then I manage to overhear some disparaging remarks like, ‘if she wanted to manage the care herself why didn’t she just go to med school?’ The truth is I have no desire to go to med school. I often try to push the scope of my practice to its breaking point while feeling like a bottom dwelling cog in the medical machinery in order to do right by my patients. By no means do I plan on ordering imaging tests and labs outside my medical directives a regular part of my practice but in this instance I felt completely backed into a corner. I have seen many skilled and experienced nurses go beyond the scope of their practice for their patients because they feel that it is the only way to get things done. I’m far too hesitant to do that because I have no one to back me up if I’m wrong outside of my scope. And yet, it can be very frustrating and limiting to know that my influence on patient care is negligible no matter how hard I advocate on their behalf.
As nurses we’ve all been there, we’ve all argued vehemently with our physician colleagues, we all have pushed the envelope on our scope of practice (pace College of Nurses of Ontario), sometimes it seems our options are severely limited, and we are ethically conflicted. When this happens, it’s called moral distress, and it causes nurses to leave the profession. Read Maha’s whole piece: it’s worth it.