Archive for category Warm Fuzzies
Posted by torontoemerg in Good Nursing Practice is Practising with the Heart and Mind, Uncategorized, Warm Fuzzies on Friday 20 April 2012
Some real nurse love — and incidentally reminding us why we have the most tremendous profession in the world and how we each day make a powerful difference in the lives of our patients. Via the blog The Spohrs are Multiplying, Mike Spohr writes about the day his child died:
On the horrible day that Maddie passed there was a nurse who stayed by Heather’s side the whole time, and I am so thankful for her kindness to my wife. There was a nurse that mattered to me too that night, though she didn’t stay by my side, bring me a glass of water, or even say a word to me. In fact, I don’t think I saw her until the last few seconds I walked out of the PICU, but she made a difference nonetheless.
You see, that day my life shattered. I watched my daughter die in front of me, and it was an experience so horrific that even now it seems almost surreal, like, “Did that actually happen? To me and family?” But it did, and one of the things I remember most about it was how the key medical personnel there didn’t make me feel like they found Maddie to be beautiful and strong or amazing and a gift. The lead doctor, for example, was under a great deal of stress, but the way he pronounced her dead was not right. It was more like a referee calling the end to a heavyweight fight than the end to a beautiful child’s life. Then, as we held our dead child in our arms and kissed her goodbye, doctors stood behind the curtain discussing the specifics of what had happened with about as much feeling as mechanics discussing a broken down car.
It was only as I left the PICU that I felt humanity from the medical staff. There, sitting on a chair with a single tear rolling down her cheek, was my nurse. Her tear told me that she cared. About Heather, about me, and most importantly, about my beautiful Madeline.
That’s what nurses do that is so important. In addition to all of their medical expertise, they bring a human element to the cold, sterile world of a hospital. Doctors do great things, but have a heavy case load that means they can only visit each patient briefly each day, but the nurses will hold your hand – figuratively or literally – and remind you that you are not alone, and that your life is valued even if it can’t be saved.
A good and valuable antidote to the river of treacly pronouncements and saccharine encomiums we are about to receive from our employers, nursing leaders and other power centres in the nursophere in anticipation of Nurses’ Week. Worth about a million of ’em, I think.
Should nurses give up their chairs for physicians? A nursing professor named Susan Kieffer writing at NurseTogether.com thinks so:
If you have been a nurse for any length of time, you know how precious the seats at the nurses’ station really are. These seats are a rare commodity; one to be cherished and guarded once you snag one. It is also true that the coveted chair can be very revealing regarding the professionalism of the person occupying it.
Uh-huh. Kieffer goes on:
I will pose to you a question that I recently asked a class of students: registered nurses who are taking their first course in their journey to their bachelor’s degree and are studying the art of professional nursing. Many of them have been practicing nurses for 20 years or more. Here is my question to them: “As a professional courtesy, would you willingly and gladly give up your chair at the nurses’ station to a… to a… wait for it… a doctor?”
Kieffer goes on to argue that nurses are bigger than their ownership of their chairs by a mile. In other words, we’re better than those nasty physicians, even when they are nasty to us. I call Kieffer’s argument The Chair Strategy for Recalcitrant Physicians:
So, here is the point that I wanted to make with my students and will do so here as well: I believe that giving up that chair to the doctor shows the utmost in professionalism, courtesy, and confidence.
Can we not be confident enough in our abilities and our practices that we do not feel like we have to prove ourselves by remaining seated while the physician stands? If a nurse gives up his or her chair at the nursing station to a physician, maybe even the very doctor who was disrespectful a few minutes ago, I believe that it shows that the nurse’s professionalism is a notch above the norm. It’s like taking the high road in the midst of mistreatment. Such professionalism could go a very long way in increasing the respect given to us in the health care community. Who knows… maybe our example will eventually lead to a physician offering his or her chair to US!
I know many of you are now rolling around on the floor in a display of unrestrained mirth. But stop it. Right now. This is a serious question, posed by one of our nursing
betters leaders. And I will offer a serious and considered response.
My short answer is not only No, but Hell, No.
Two reasons: first, though I do have a streak of unreconstructed idealism a mile wide, I am not so naïve to believe that the Chair Strategy will ever cause physicians to respect us more. There is not enough Pollyanna in the world to make this possible. It isn’t as though physicians spend their sleepless nights agonizing over the burning question of Disrespectful Nurses. In any case, why (insert eye-rolling here) are we obsessing over what physicians think of nurses anyway?
And the Chair Strategy as the cure for bullying physicians? Please. Good physicians treat nurses professionally, with dignity and respect. Their opposite numbers are only going to be encouraged by subservience. Such physicians need to be called on their behaviour by assertive and confident nurses and if necessary reported to higher authorities, not coddled and enabled to be bullies.
My second reason has to do with the paternalism implicit in Kieffer’s article. I am not old enough to remember those halcyon days when nurses rose to their feet when the physician (in all of his god-like powers) entered the nurses’ station — no nurse would ever sit in the presence of a physician, God forbid — and when the charge nurse followed him on rounds, to open the door to ward rooms and take orders. But I am old enough to to have been educated by nurses who did remember those days, and their memories were not fond. The point of all the sitting and not sitting, giving up of chairs, and attending the physician like a pug dog follows a child was not “professional courtesy,” but a reminder of the power relationship between physician and nurse, and the place of nurses and nursing in the hospital hierarchy.
Kieffer misses this point. She ignores the obvious symbolism, that who gets to sit and who doesn’t speaks directly to hierarchy and deference to superior authority. Nurses who robotically and without thought give up their chairs are implicitly saying, “Here, doctor, take my seat, because what I am doing can hardly compare to the importance of your mighty role in the provision of health care.”
Let’s put this in practical terms: if I am sitting in the nurses station, I am charting or otherwise doing something requiring the convenience of seating. I am not going to offer up my chair to a physician qua physician for her or his convenience. The reason for this is simple: I have work to do. Which in the scheme of things, is as about as important for overall patient care as any physician’s. If you believe what you do is somehow of less importance or insignificant compared to a physician’s, by all means give up your seat. (Neck rubs for said physician are optional.) If you believe your time and convenience is at least as important of the physician’s, kindly yet firmly direct them to the consultants’ room — or any other alternate seating.
I will grant Kieffer this: she is right on the larger issue of professionalism. If nurses are sitting around texting or Tweeting or drinking coffee while looking over catalogues, by all means move if a seat is required. But that’s just common sense and courtesy, and not restricted for physicians alone.
One last point: does anyone know why, exactly, we are talking about nurses giving up their chairs for physicians, in this the year of God’s grace, 2012? Does anyone actually think Kieffer is correct?
Posted by torontoemerg in If You Gonna Have a Circus, You Gotta Have Elephants, Warm Fuzzies, What Nurses Really Want on Thursday 17 March 2011
My question: where can I get some, and how soon can they be delivered?
Will Hardy over at Drawing on Experience wanted advice for new grads. My two cents.
Learning never ends.
Learn by doing.
See one, do one, teach one.
Pay attention when a patient complains of imminent death.
Go to codes.
Never pass up the opportunity to see a procedure.
Not everything can be fixed.
Patients die unexpectedly for reasons unrelated to the quality of your care.
Don’t think you know more than you do. You don’t.
Ask for help.
More importantly, know when you must ask questions.
If you still don’t understand, ask more questions.
Advocate. For your patients. For your profession. For yourself.
Critical thinking is not optional.
Bedbaths are an essential skill, even for RNs.
Chart. Then chart some more.
Read Notes on Nursing.
Walk before running. Basic nursing before Swan-Ganz catheters.
Listen. Carefully. When someone offers you a piece of chewing gum, you’re not thinking your breath stinks, right?
Wash your hands.
Foley catheters are not a substitute for good nursing.
Housekeepers and ward clerks are your best friends. Treat them as such.
Your most recent assessment is the most important one.
Find a mentor.
Sixth sense counts. Ignore it at your peril.
Five rights. Three checks. Always and forever. No exceptions. Ever. Amen.
If you’re giving more than two of anything — tablets, capsules, vials — you’re giving too much.
If your colleague is drowning, throw her a life ring.
Specialize in a skill. Be the go-to guy for hard IV starts.
Make it your rule: take no shit from anyone.
Feel free to add your own: I’ll make a page for them.
[Update: Will’s cartoon added]
Posted by torontoemerg in Before I Start Throwing Things, I'd Better Write This Down, Teddy Bears, Ribbons and Wristbands Make It All Better, Warm Fuzzies, What Passes for Humour Around Here on Monday 29 November 2010
A well-deserved shot at corporate pink ribbon campaigns.
Lest you think the satire is a little harsh, or if you get warm fuzzies donating to pink ribbon campaigns, consider that corporations jumped all over pink ribbon campaigns not just because of their intrinsic worth, but more importantly, because it’s a “safe”, non-controversial issue, and more to generate profits. Think Before You Pink, an advocacy website, makes a necessary corrective:
She and the Times agree on the source of the disease’s peculiar popularity in corporate America. It is a quality that the breast cancer awareness ribbon both captures and enables. “Companies want to support breast cancer,” Cone says simply. “Breast cancer is safe.”
Unlike AIDS, breast cancer is free of what companies euphemistically call “lifestyle issues.” And, perhaps as importantly, breast cancer provides charitable credentials for what can be a very small investment. With the ribbon’s message of ”awareness” translating most often into a familiarity with early detection techniques, all a company has to do, to do good, is put a ribbon on its merchandise.
New Balance, for example, donates money from the sale of its Race for the Cure caps, socks and T-shirts to the Komen Foundation, but its pink ribbon sneakers, a Foundation spokesperson says, are ”just for awareness.” The sneakers have the tiny pale-pink outline of a ribbon sewn onto the corner of their tongues—difficult if not impossible for anyone except the owner to see. The possibility that those two wan loops might remind woman to get the mammogram that saves her life, however, provides the sneakers with their raison d’étre.
It is this dynamic that drives the pink ribbon’s detractors to distraction. “There is a value to awareness, but awareness of what, and to what end?” asks Barbara Brenner, activist and executive director of Breast Cancer Action (BCA) in San Francisco. “We need changes in the direction the research is going, we need access to care—beyond mammograms—we need to know what is causing the disease, and we need a cure. The pink ribbon is not indicative of any of that.”
Check out the website’s list of questions to consider before buying pink.