Sunday, March 02, 2008

An apology.

Dear Nursing Students Who Were On Our Floor Two Weeks Ago:

I'm really sorry about your last rotation with us. If I'd known my coworker Peevie McGripersons would be there, I would've taken each and every last one of you on, like a string of ducklings, to save you from McGripersons.

I probably should've realized there would be problems when I heard McGripersons berating a student about how Medication Sheets Are A Legal Document, Like Charts Are. I mean, yeah, you copy down all the meds your patient has and you learn all about 'em before you come in the next day, right? It's probably still not a good idea to go with your hand-copied notes when you start to pull meds, because something might've changed--but there's no reason for you to get excoriated about Legality and License and So On because you're inexperienced. 

It would've been better if McGripersons had said something like, "Oh, you copied everything? Damn, you're dedicated. Snag the med sheet out of the chart, willya, and let's go yank some pills out of the machine, eh?"

I *knew* there were problems when I watched one of you pull up a couple of different meds into the same syringe--something we do all the time--and watched your face change when it became obvious that the meds weren't compatible. Not one of us hasn't cursed inwardly when we've seen incompatible solutions crystallize in a syringe. Not one of us hasn't grumbled our way back to the med cart to grab two more syringes and re-up the meds. It happens all the time. We just don't give the crystallized solution, y'know?

But to hear McGripersons, you'd've thought the world came to an end. 

Seems to me that a better way to have done it would've either been to have warned you that Solution A isn't compatible with Solution B *before* you pulled 'em up, or to have sympathized and explained after it turned out they weren't. I don't see that you needed to be subjected to a pharmacological lesson *after* you'd screwed up, which does nothing to help you figure out what the hell is going on and a lot to make you feel an inch tall.

And, finally, I apologize for not stuffing Peevie's limp body down the laundry chute after he told one of you that you weren't to do *anything* without him there, because A Chart Is A Legal Document.

Yeah, Peevie, we know. There are better reasons, though, both to follow a nursing student pretty closely and to chart completely and correctly. Legality is a very minor concern.

First of all, your average student is scared to death of your average patients. They're not people to the nursing student; they're huge bundles of foreign problems who are likely to die suddenly while gasping out that it was all the student's fault. Having an experienced nurse at your side makes you a much less scared student (unless the nurse is Peevie McGripersons, that is).

Second of all, other nurses--and the occasional doctor, alors!-- read your charting every day. They do so to figure out what's been going on with the patient and to make sure they don't reinvent the wheel. Charting completely and correctly is about *safety* and *information* more than it is about legality. Yes, good charting will save your license in the event you're sued--but it's much more likely that it'll save your patient some trouble. Other people need to be able to read an informative, intelligent chart to decide if that numbness warrants reassurance or a call to the doc.

Guys, on behalf of my other coworkers and decent, humane nurses everywhere, I apologize for Peevie and his ilk. Please don't be scared away by one jerky nurse. I promise that I'll steer you away from him in the future if you'll just come back. 

And I promise, too, that you are not the idiot McGripersons made you out to be. You're inexperienced, yes, but that does not in any way equal stupid. You've gotta be smart and hardworking to have made it this far, okay? What remains is more hard work and a little more time with sick people and their pills, and you'll have it made. You may not feel confident until you've been a nurse for a couple of years (I didn't, and I don't know many people who did), but it'll come. Just avoid the McGripersons of the world in the meantime. 

Sorry, guys. I really am. Come find Auntie Jo next week and she will set you up, okay?


overactive-imagination said...

It's a damn shame that it's unlikely any of your students are going to read this because I gurantee you it would make them feel loads better about themselves.

I have to tell you that I laughed out loud when reading the paragraph about patients not being people to us students. So true and some of the funniest shit I've ever read. Thank you.

I just left a clinical rotation where about 6 of the 8 nurses were the same as McGriperson and the techs were even worse. Speaking as a nursing student and a tech (since I passed Intro. almost 18 months ago) I KNOW the techs want all those baths done so they don't have to do them themselves.....I get it..but I DO think that it's more important that I get my IV pushes, IV piggybacks and oral meds done correctly before I worry about changing the guys bed. Sorry.

99% of the nurses threw us out to the wolves. Basically it was "Oh, you are his nurse today? Will you be giving meds? Okay...see ya at 3:00" We never saw them again even though they were supposed to witness all med draws and any hangs or procedures we did.

We do appreciate y'all having us underfoot Thanks. I wish they were all like you though.

Penny Mitchell said...

Honey Baby Doll Sweetie Pie Poopie Kins, if I add a few more adjectives, will you come work at whatever hospital I'm doing clinicals at, and change hospitals whenever necessary and hold my hand and pat my head and stuff?
Pretty please?

molly said...

Isn't there a book out there - Ending nurse to nurse violence? Why nurses eat their young? should be standard issue and required reading anyplace bringing up student nurses...

shrimplate said...

A lot of students are better charters then nurses who've been on the job a while, because students tend to be more comprehensive and thorough.

You would be too, if you had people like Snootie McNursepants or Peevie McSmaltool breathing fire down your shorts.

shrimplate said...

"Why Nurses Eat Their Young" is a classic enactment of what we probably would call "dysfunctional" family dynamics. I do not really like that term, ever since I was in a fancy restaurant long ago and overheard someone say to their dinner partner that "all families *function* one way or another..." OK... yeah. I get it.

Daddy is allowed to berate everybody. Mommy is allowed to berate everyone except Daddy. Oldest is allowed to berate everyone below Mommy. Second-oldest (favored) is allowed to berate everyone except those above. Etc. etc. Blah etc.

And little Susie tortures the gerbil.

My god. See what I mean?

So this person gets a Nursing Degree and a job in Cardiac Intensive Care and the next thing you know is:

A lot of these patients are getting totally mentally screwed by their nurse. And surgeon. And cardiologist. And pulmunologist. And nephrologist. On and on.

Blah blah blah. Dead. Blah. Etc.