Friday, October 27, 2006


I wrote, for the first time, an order which made a nurse angry with me. The good thing about the situation is that the order was necessary for patient care, but I still felt bad doing it. I even apologized to the guy, but hey, if a patient needs an enema, she needs an enema, right?

I'll admit though, with this guy, I felt less bad than I might have with another nurse. He was the reason I started a morphine PCA on my patient. She didn't really need a PCA, but she kept getting him as her nurse, and he would take two hours to get her the morphine shot I had written for. So I gave her the PCA, with some hesitation, and though her morphine use is about the same, her mood and outlook on life is miles better.

Most nurses are amazing. Even the ones I'm not flirting with. Seriously, though physicians (and budding physicians) are great at figuring out the long term plan for a host of patients, performing complicated procedures and interventions or surgery and guiding a patient towards recovery, none of that would take place without good nursing. But like most things done well, good nursing is difficult to notice unless you are looking for it. Bad nursing sticks out like that ghastly Millenium Wheel on the Thames.

So good nurses, (which includes all those who read this blog, I'm sure) thank you. It is people like you who keep us from going completely insane when your colleagues let my patient sit with a heart rate of 160 for two solid hours before calling me.

I don't want to end this on a negative note though. With this same patient, Mrs. Dalrymple I'll call her, I have dealt with three other nurses who were absolutely amazing. Nurses who are good enough not to demand a cosignature on my orders for Tylenol. Who have the patient's vital signs ready when they page me. Who know how to draw blood from a PICC line without causing a lab error by drawing TPN into the blood tube. I'm sure there are a thousand additional thankless things you do that I never see, without which my job would become infinitely harder. You guys rule.


zhoen said...

Wow. Thanks for the well balanced take. I tend to look at my fellow nurses much the same. Most I would let take care of me and mine, without hesitation. A few make the whole profession recoil.

I feel much the same of the surgeons and doctors I work with.

I strive to be the kind of nuse you want to have.

Jess said...

Your post really emphasizes that medicine is a team effort. I'm sure other medical professionals appreciate that attitude. I just wanted to tell you that I love your blog....always so real and honest. You almost make me want to go to med school...almost. Thanks for sharing all of your experiences!

By the way, I'm your sister's roommate from last year, that's how I stumbled across your blog!

Irishdoc said...

Great nurses can make your shift but lousy nurses make it sooo long

Anonymous said...

Hey, thanks for this. It was encouraging to this relatively new nurse (2 years out) who many times wonders if she made the right choice for a profession. It also helped to gain a glimpse into what makes a good nurse from a multi-disciplined perspective. I confess to not knowing it all as I should and I do make a few dumb mistakes on occasion but any insights for helpful (or not so helpful) nursing practice are appreciated.

Keep up the great posts.

~An anonymous RN

Nathan said...

Thanks for the comments, and annonymous, glad you enjoyed it. Come back again sometime.

Judy said...

2 hours to get the patient's pain meds? I've had that nurse after more than one surgery. Makes you wish someone would put them in a bed and leave them in pain. PCA is SO much better way to deal with pain than that!