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.