Some things have been said and done that have rankled with me. A lot of things that are said, I blow off because it isn’t worth getting my panties in a twist. Some things, I let go because it’s just the reactive nature of new nurses who think they “know it all.” But when there is an implication that my skills are sub-par or I’m not taking care of my patients . . . the gloves will come off.
I may be almost exclusively taking care of the psych patients at this point in time, but that is by my choice. There are those nurses who think it’s a “cushy” job — that all you do is make a note or two and babysit. HA! Not even. Psych nursing is harder than medical nursing because the mind does not follow a set pattern. You have to have empathy, you have to be able to put aside your ideas and actually LISTEN to what your patient is saying and interpret it. For a patient with chest pain, we do A-B-C, with a schizophrenic patient we may have to do A-H-C-B-J-Y because the brain is wired differently in everyone. If it were so easy to take care of the psych patients, WHY isn’t everyone throwing down to take that assignment? No. . . most nurses dread it, they hate it, the patients make them feel uncomfortable, they are afraid of the patients. I think they hate it because to be successful at it, you have to identify with your patient in some manner and nobody wants to explore their own thoughts. Most people do not want to reflect on the times they were sad, angry, lonely, felt left out, or *gasp* suicidal – even if it was just a passing thought.
My skill set has been developed over 30 years filled with experiences, training, certifications, classes, conferences, workshops and multiple degrees. The idea that taking care of medical patients versus psych patients is “outside (my) skill set” is preposterous. Yet, that very statement was made to me by a nurse with less than 3 years of experience. Go figure . . . a nurse with 1/10th of my experience attempting to define MY skill set.
The same day my skill set was called into question, I had a medical patient that had come in the wee hours of the morning on the nightshift. She was an octogenarian with a history of stroke who had woken up with nausea and vomiting during the night at the nursing home. After cleaning her up, they noted that her oxygen level had dropped and were concerned that she may have aspirated, so they sent her to the hospital for evaluation. She had arrived shortly before 3:30 in the morning, so had probably been up since prior to midnight. She was exhausted. I woke her up from her loud snores to do my morning assessment, asked if she wanted breakfast to which she replied, “No, I’m too tired to eat.” The doctor came in and woke her up (with some difficulty) to speak with her. The lab tech came in and woke her up to draw some blood. Shortly afterwards, I woke her up to check her blood sugar. Each time she was difficult to wake up but was completely alert when awake. The entire time she was connected to the cardiac monitor with her blood pressure being taken every 30 minutes and her oxygen level being monitored continuously. Suddenly, there was a huge commotion at my patient’s bedside!! One of these new baby nurses with less than 3 years of experience is “assisting” my patients breathing by providing respirations with an ambu bag, two of her baby nurse friends have my patient’s arms held down as they searched for additional IV access sites – the patient had a perfectly good IV already. One of the other nurses had grabbed the crash cart and was attempting to put defibrillator pads on my patient. My patient still had a lovely heart rhythm, a good blood pressure, excellent wave forms on her oxygen. An orientee had gone to grab the physician with the pronouncement that the patient was “crashing!” As this overzealous baby nurse was holding the mask to my patient’s face, my patient was moving her head from side to side as well as up and down to which the nurse yelled, “I think she’s having a seizure!” All of this commotion because the monitor showed that the patient’s oxygen level had dropped to the 20’s. Did anyone come talk to her nurse? Of course not! Did they assess my patient before clamping an ambu bag over her face? Nope! Why? Because the monitor showed a low number and she had snoring respirations. SHE WAS SNORING BECAUSE SHE WAS ASLEEP! Nor was she having a seizure when her head was bobbing to and fro – with her arms being held down, she was attempting to get the mask off her face. Then to save face, the baby nurse insists that the patient be moved to a different bed for “closer monitoring” by one of her baby nurse friends. The patient was still going to be hooked to the same type of monitor, on a hospital bed, but in a room farther from the nurse who would be “more closely monitoring” her.
And MY skill set is being called into question? Puhlllllleeeeeeaaaaaasssssseeeee!
Yet these same nurses can type the wrong information into a monitor and erroneously report that a patient has a heart rhythm that is dangerous causing the patient to be admitted before realizing they had typed the wrong patient information into the monitor and it wasn’t actually THAT patient that had the dangerous heart rhythm.
They get a patient with a fall and get so focused on his rib pain that they neglect to notice that his heart rhythm on the monitor is abnormal, he has a significant cardiac history in his chart and he also takes blood thinners and has a goose egg on the back of his head where he hit it when he fell.
I cannot address these nurses with this behavior because they can do no wrong, not in their eyes or the eyes of our manager who has scant experience himself. Therefore, it is necessary that I move forward and look for positions in which my “skill set” is valued.
God bless their pointed little heads, and may His angels protect the patients.
The Road Back Home 