Monday, April 18, 2005

Just The Nurse (

When I saw this post at spankysplace, I just had to post it on my site so that everyone possible could read it.. Thanks for letting me pass on your work!!

Just The Nurse ( "Just the nurse.

An oft used term mimicked, pronounced with derision and scorn, mockingly sounded by patients, doctors, allied staff and nurses themselves. Just the nurse. I hear it echoing in hallways, elevators, offices, and hospital cafeterias. Just the nurse. But I also hear it in other situations and know that nurses repeat it to themselves many times in the course of their career.

Will you adjust my pillow the patient asks? Sure, the nurse responds as he adjusts the pillow, because I am "just the nurse."

Will you get me some pain pills the patient asks? Sure the nurse responds, and then proceeds to examine the patient’s condition for signs of stress and pain. He asks many questions to make sure he understands what is hurting and if something new has gone wrong. Vital signs are taken to further evaluate what might be wrong. Satisfied that the patient’s pain is with in normal considerations for the condition the nurse gets the pain pill. He checks the names and expiration date of the medication. He checks the order to make sure it really has been ordered for this patient. He checks the dose and route of the medication. He goes back and checks the patients name against the ID band. He asks again if the patient is allergic to anything. He helps the patient sit up to take the pills and settles the patient back into a comfortable position. He returns in twenty minutes to check for adverse reactions because he knows every medication can cause adverse reactions. With over eight thousand medications he tries to learn the major classes of medications and the major adverse reactions of each class. Satisfied the patient is ok he leaves to let the patient rest. Forty minutes later he again checks on the patient to see if the patient’s pain is diminished and to again check for allergic reactions. Finally he leaves the patient to rest, because he is, "just the nurse."

He holds a cool cloth to the head of a patient while they vomit into a basin. He adjusts the weights of a patient in traction to allow for better treatment. He cleans the pins protruding from the patient’s legs where the traction is attached. He brings meals to the patient and removes soiled waste pans from the bedside. He assesses his patients for blood clots, fevers, coughs. He changes bandages and cleanses wounds. He checks IV sites, catheters for urine and heart monitors, arterial blood pressures, cardiac output, and even brain pressure. He does this because he is, "just the nurse."

He monitors the patients breathing tube and ventilator settings, skin for pressure sores, feet for foot drop or blood clots or loss of circulation, urine for infection, chest for pneumonia, surgical wounds for infection, chest tubes for air leaks, lungs for collapse, heart for fatal rhythms, wound vacs for proper seal and wound healing, ABG’ for proper oxygenation of the blood, abdomen for pain or loss of motility. He does this because he is, "just the nurse."

He explains to family how all the machines work. He translates doctoreze into plain language the family can understand. He helps them fill out forms, find the bathrooms, find the cafeteria, the lounge, a hotel, a restaurant, a phone to make long distance calls, a pastor. He holds them in his arms and allows them to cry on his shoulder during the worst moments of their lives. He does this because he is, "just the nurse."

She holds neonate babies in her arms while they fight to survive after being born half formed. She monitors the jet oscillators, the IV, the catheters for heart and kidneys. She wraps them in saran wrap to protect them from hypothermia. She calculates and measures infinitesimal amounts of life saving drugs and administers them to her tiny charges. She places her hands on the baby to impart a human touch to another living soul, knowing that mom will never return and and that baby will never survive because of the abuse suffered under mother’s management. She does this because she is,"just the nurse."

She pumps on the chest of a patient needing cardiopulmonary resuscitation, changes with another nurse so she can administer life saving drugs, monitors the patient’s heartbeat, draws arterial blood gases and then bags the patient while the respiratory tech runs the ABG machine. Lets the RT bag again while she draws blood to check patient chemistries. Monitors the patient’s heart, ventilator, life while transporting the patient to another hospital for life saving surgery. Gives blood and medication in route to the other hospital to keep the patient alive. She does this because she is, "just the nurse."

She makes a game of changing the child’s sheets while smiling and providing comfort care to a child with cancer. She buys the kids funny hats to help ease the pain of loosing all their hair. She sedates her patients and monitors their breathing and vital signs while the doctors perform painful tests on her small helpless patients. She holds them when they become scared and frightened as people come at them with needles. She finds their favorite foods, provides game cubes and play stations to ease the boredom all between administrating toxic concoctions to stave off cancers deadly march. She explains to mothers and fathers the intricacies of the disease process. She repeats this to aunts, uncles, and grandparents. She sits with brothers and sisters and explains in children’s language what is happening, without trying to frighten them. She provides literature to the parents in Spanish, English, Romanian, German, Japanese and a host of other languages. She does this because she is, "just the nurse."

"She makes sure the patient is who he says he is and makes sure which surgery he is there for. She helps him fill out the papers, mark the correct extremity for the procedure, start the IV, explain the procedure, transfer the patient to and from the surgery table. Monitors the doctor to make sure he has everything he needs, runs to get drugs, instruments, blood, suture, sponges, other doctors to assist. She keeps count of every thing that enters or leaves the operating room. She sends surgical samples to the lab, holds the phone to the doctor’s ear so the pathologist can tell the doctor if the tissue is cancerous or not. She recovers the patient, gets them through waking up, shaking, vomiting, breathing treatments, heart monitors, and teaching for going home or admission. She sits with the family while the doctor explains that nothing can be done. She stays with the family to answer questions after the doctor leaves. She holds hands, hugs, gives hope and sometimes cries with her patients. She does this because she is, "just the nurse."

He speaks to the young wife of the 26 year old male nurse who is unresponsive and has a flat EEG after a medical error. The young wife, also a nurse, has to make the decision to remove life support after a massive medical error has left him brain dead. He helps the young wife fill out the papers for organ donation and leads the young wife to the bedside. He watches as she says good-bye to her young husband. After a time the young wife says she is ready. He turns off the ventilator, removes the tube from the endotracheal tube, and holds the young wife in his arms as she watches her husband. He does not breathe, he is dead. He turns the ventilator back on and leads her back to the lounge. He feels crushed inside. He does this because he is,"just the nurse."

He speaks quietly to his 96 year old patient whose every friend and family member she ever knew has already died. Whose home is gone and whose life is coming to an end. He shuts out the din and chaos of the ER and asks the patient if she is ready to die. He holds her hand and prays with her as the spirit of the Lord carries her to eternal rest. He does this because he is, "just the nurse."

If this is what being "just a nurse" is all about, then I want to be "just a nurse" my whole life!!
Keep up the great works out there!!!

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