One thing I admire about nursing is the need for one to be versatile and being good at it. I remember how it used to be part of my training how to maintain composure in the midst of a tight situation. For that we have to deal with monster instructors, stressful examinations and mounting paper works to complete the course. A good nurse is expected to be able to assess their client properly; plan an effective course of care; administer health interventions efficiently ; monitor and evaluate outcomes logically not to mention the task of documenting relevant events for recording, reference, reporting and even legal compliance.
The role of nurses is being played practically in each ticking of the time and on everyone. A nurse is a teacher, an advocate, a health provider, a coordinator, a leader yet for all these tasks nurses are to be sensitive, decisive , respectful, patient, humble and effective.
In the exercise of the nursing task there is always room for improvement. There is also ALWAYS the call for understanding especially on the attitude and actuation of people we deal with. Somewhere along the line though is a time when we have to put people in their proper perspective.
Times when I was giving orientations/ lectures in seminars and trainings. One thing I first think about is my audience - who they are, their background, what they possibly know ( best ). My main concern was how to disseminate an information as an added information for my audience to realize its significance and gain cooperation for them to implement desired action. For most of these chances I had to deal with fellow PROFESSIONAL health workers which make the challenge a lot easier if carried correctly otherwise it gets tough when you approach the job the wrong way.
A person of experience would deal with life in an easy and calm mood. Understandably they knew a considerable lot about the realities of a field. Most often it is more about the refinement of ways and improvement of techniques that they have to deal with. More so they have to deal with the changes brought about by the evolution of age and reconciling the experimental skills to bring about better outcomes. Yet the knowledge from history of experience is something that a teacher ( whether they be professional ones, or those acting teachers, or hopeless teachers ) has to respect.
Once upon a time I had a chance to be orientated for a job. Coming across a client with swollen legs and looking very drowsy I gasped, oh no this man is unwell - his legs are all swollen and he is very tired. The person orientating me confidently said - never mind, he has been like that for ages. My heart sunk - for ages ???? . I went through the chart and read something about a recent diagnosis of cellulitis and a recent prescription of antibiotics. I went into the room and tried to talk to the man. The junior staff started pulling me out of the room - leave him alone, he gets upset when asked. I carry out with our conversation and the man did reply courteously, " yes I know my legs are swollen dear but I will be fine ". The time for his medication came and as a nurse I pulled my spoon and gave the pill right into the patient's mouth yet the junior staff told me - you just leave his pills at bedside otherwise he will get mad. I felt a lump stuck on my throat yet keep quiet.
The next time, a newly registered nurse asked me to do a patient's dressing for her. She added to say that the dressing has to be done everyday. I asked what is it about the wound that the dressing has to be done every day? She said, i just think that it has to be done. It was then that I said - I am happy to do wound dressings but as what I have learned dressings are not done daily as it interferes with the healing process unless of course if the oozing has leaked or the present dressing has fallen of. The young charming nurse argued, no there is nothing there to upset I just want it dressed. I gave a chuckle but went to check the wound. There was nothing there to dress, the leg was dry without skin breaks in fact the old dressing has nothing on it. I removed the old dressings, washed the leg and applied cream and without saying anything I wrote on the wound care plan - dressing removed, no skin break found - leg washed and cleaned - moisturizer applied over dry skin.
Then the sweet young nurse proceeded to demonstrate the medication procedure. She confidently arranged her tray of pills on top of the trolley and showed all the spoons and tumblers inside the drawer. She also explained how to administer the pills with the yogurt she carried with the medication. With her mortar and pestle handy she readily dropped the pills from the blister pack and started crushing the pills and gave it to some residents. My heart once again felt crushed as I saw the heart-shaped Aspirin crumbled.
As we moved from room to room she opens the blister pack and asked me to deliver the pills to the resident ... I could laugh in the inside acting like a courier. Most of the medication she said I should leave at bedside for the family or the patient to take to make it to a certain time. I started to feel uncomfortable that at the middle of the rounds I said - okay, I got the technique, but just let me read the medication profile first - match the medication list with the pack and I can read the names on the doors or ask the other staff for those that I cannot locate. I urged her to leave me to manage by myself but the young nurse refused to leave and zealously guarded HER MEDICATION TROLLEY. Funny for this thing to happen between two licensed professionals but it did.
Back to the medication cupboard, she put out another set of breakfast pills which was to be controlled drugs. I looked at the time - it was around 10:30 - I realized they were all pain management one. I then asked could it be better if we give these drugs early with the breakfast for the patient to have some relief before they are moved for morning cares? She said - well that is how we do it because we do not have the time. I could not help but wonder - what time is she talking about ??????
Finally I was given the chance to bring my own trolley, I put all my pills inside the drawer. I put the spoon and cups on top. I emptied my trolley from stuff that are not used during the rounds and set off to do things my way. Then a junior staff approached me - she asked, please this is only between you and me , may I know why you are not doing things as told ? I said it is not you nor anyone my dear, it is just how my own mind works considering safety and reading the policy. On the first page of the medication chart is the copy of the said policy and you can read it afterwards when you have time.
Then another junior staff yelled at me to say - look here, when you do your medication you should start from this wing and check the windows, and close them. I said, really ? I then look her straight in the eye and said, if you need help what you need to do is say it nicely ... you are paid your rate and should be doing the tasks expected of you. I am paid a much higher rate for greater duties and when I am assessing the well-being of the residents do not tell me to close the curtains because my license is not issued to do that ; when I am timing my medications do not tell me when to start and when to finish because you are not responsible for me on these matters. If everyone is too busy to close the curtains in the lounge - it is common sense to draw them just as you close the windows of your room at night. I do not need an instructor for that.
Oh this attitude of trying to be ALL KNOWING and too perfect in the midst of our human frailty. ARROGANCE in the face of IGNORANCE.
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