Interacting with Other Healthcare Providers

 

So I had an interaction with a physician the other day, and my clinical coach and I had very different reactions to the situation that prompted me to write this blog today.

So first of a little back ground, its 0730, everyone is finishing report, and I happen to get a phone call about a critical lab value for a patient. Our policy states that any new critical lab value requires we notify the physician within 30 minutes, so my clinical coach happened to notice the physician was on the floor and told me just to walk in and let him know, but be mindful it is the beginning of his shift just like us so he may be a little disoriented as to what patient it is we are discussing. So not to my shock I walk in to inform him of a critical level and he is a bit gruff and does not want to hear much of what I have to say, and after expressing to him that this is our hospital policy, I have to report this within a half hour, he informs me that this is not necessary and proceeds to ignore me further after scolding me for doing my job. At this point I am not so upset, as I almost anticipated it, but then my clinical coach was much more upset and had hoped there would be more teaching involved instead of just a scolding for doing my job properly.

Later as I am giving medications to a patient, we are called to rounds with the doctor. She agrees to go as we have previously discussed what is needed of the doctor, and allow me to complete my medication pass. When I return to the nurses station to complete more charting, I am met by my clinical coach saying the doctor wanted to speak with me, and that she had mentioned to him that she did not appreciate what had been said to a “new graduate” that morning.

As I walk into the room where the physicians may sit to do their dictations, I find that the physician that I had met that morning was much calmer and more relaxed, apologized and went over the plan of care with me for the patient.

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Something that we are taught in nursing school, well its almost drilled in to our heads at the point of graduation is to not take things personally. This is something that I bring to my practice every day, and as I try to approach every situation with a fresh set of eyes. Doctors not only are doctors, but they are human as well and are privy to emotions and stress just as everyone else. Treating everyone you work with, with respect and dignity is just part of the job, as is work in any service related industry. This mentality aids in the ability for many disciplines to work in harmony.

Anyone have a story about a fellow healthcare provider, good or bad? Or perhaps a patient or family member of a patient? Please feel free to leave your stories in the comments!

 

~Niki

Dealing with Death

When working in a hospital, death is inevitable and unescapable. How does that old saying go…There are 2 things in life you can’t escape, death and taxes…or something to that effect. **There are some graphic details in this so if you would rather not be exposed to that please stop reading now 🙂

In this field that its truly inevitable, especially when working in a hospital…on an oncology unit…that also cares for other end of life patients.

The first patient i ever encountered that had passed on was during a night shift in nursing school. The patient was not mine on this particular night, but several of the other nurses on the unit encouraged me to go in to that room so my experience was not on my own. As  I walked into the room, you could feel the energy was just different. The patient was still laying in the bed the blankets tucked to his/her chin. He/she just looked like he/she was sleeping with the exception that his/her skin had taken on a yellowed waxy appearance. I helped one of the CNAs to prep the patient for transportation downstairs to the morgue. Placing someone into a glorified plastic bag after they have passed seems eerie like there should be more to it than that. We enter the world with people celebrating and anticipating our arrival, it seems like there should be more to the end than tears of loved ones and a body bag, but thats just my outside opinion.

I also accompanied the patient to the morgue where the security guard was a little over zealous and showed me all of the different things stored in the morgue. I did not realize and came to the rude awakening that more than deceased patients were kept in there. Not to go into too much detail, but I was not prepared for biopsies, amputations, and fetuses from fetal demise for any number of reasons, in the room in a cabinet. They were in jars and many in plastic bags that just looked like something you would find in a refrigerator, which made me uncomfortable for many reasons, but mostly because it seemed like they should be in something a little more substantial.

I definitely went home and had to have a couple of cups of soothing tea before I was able to go to sleep that morning. The image also stuck with me longer than I like to admit and I had a few nightmares about it before learning how to cope with it.

I had another experience in nursing school, but this experience was at the VA. After the patient passed he/she was prepared to be brought to the morgue, but at the VA they drape the patient in an American flag, and have a mini ceremony/procession. They ring a bell and announce that a Veteran is leaving as he/she passes through the hall. The medical personnel can move into the hall to show their respect as the patient passes through.

This was a MUCH different experience than my first one. This patient’s passing felt much more like a celebration of the life of this patient and his/her passing. I felt like this was a lovely way to not only honor the patient, but give the family closure. The family not only gets closure from this, but also the staff who have cared for the patient for the many months he has been there.

The important thing to note from all of this, is that different hospitals do different things when it comes to death, and each person deals with it differently. Being respectful of everyones wishes helps family members of patients feel supported. Finding healthy coping mechanisms for healthcare personnel is essential for not feeling burned out.

What are some of your coping mechanisms for dealing with patient deaths? Any other questions comments or concerns? Please leave them in the comments 🙂

~Niki

 

Emotional Turmoil

So I was on Instagram earlier and I saw a post that made me think more than I have in a while about my chosen profession and wanted to write a little bit about some of my thoughts and feelings about it. Here is the link incase you’re curious what I saw.  https://www.instagram.com/p/-5new1Q52l/?taken-by=medicaltalks  Disclaimer, this may be a little bit of a rant so go ahead and close the window now if you’re not down for that :).

The shot showed an ER doctor that was outside grieving the loss of one of his patients, which is something that most people accept as part of our profession. However this person who posted this touched on an aspect that even I, as someone in the healthcare profession, had not put much thought into.

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Once the patient has passed away, doctors, nurses, and other healthcare professionals are expected to carry on and continue to care for our other patients, who have no idea what just happened in the other room. The purpose of this post is kind of just to let people know that yes, we are healthcare professionals by choice, but we are still human and we are not immune to emotions that come with death. I think that when you are not feeling your best and you come to a hospital, it is easy to forget about everyone else because of the pain or suffering being endured that brought us there in the first place. Yet, there is that trauma occurring in the next room where the patient doesn’t make it after 3 hours of many people working to keep him/her alive, and that is tough for anyone. Especially those directly involved that tried to prevent that tragedy. Then after all this has occurred, the expectation is for health professionals to complete the paperwork necessary, and move on to care for the next patient. There are always exceptions and if there are enough staff, we hopefully give those people the time to grieve, but oftentimes there is not the excess staff to pick up the slack, so on to the next patient it is.

It’s an unfortunate reality of working with the public and in acute healthcare settings, but despite the sadness and the drawbacks, I wouldn’t chose any other profession. We do this because we love our jobs, and it is not everyday we endure tragedy, there are days where we get to save lives and make a difference in the lives of people. We just have to take the good with the bad.

Any thoughts comments or questions? Please leave them in the comments 🙂

~Niki

Transitioning to a New Hospital

One of my biggest fears when beginning a new job was that I had to go to a hospital system I had never been to before. There were several reasons I was nervous about this transition. Some of the biggest ones included being in a new place, with new people, and a new EMR (electronic medical record).

One of the actions that helped me over come some of my nerves on my first day was driving past the hospital a couple of days before my first day. Knowing where to drive and where to park made me feel like I at least knew where I was going on my first day.

I was also fortunate enough to know another girl who was was walking in to the hospital on her first day on the same unit as I was. We walked out of the parking structure together, but then quickly realized we both had no idea where we were going, we had a general idea, but that was about it. Thankfully there was a security guard that happened to be walking by just as we walked out of the structure and pointed us in the right direction. We made it to the unit without further incident 😉 .

The unit was warm and welcoming and everyone on the unit was prepared to help us with our transition. This also immediately alleviated a lot of the worry I was having about being “the new kid” on the unit.

What I had the most trouble with was with the EMR. I had used a couple of different EMRs prior to this experience, but this one was different than the others, and one I was completely unfamiliar with. Realistically it took me about 3 solid weeks before I was comfortable charting my assessment completely on my patients, and I am STILL not comfortable with everything in the system. That and there is a combination of paper and electronic charting and that is something I am still not completely comfortable with and it confuses me at times. The other nurses I am working with have assured me several times that learning that whole system is something that takes time and I will become more comfortable with it as time goes on. I certainly hope thats the case, but for the time being it still feels crazy.

There are many reasons I was nervous, but those were some of the main reasons I wanted to hit on. Does anyone have anything that made them nervous or anxious on their first day? Leave it in the comments 🙂

 

~Niki