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Caution: RN Ranting but luckily for you she has nothing sharp with which to poke you

November 22, 2010

Sometimes its a relief to be through that first year or so of nursing so that you feel your feet planted more firmly on the ground allowing you to petition care for your patients you think they require. On some mornings, like this weekend, I am longing for the days that my inexperience prohibited me from getting in some MD’s grill because I was 1. Too intimidated 2. Too inexperienced to know something was goofy 3. Too frazzled by all other basic duties to try to do anything “extra” like checking up on the MD’s to make sure they were doing what they need to do.

Sadly, now, I have time, balls to argue and the knowledge of what needs to be done-mostly. I am NOT stating that I am a know-it-all BUT I do know some basic shit.

So, MD’s, beware.

When a patient is transferred to your service-regardless of where they are physically are located in the hospital-you must round on them. You must write their orders. You must call the RN back when she/he pages you because they are on your service ergo-you are responsible for them and while I will not actively let them die your inaction could cause catastrophic events for that patient and I will be certain it is not my fault.

When a patients IV pole is beeping you can do two things 1. Call the Nurse so they can fix it for you because it is horribly annoying to the patient and you while you are trying to talk to them and answer their questions. Your time is valuable and important to the patient so I can help you out so DON’T just turn it off and not tell the RN. The second thing you could do is far too practical for a MD to do so it’s just a suggestion-but you could learn how these simple common pieces of hospital equipment operate so you can stop the beeping.

(Standing on soapbox)….While pain control is one of the most important jobs we do for patients on the surgical floor it is also an equal responsibility to ensure that our patients do not become addicted to their medication. I am not offering solutions for that but one thing you can do is when a patient says “I just told them I like IV push narcotics better than pills, its faster, I get immediate gratification from it and I have severe pain (while they calmly watch TV, SLEEP and ask to be woken when its time for pain medication and NO I don’t do that because if you are soundly asleep you are not in pain)” , please MD’s don’t do it because you refuse to “argue with them” and wait it out for the pain management team to handle it on Monday. Especially when the patient has a long history of drug seeking and high tolerance and a complete inability and refusal to follow medical advice causing her to have complication after complication. There is a fine line between helping patients and harming them and you have to be strong enough to know that while the patient may not like what you are saying you are doing what is best for them.  I see a lot of unwillingness to cope with difficult patients who refuse to do what is needed of them to facilitate their recovery in both the RN and MD world. Yes, patients have choices but we can not allow them to actively harm themselves while they are directly under our care.

I promise, as an RN, to always support the difficult choices. I promise to help your patient heal as quickly as possible no matter how complicated it makes my job for that shift. I will deal with my patients flaws in coping if you promise to support me when I need it. Answer my pages, think ahead of their recovery down the road.

Its bad enough I have to wear ugly polyester clothes, sensible shoes and I am always wrecking my nails at work so stop fucking pissing me off so early in the goddamned morning. OR, I will pinch you. Just ask Doctor Jeff.

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