(As posted on my blog at http://dustyangels.blogspot.com)
Sometimes I lay awake at night and wonder where I'll work when I finish school and get my RN license. (January 2010). There are a few jobs I know I don't want and some I've thought about, but so far, I'm not finding opportunities where patient comfort and teamwork is paramount with nursing care.
Just last week I witnessed some situations as a student nurse that continue to haunt me. At the time, I told myself that I'm just a student nurse - there to learn and not teach! But, maybe I should have gone to my instructor anyway and asked that something be done.
I'll be discrete and perhaps change the actual events a little to protect identity, but on one assignment, a couple of us student nurses followed a director from another department (not nursing) as she did her job. When we entered a room, the patient was surrounded by family as he lay quietly with several machines attached. I immediately noticed that a tube going into his stomach (NG) was not attached like it should be. The tape had come loose and the tube could have slipped out with any movement or tug. I also noted that the machine for his nourishment was turned off (which is sometimes done for an hour or two), but the feeding tube was still attached to the machine which meant that the tube would be clogged by the time the machine was turned back on. (It's supposed to be flushed with water and disconnected from the machine when the patient isn't getting his feeding.)
Now you may be asking why I didn't just fix the tube like it should be. This is where there's a fine line between being a student and being a nurse! I did go and find his nurse and told her I noticed these two things. Her response was, "I know. I turned it off. It's no problem," as she walked down the hall in the opposite direction of his room.
Another time I was asked to do a blood draw on a PICC line (going directly into the heart). We couldn't find the patient in her room, so I started asking the regular nurses, charge nurse, unit clerk and unit coordinator if they had seen this patient. Not one of them knew this patient by name or room number. They looked up the room number on the computer to give me his name (which I already knew) and suggested I go look in the medication record for his picture. I was saddened that these nurses who work there every day didn't know the name or face of a patient who had been in their care for several weeks.
It's not really their fault. It's the system that puts more emphasis on making money than real patient care. The nurses who actually have patient contact spend all their time rushing through the med pass from start to finish of their shift. Most of the other staff have assignments so heavy that they only see the patient on the computer! The nursing assistants who actually 'touch' the patients have such a big assignment that they rush from one patient to another answering call lights, passing food trays, giving baths as fast as they can, and feeding those who can't feed themselves, so they have no time to provide anything extra or spend more time with someone who really needs it. (Those of you have ever worked as a CNA know what I mean.)
Living in the capital city of Ohio, I could have the opportunity to work in some of the finest medical facilities in the country such as Ohio State, Riverside Hospital, Children's Hospital, the many facilities of Ohio Health, and many more more. But, I want to make a difference to the patients - and the more I look at these websites - the less I see about patient care. It worries me.
It seems it's all about making money and keeping up with guidelines set by the government: Joint Commission on Accreditation of Healthcare Organizations (JCAHO, Occupational Safety and Health Administration (OSHA), Office of Managed Care, Health Care Financing Administration, Health and Human Services Department, Equal Employment Opportunity Commission (EEOC), Employment Standards Administration, US Department of Labor, Food and Drug Administration (FDA), Health and Human Services Office of Inspector General (OIG), Centers for Medicare & Medicaid Services (CMS), MDS and RUG http://www.aasa.dshs.wa.gov/Professional/MDS/Automation/primer.htm.
Don't worry, there's a lot more.
I will be a Registered Nurse. I will work where I can make a difference to my patients and my coworkers. I know there are many rules and regulations, but I won't give up my belief that there is a place where patient comfort and tender loving care can be offered while working with a professional caring team who wants to provide both AND keep the facility in good standing.
As my MySpace website says, "Anything Is Possible. You Just Need To Believe."
Take Care on the Journey,