Friday, June 10, 2011

Home Nursing

I was recently the unintentional participant in a concersation between mothers about difficulties wih home nurses.  Many concerns were expressed about the quality of their nurses from things like the nurse's age (too old, too new) to whether or not she is a smoker or how she dresses.

Apparently we are held to very strict standards.  From this 2 hour conversation with a limited sample I gathere that public opinion about what a nurse should be hasn't really changed much.  We should live a clean lifestyle, always be a few years out of school but not really showing true signs of aging, do everything exactly like every other nurse (tiny variations in how things are done seemed to be a big concern) and either looking too much like a nurse or too little like a nurse. All of thsi being said right in front of me, as though I wasn't there, or wasn't really a person.  Reminds me fo what it's like to be a child with adults talking about you right in front of you.

I guess what my point is, is that being a home nurse is much more trying than I thought it would be.  I have heard of friends in home nursing being accused of things that I flatly do not believe are true.  In my own case, I had a parent call my agency and create a false story about something I supposedly did and ask that I not return.  It was the worst thing that ever happened to me, and it was only my word against theirs.  In my two years working in the hospital I felt relatively safe from accusations made by patients.  My fellow nurse-assistants and nurses knew me and the quality of my work and knew when a patient was confused or not.  Patients, in that situation, I believe are less likely to concoct a lie just to get rid of a nurse because they realize that there are probobly many witnesses.  Working in isolation in somone's home is sometimes heroing.  When a patient's sats plummet and their heart rate skyrockets and you have to climb over furniture to get to the oxygen tank in the closet, hook it up, and get it flowing while your patient lies there, you feel totally incompetent.  Thank goodness for daily equipment checks!  If I didn't do it of my own accord, I could have gotten in some sticky situaitons...

I also had a sibling of a patient accuse me of hitting her.  That was horrible.

I have had 6 differnt cases in the past 2 years.  I have been accused of something I did not do in 2 of them either by other nurses who have never met me or by a drunk parent.  In the other 4 one of the other nurses either did in fact do something inappropriate or was falsely accused of something.  Knowing this, and then spending 30-40 hours a week with a patient and their family, is very stressful.  I would never compare it to the stress of having 4-7 patients of high acuity to manage with an overloaded care team and family to deal with.  It is just a totally different kind of stress.  It's the sort that makes me long for night shift when the parents are asleep and the kiddo is restful and if they start crying nobody exclaims "what is it!?  What happened!?  I can just pick the kiddo up and calm her.  She goes back to sleep and no one worries.  If the patient's sats take a dive or a fever occurs or any number of minor emergencies occurs I can just handle it.  Which is great except when you really wish for an extra set of hands or the comfort of checking with collegues about your decision-making process.

And here I go, into a career in midwifery.  Obstetrics is one of the most politically charged areas of medicine, especially where midwifery runs into obstertics.  And I plan to attempt to join the nurse-midwives trying to bridge that gap.  Hah.  Sometimes I wonder if I've lost my mind. 

And while my daily runs, long showers, Friday nights at the club, dinners with family and cooking with Abe sound wonderful and are, I think I will need to reframe how I think of my interactions with patients their families.  With other nurses as well.

Friday, May 13, 2011

Monday, May 9, 2011

Post Number One.

Hey Cats and Kittens!

I set up a blog.  I am officially a part of the computer literate generation!

I hope it works!  Email me if you run in to problems.

Be cool, kids.