What nurses talk about....

At the end of my shift last night, a bunch of us nurses gathered to talk about a couple of things.... we talked about one of the new hire nurses (got hired at the same time as I) experiences and how it differs from the veteran nurses experiences - more like what one would do vs. what another would do.

The situation was this.... if you did a bladder scan on a patient because they were complaining about fullness and pain - found that there was a substantial amount that was being retained, would you do a straight in and out THEN call the Dr for the order OR would you call the Dr, report the finding and request an in & out, also, what would you do if a Dr refused it....

Veteran nurse said that she would NOT have waited for a Dr's order, would have done the in & out and called the Dr for the order - neglecting that policy indicates otherwise... and even said that she didn't care if she got fired for it because it was in pt's best interest.

Newbie nurses (I included) - have called Dr's for such FIRST - but this is seen as us not having a back bone.

So what would YOU do?

When I have called Dr's for in & out's, I have already done a bladder scan and feel that information is a girl's best friend. I think it's like arming yourself for when questions get asked. Now, if I had a pt who required an in & out but a physician was refusing to give one (did happen to that newbie btw), I think I would go to the unit leader/charge nurse to speak about it, since having the leader on your side is like arming yourself - it's peer review and support. I know that the nurses on my unit support one another, and their patients - and ultimately would do what's best for the patient. Even if that means going against a Dr.

The newbie kept paging that Dr. for several HOURS, probably not realizing that the other option available to him was to do the in & out without the order and that one could be obtained later from the MRP (most responsible physician).

We also talked about our past patients and where they are... one of the nurses generally checks out various units within the hospital, as some of our patients end up on rehab units, we like to know if they're still there or not...

Last night this nurse revealed that one of our patients.... the one I told this blogging world about - the woman with the MASSIVE CVA (AKA stroke). Turns out that she aspirated at home - from the family trying to feed her! And she was back in ICU, intubated and STILL not a DNR (Do not resuscitate)... it amazes me, truely astonishes me that a family would WANT to watch someone suffer. If that was MY family member, I would NOT want my family member to be a full code if they are going to have crappy quality of life. If they can barely move, can barely communicate, and are entirely dependent on others for EVERYTHING, and that the family isn't all that interested in learning to take care of this family member.

It's crappy when people keep a loved one around for THEIR need, not caring about how it is for their family member. I guess this is something that I will learn to live with, because there is NOTHING I can do about it.