April 10, 2009, 1:47 pm

And I Begin to Wonder Why You Came

bob-evans-uniformsI tell ya, I was born thirty years too late!

Are these elegant, or what?

Of course, by the time I was wearing white, the dresses were mini-skirts (don’t ask how we bent over in those things!)

And I was never 5’11” or had an 18-inch waist like these nurses did.

(They aren’t bad, they’re just drawn that way…)

But oh, how I would have basked in these dresses back in the old days!

Now I wear scrubs.  I’m comfortable, but I look like I’m working in pajamas.

Apparently Bob Evans is still around, or at least the company is.

They make restaurant uniforms

********************

Okay!  By popular demand (and a suggestion by Doctor Anonymous on his radio show last night), there is now a special page for the BlogWorld/NewMediaExpo 09 Medblogger Conference here on Emergiblog.

If you click the button up top that says “Blog World” it will take you to a dedicated page where you can comment, tell us you are going to be there, talk with those who are,  nag those who aren’t and stay abreast of all the news.

As registration begins or Southwest starts taking reservations, I’ll post it right on the page.

Oh, and no, I don’t get paid by Southwest for mentioning them.

I just think they rock!

Won’t fly with anyone else.

********************

“Why the hell do people get out of bed in the middle of the night for nothing?  I mean, who in their right mind visits an ER at four a.m. for a freaking paper cut?  Are they nuts? What possesses a supposedly rational adult to wake up their spouse and all four of their children and come to the ER because they have a fever of 100.7? Don’t they know Tylenol is over-the-counter, or is it now a controlled substance?”

“They can’t cope.”

“Huh?” I looked up from the stack of charts I was trying to finish.  It had been a very busy shift.  A very busy clinical shift. Not an emergent complaint within ten miles of the joint.  I had smiled through the role of compassionate nurse for six hours and I was not in a good mood, hence the rather rabid rhetorical rant.

The ER doc repeated his answer.

“Patients come to us when they have reached the end of their ability to cope with a problem.”

“Are you serious? Keith, it was a paper cut, for god’s sake!”

“Sure, I’m very serious.  Paper cut, toe pain, headache, abdominal pain.  Everyone winds up here for the same reason.”

I dropped my pen and turned around.

“Think about it,” he continued. “It’s really what we are here for.  When the patient comes in with their problem, they are able to share it and it then becomes our problem. We take it on with them. Their coping skills are depleted, they rely on ours to help them get through the crisis.  Yes, even if it is a paper cut.”

*****

Dr. Keith was right.

That’s exactly why people utilize the ER.  They are unable to cope.  With pain, usually.

But when I really thought about it,  maybe there were other issues, too. Perhaps they were unable to cope with waiting overnight for an answer from a clinic that may or may not give them an appointment. Perhaps they were unable to cope with the fact that they didn’t feel well and had to be at work by 7 a.m., or else.  Maybe they couldn’t cope with what they didn’t know; what if the paper cut was infected or the ankle was broken?

And then I realized something else.

*****

What do nurses do?

Really, at the heart of all patient care.

We help people cope.

With illness. With disability. With fear.  With pain.  With loss. With change.

And then we take it one better.

We give them the skills  to strengthen their existing coping mechanisms and to learn new ones.

By listening. By teaching. By supporting. By encouraging.

It’s what nurses do.

*****

So I came away from my shift with a clearer focus.

I realized I had always known the truth of what had been discussed that night,  but I had lost it in the hectic bustle of numerous non-stop shifts.

Dr. Keith had it down.

I also realized something else.

Nurses don’t have a monopoly on compassion.

10 Comments

  • Hi Kim,

    I remember those mini skirt uniforms! LOL

    You got a great point on the heart of patient care. As nurses, we help patients cope – physically, mentally, emotionally & spiritually. When I look at my role as a life coach for nurses and other women nurturers now, this analogy also applies. I help my clients cope with stress and whatever life circumstances they cannot handle, through coaching, listening, supporting, educating and teaching them new skills, etc. In a way, I’m still doing the same thing, as I did years ago as a nurse, which is pretty cool. Thanks for this great reminder. 🙂

    Warmly,
    Hueina


  • maha
    maha

    April 10, 2009 at 9:31 pm

    A great post Kim – just what I needed after a couple of harrowing shifts! I’m printing your post and putting it in our nursing stations 🙂


  • Medic999
    Medic999

    April 10, 2009 at 11:46 pm

    Nice post Kim, one that creates a thought that slowly gathers pace in your mind.
    As I was reading what Keith said, I was thinking “what a load of rubbish!” then gradually you think about it and it makes sense.
    Not for EVERY patient though, but you can certainly see the reasoning applied to a lot of the minor cases that we all deal with.
    It must be nice to have a doc like that to work with.


  • Shrtstormtrooper
    Shrtstormtrooper

    April 11, 2009 at 3:50 pm

    Hey Kim-

    About that scrubs nursing choir…when I get it together, I’ll be sure to call you!

    Also, I wanted to give you permission to pull anything off my blog if you ever want to post on Change of Shift with it. I don’t think I write stuff all that worthwhile, but if you like it you’ve got the go-ahead to share it with all!

    -Shrtstormtrooper


  • missbhavens
    missbhavens

    April 12, 2009 at 10:16 am

    Wow. Talk about hitting the nail on the head.

    Remind me to bring this up at work next time we admit a mom of 6 “theraputic rest”.


  • galfromcal
    galfromcal

    April 12, 2009 at 7:04 pm

    Seriously? I work as an ER nurse in the golden state and another nurse I know uses the motto “you can’t fix stupid.” Amen, he’s right. The fact that people can’t cope with minor problems that clog up our emergency rooms is a really sad statement for people in general. I am out of compassion. I am out of it because of the 21 year old retard with his girlfriend who comes to my ER because he cut his lip with his own knee jumping up and down on a bed. He called his dad to complain that he was being ignored. He was being ignored because we had a full all-hands-on-deck code going on right next to him (that he could hear and if he wanted to peak around the curtain, see). This particular ER has only one doc working. Dad called to rip several nurses new assholes for the fact that his precious idiot son had to wait! The nursing supervisor had to break into PR/customer service mode and kiss this moron’s ass. Aside from compassion burn-out by previous example, another 50% of the people who present to the ER are psych problems with little to do with emergent medical issues per se. Unless mental health is going to be taken seriously we’ll continue to waste time on non-emergent problems that will increase wait times for both real and imagined problems alike…


  • Barbara Olson
    Barbara Olson

    April 13, 2009 at 12:53 pm

    Thanks for sharing such great insight, Kim! I was diagnosed with a PE in our local ED several years ago. It had taken me a long time to decide to seek care because I saw myself as young, healthy, and pretty much absent risk factors that would suggest something serious needed to be evaluated (despite pain that just wouldn’t go away for a length of time that, well, I think I’ll decline to disclose). I know people who work in EDs may not believe that some people hesitate to come, but some do. By the way, I think Keith was right. I finally decided to go to the ED because I was exhausted and overwhelmed trying to figure out what was going on by myself. I needed anticoagulants, but I also needed a break! Great post!


  • NumbersGuy
    NumbersGuy

    April 15, 2009 at 12:36 pm

    Hi Kim,

    Great post! It’s nice to hear such honest and inspiring ideas.

    I’m working on a huge salary survey for nurses and I was wondering what type of characteristics best distinguish nurses from each other?

    Keep it up 🙂


  • […] than doctors? April 17, 2009 “Nurses don’t have a monopoly on compassion,” writes Kim over at Emergiblog in a thought-provoking post about—among other things (including vintage nurses’ […]


  • Shawn
    Shawn

    April 21, 2009 at 2:05 pm

    Re nurses and compassion – not only do we not have a monopoly but sometimes I wonder if we’ve got a black hole. We cry stress, burnout, overwork – true, but it’s no excuse for callous, rude, disrespectful behavior. Nurse Ratchet (and no offense to that blogger) lives in way too many of us.


About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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