February, 2012 Archive

February 2, 2012, 11:37 am

(Not) Everybody’s Talkin’

Looks like someone has some explaining to do.

This photo has a very “Twilight Zone” feel to it.

The only thing missing is Mr. Serling.

Unless he’s standing at the other end of the table…

<cue theme music…>


The nursing blogosphere is on fire with the Amanda Trujillo story, but there haven’t been too many comments from our physician blogger colleagues.

Dr. Dean over at the Millionaire Nurse Blog, dedicated one of his The Best in Nurse Blogs: Amanda Trujillo Edition to the topic, and followed it with a discussion of nurse/physician/healthcare team communication.

Today, I found this post by Dr. Terry Simpson at Your Doctor’s Orders, entitled Transplant or Hospice. Dr. Simpson has some valid opinions as a physician.

Unfortunately, they are buried in a lack of understanding of a registered nurse’s scope of practice, overwhelming arrogance and the use of an image of the book “Angel of Death” to make his point.

Everyone needs to go read this post.

Go ahead. I’ll wait.

This is what nurses are up against on a daily basis.

Not all physicians.

Not most physicians.

But enough physicians.


The idea that nurses are supposed to just “take care” of the patient and defer all questions and education to the physician is mind-boggling.

Dr. Simpson posits that there is a time and a place to discuss end-of-life care.

And that the doctor is the one who makes that decision.


What happens when the patient asks about it?

“There, there Mrs. Smith, don’t worry your pretty little head about stuff like that. Doctor Welby will be in first thing in the morning and he’ll take care of everything. You just get some rest.”

Don’t worry that you will be transferred. Don’t worry that you will be undergoing extensive testing. Don’t worry about what a transplant entails or what it means for your life. Don’t worry about how old you might be or how involved your care might be or what resources you have.

We know what’s best.

Well, the doctor knows what’s best.

In your depressed, ill state, you can’t possibly know what you want or understand what it all means, or have the strength to make the right decision.

The doctor will decide when it’s time for you to know what you need to know.

Some doctors call that autonomy.

Whose autonomy?


So, I guess as patients, we have a choice.

We can wait, and only ask questions of our physician, who may, like Dr. Simpson, tell us what we need to know when we need to know it based on their professional judgement.

Or, we can ask questions of the entire healthcare team, including our registered nurse, and receive information and education that will enable us to have a discussion with our physician about our health and what we should do.

You know, exercise our autonomy.

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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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