July…

It’s July. For some of you that’s no big deal. However, if you work in a teaching hospital July means something deeper… Darker…

The “brand new” residents begin their rotations…

Chaos ensues.

If you have had the pleasure of avoiding the July rush, you’re lucky. For the rest of us, there’s a sense of impending doom.

So many orders. Most make no sense.

-pediatric doses ordered for adults.

-level one head CT for “AMS” on your 98 year old patient with known dementia.

-12.5 mcg of fentanyl q3hrs for your chronic pain patient.

-one unit of blood for an hgb of 5.

-MRI of the ankle to look for osteomyolitis of the toe.

Many, many more orders from an alternate reality…

In this moment, it is your time to shine! You are the only barrier between your patient and a doctor that is still getting their bearings. You’re going to have to speak up, a lot. You’re going to have to advocate. You may even have to knock a new doc off their self-appointed pedestal (when they tell you you’re “just a nurse” please refrain from punching them in the throat).

You can do this. Take a deep breath and remember: you’ve made it through many July’s and you’ll make it through many more…

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A la carte

I work with different doctors almost every day. What I’m doing depends on the doctor I’m working with or which doctor I’m on the phone with at the time. It can be super frustrating.

Doctor A wants things done this way when they are in the department. Doctor B wants to do it a totally different way. Doctor C doesn’t care how its done as long as it’s done. None of the docs actually communicate their wants with the nurse until the nurse does it the way they don’t like. Oh, and Doctor D on the phone wants the test done with contrast but Doctor E ordered it without. As the nurse, I’m just supposed to make it work. It’s as if I should be able to read minds.

Sometimes it feels like doctors order from a menu when they give orders to nurses. A little of this, some of that, a few of those… I just wish we could all get on the same page. Let’s pick a method and stick with it. Why is this so hard?