Today I fulfilled a part of my duty as a nurse by being an advocate for my patient and her family.
Most importantly for her. I have a pediatric patient who has no voice of her own, literally and figuratively. Her family advocates for her care but what happens when nobody will listen to even them? I step in. It’s my job as a nurse to use my skills first and foremost to keep my patients alive and healthy and to “first, do no harm.”
What most people and sadly, most nurses do not understand is that our job as nurses reaches beyond the bedside. Way beyond to be exact. Mine happens to reach exactly 10 minutes and 42 seconds, four stop lights and 33 blocks beyond her bed. (For HIPPA purposes my patient is known to the outside world as “T-Rex” with her mother’s permission)
T-Rex came into my life over a year ago. I have worked with a team of three full-time nurses in her home, providing the best possible care that a little girl could have. Tomorrow one of her nurses says goodbye for the last time at 7PM. It will be the last time T-Rex will ever hear her voice, feel her touch, hear her soothing murmurs against a fevered forehead. She is moving out-of-state, onto new adventures in her career. Of course that leaves two of us who know T-Rex inside and out. We also share that same bond with her. While I am very sad to lose a friend who is a great person and nurse, life goes on for T-Rex.
Here lies the problem. I have worked nights with her for this time. The nurse leaving works days. I put in a petition to take over her shift so that T-Rex would have a nurse who she is familiar with during the day, caring for her. She is a complicated case with several co-morbidities and this change will be hard for her and I thought to myself, why would we put someone new with her when I can be with her during the day? There are other nurses who have worked with her at night. They can take my place. After being told by my DON to email a formal letter of petition to switch over to days, and to copy it to the human resource director, the answer they gave back was basically no. Not at this time. We’ll put you there when we can. I would LOVE to copy and paste the email I received but in the end it wouldn’t matter. That email and the answer I received are not the point to this piece.
The point is, I was and still am not happy with their decision. It’s clearly in my opinion and the opinion of her family and the remaining nurse, that not placing me on the shift that is open is detrimental to T-Rex’s emotional well-being. Which really people…isn’t that part of healing? Not just the physical, clinical part of nursing, but nurturing the spirit, the mind, the soul. I promised that little girl last night as we lay snuggling in bed that I would go in this morning and fight for her rights to be emotionally cared for. I knew I wouldn’t get a different answer, but what kind of nurse would I be if I didn’t advocate for her and her family? Speak my mind on what I felt was the right thing to do. T-Rex wouldn’t know though if I ever went. She can’t talk and supposedly she can’t hear. She would have never known. I made a promise though. Actually I made a promise seven years ago when I held my hand up at my nursing graduation and took an oath. The Nightingale Pledge to be exact:
I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician, in his work, and devote myself to the welfare of those committed to my care.
I walked into that office this morning, hands shaking because I have to admit that I’m not good at confronting superiors. I had T-Rex with me in my heart though this morning and once I opened the door to the office I felt a calm wash over me. I was doing the right thing. I was fulfilling a promise and more importantly I was fulfilling my duty as a nurse. In the end, I was promised that they would rectify the situation as quickly as possible and that I would be on the day shift as soon as they could find a replacement for me. Do I believe that? I told him I gave him a 50% chance of it happening right now. He was very nice and I like the man, but in reality the red tape usually wins. I did however leave him with two very important Nightingale quotes that I have carried with me since the first day I placed a stethoscope around my neck: “I attribute my success to this; I neither gave nor took any excuse” ~ Florence Nightingale “I’d rather die ten times in the surf, heralding the way to a new world, than to stand idly on the shore.”