I’d like to speak a bit on confidentiality. Confidentiality is incredibly important in my profession. Being sick is not something people like to be. Nobody is in their best frame of mind when they’re sick, and they often say or do things they regret. This includes doctors. Every doctor has their strengths and weaknesses and some of them cannot handle crashing patients. It’s not something that nurses talk about to make the patients or doctors embarrassed. We talk about it because we have to.  Call it venting, de-briefing, decompressing or just bitching.  

Walk through a hospital and listen closely, and you’ll hear patients being discussed everywhere. Elevators, cafeterias, hallways, even coffee shops close to the hospital. Nobody means to break confidentiality, and yet that is considered a breach.  Do you talk about your patients in the break room? Breach of confidentiality. Do you post a facebook status or twitter about your bad day because of a patient? That could be considered a break in confidentiality.

People have approached me about this blog, as they feel they know the situation I was describing, or they felt I was breaking confidence. In the situations where they felt they knew the patient/doctor/hospital I was speaking out, they did not. I change almost everything about the situation. I read and re-read the posts before I publish them, making sure that there are no identifying characteristics.
But, if you have a concern, e-mail me or contact me and I’ll be happy to discuss it with you.

 
Every nurse has it. The sixth sense; that gut feeling. The thing that tells them to check on their patient “just one last time” The ability to judge what is an emergency and what isn’t, even though the two situations seem pretty much the same.  It’s the thing we can’t really explain to other people. In school it’s called critical thinking; the ability to look at all facets of a problem and come up with a solution. In reality, it’s instinct. It’s the years of experience you have, plus the experience of other nurses you’ve worked with. Hearing about other people’s stories gives you the ability to recognize the same situation. Plus that little voice that tells you  “just check one more time”
I was working nights, about to go for my break. I gave report to the covering nurse, and was about to head down to the cafeteria to meet a friend. I decided at the last minute to check the vitals on a patient that hadn’t been doing that great. They had been having some problems protecting their airway. The situation appeared to have been resolved. The MD was aware of the situation, the RT was aware; the patient had been doing okay. When I checked, the O2 sats were 75% on room air. They were totally obstructing their airway, and ended up being intubated and going to ICU.
A fellow RN decided to do early rounds one night, and found a patient attacking another patient in a ward room.
Call it what you may, but nurse’s instinct has saved more patients that anything else I’ve seen. 

 
I have spoken a lot about the violence and abuse nurses are put through. As a nurse, that’s not what I carry with me. That’s not what gets me through the bad days. That’s not what I live for. There are a few moments that have gotten me through the worst days, the worst situations.  There are moments that make every bruise, every curse, every obscenity and every long day worth it. These include:
-a grandson bringing me a cup of tea after I cared for his grandmother when she died
-being told “you are a wonderful, caring person and are definitely in the right job, this is your calling”
-being introduced as “the nurse that knows everything” (and NOT in a sarcastic way!)
-getting an e-mail from a colleague that said I was the calm eye of the storm, and she was grateful I was there.
-Being told by a nurse that “I’ve never felt so supported, I’m so glad you were there for me”
and a million other little moments that I call on when I’m having a bad day.