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Archive for April 27th, 2019

Time to Write

Finding time to write is always a challenge when I travel for work. My days can be long and exhausting and, all that swirls in my head is the clinical education that I am providing. It is very rewarding to work with nurses around the country. And I say this even more emphatically, since Washington State Senator Maureen Walsh said, “Nurses probably play cards for a considerable amount of the day.” This week in my assigned hospital as a clinical educator (for a medical product) I started the staff training in the ER. When I entered early in the day shift, it was obvious the ER rooms were full. Staff scurrying everywhere. Rushing with medication, intravenous bags, bags of blood and pushing patients for testing or to other units. I was able to get a few nurses together to hear the in-service and train on the new product when staff, came rushing into the ER with a patient laying partially in a wheel-chair as other held his legs and lower torso while running him into an ER bed. This talented staff were doing chest compression as they were rushing him to get help. The small group I had rounded up had to respond to the code, and the in-service was no longer the priority. I told the secretary, “no worries, I will be back later when things calm down.” So off I went to each unit in the hospital to train nurses for the upcoming “go live”.

As I entered each unit, I often found no one sitting at the nurse’s station. Looking around, I wondered if they were hiding somewhere playing cards. I gently knock on a dictation room door, and no one was there. As I walked down the hallway. I found the computer charting stations empty. A few had signs there was once someone there. A bottle of water, a scrub smock hanging on the back of a chair and a collection of pens and papers. Passing the patient rooms, I could hear voices. The voices were comforting, some laughing, some encouraging, and one doing her best to re-orient a confused patient. As a nurse for more than three decades I am always filled with pride when I hear the compassion, caring, and intelligent voices of our nurses.

After rounding to all the nursing units on four floors, I returned to the Emergency Room. As I entered, I was greeted by several nurses who said, “Better timing, we have been watching for you.” Feeling a pleasant relief and an “aaah,” feeling in my heart, I restarted the in-service. Not even a minute into it the training, a loud overhead page rang out through the ER, “Emergency Response Team, out-patient infusion center.” Two of the nurses I was training jumped up and moved quickly out of the ER. I continued with the two nurses left. It only took another minute for them to get a call on their pagers. The one nurse looked shyly at me and said, “Sorry we have to go and prepare a room for the rapid response. Maybe tomorrow.” “No worries, I am here all week.” I called after them as they ran off to prepare for their new incoming patient.

I am not sure what Senator Walsh was referring to since I also train in small rural hospitals. An often you may only have 2 to 4 nurses in the hospital (depending on size) to handle all that occurs. This includes the emergencies, and the patients admitted. I can spend more time there then I do in a full-service hospital with 175 beds. Why? Because they have no backup, they may not even be able to get a break when their patients are very sick and unstable. They would welcome an in-service so they could sit down for just a few minutes. Yet, it may take more than an hour or two before one of them can free themselves long enough for a seven to ten-minute in-service. I always tell them it is five minutes without questions and seven to ten minutes with questions. Nurses are intelligent, they ask great questions and strive to understand how this change impacts their patient and the care they give. They embrace changes that support improved care and improved outcomes for their patients. They recognize changes that are a redundancy that slows them down and may create a new pitfall for the patient.

I feel blessed and grateful, the product and change in practice, I am training them on is a real winner. They have been excited to implement the new product for the benefits to their patients and to improve their ability to give quality and compassionate care.

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