Being transparent…time for confessions

I found myself feeling upset today, especially as we were discussing the case study. I felt so frustrated as a nurse when we were trying to figure out the accountable person for the patient fall. I felt like I had a weight on my shoulders. As nurses, we do shoulder a large portion of the responsibility related to patient falls. We talked this afternoon about how it is EVERYONE’s responsibility to help WATCH the patients in an effort to prevent falls.

I also confessed to my group that a lot of times I do not feel comfortable going to lunch when I am staffing. Why, you might ask? I know part of it is that it is hard for me to hand over control of my patients to another nurse, even if only for 30 minutes. So, I am working on that. The other part is that I work with a young group of nurses (young in experience), and so sometimes I am nervous about leaving my unit. I know that I need to build better trust. It will be one of my goals.

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Collections of random thoughts for the day

Loved the discussion on communication and the different styles. When we were in groups for the case study, it struck me as interesting that the behavior of the surgeon in one version was not “bad”, but it still changed behaviors, and not in a positive way. Also, I was thinking about how I would feel if I were Naomi or Tess? I was thinking it would be hard to “rock the boat”, especially in a time-sensitive situation like an operating room, and especially at the end of a long shift / procedure.

I really like what Cliff had to say about why do we keep trying to hide information, when he was referring to his operation record. It is so true. We are all so egotistical, proud, scared, and a host of other emotions.

I like the thought of looking at the hazards, and not just the extreme cases. I think we do not talk about near misses, and these are huge learning opportunities for staff, as well as for thinking about system improvements. I appreciate the comments around “mindfulness”, and especially the dialogue between Gwen and Terry. I think I probably see things a little differently than Terry, but that is okay. I think of it this way. If a nurse is not mindful, goes on with some tasks, rather mindlessly, there is an increase for potential error. However, if a nurse is mindful during these tasks, I believe there is less chance of error.

Moving too fast

Tonight, we were talking at happy hour about the case study presented by Gwen, with Gwen and some other students (some of my fellow UNC classmates). I mentioned I knew there was trouble when the physician “grabbed” the chart. This made me cringe, and I was thinking that we move too fast much of the time. How many pressures do you feel in a shift? It is so hard to not give in to those stresses.

I had seen the Lewis Blackman story previously when I was a training session with a HEN focused on Adverse Drug Events. Something that hit me this time was the administration of Ketoralac in spite of the black box warning. I can hear some of my colleagues saying something like “I didn’t know” or “I hadn’t read that research article, how would I have known?”. My answer to this is: ANYTIME you are about to administer, or order / prescribe, a medication, you should know 2 things: What is the intended effect? (Why am I giving this?) and What are the possible side effects?

I told Paul earlier that my head was just spinning with all of these ideas and thoughts. I can’t wait to hear more of the discussions tomorrow.

Renee

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