Thursday, April 29, 2010

Your Career

There is no aptitude test to take before you become a nurse. The same is true, of course, for many other professions. Any idiot, fool, or halfway intelligent psychopath can wait their turn and go to nursing school, just like I did.

Therefore, fellow nurses, you may find yourself in difficult situations as you negotiate the twisted path of your profession. People will give you bad information. You will react appropriately, only to find out later that you may have caused harm, through no real fault of your own, but it will be on your hands.

This is the story I was told, by a lab technician who I can trust implicitly with everything: a blood glucose level of 526 is reported to a nurse. That's odd, because the glucometers don't even read that high; at that level it would just read "HI." As if it were glad to see you. Our glucometers are then programmed to prompt the user to report the result to a nurse or doctor. The nurse calls the doctor to get coverage for the very high blood sugar level, the lab draws a repeat level to run on their big fancy million-dollar blood chemistry analyzer, the nurse gives the patient a boatload of insulin, and then the lab calls.

The true blood sugar level isn't above 500. It's 220. And here's the kicker. It never happened. The blood sugar level of 526 was ignored because it was an accident that the patient was even checked; they had no order for glucose levels. Somebody checked the wrong patient, got a way abnormal lab value, and blew it off. The patient went untreated.

What went wrong?


If you are working in an environment in which things like this happen, there's really only one thing you can do. Quit and get another job someplace else.

If that is impossible, then make as many friends as you can among the competent people among the staff. Respiratory therapists are good friends. Lab techs, aides, and especially house-keeping people! Call them by name. Ask them about their families. Tell them when they do good work. Bow reverently to them.

They are all you have.

1 comment:

Eric said...

"Hi, as if it were glad to see you" ... made me laugh :-)