Once upon a time I accepted a patient assignment just to discover that one fella would be discharging home that morning. That’s pretty typical, and I dove in head first to help make the process go smoothly for this man whose biggest concern was going home to cuddle his dog.
The physician described to him a new blood thinner he would be going home with, and as the doctor left the room I cornered him in the hall.
“Do you have any samples in your office?” I asked.
I explained the cost of this medication was high, but the physician felt certain the patient’s insurance would be adequate to cover it. I wasn’t so sure, and before he had time to leave my unit I had called the man’s pharmacy and verified that indeed his insurance would deny coverage.
That’s the thing; I thought about stuff like that. So while it was my responsibility to make sure the patient understood how to take this new medicine and possible side effects or drug interactions, it also fell on my shoulders to make sure that when he left my floor he could actually fill the medication, and affordably.
Then there was the matter of a new little problem with a thing you might have heard of called Diabetes. There would be new discharge medications for oral, diabetic medicine, but also for sliding scale insulin coverage.
These were very good medicines to treat his elevated blood sugar, but I would be the one who happened to ask the patient, “do you have a glucometer at home?” or even, “have you ever administered insulin before?”
The answer would be “no.”
The fact is nurses play an integral role in patient care from the moment a sick individual enters the door, during their hospitlization, and throughout the discharge process. I work with some of the most compassionate, skilled physicians I have ever encountered, but they are also some of the busiest. The patient load under a doctor’s care is huge, and many important aspects will only be noticed by the bedside nurse. That’s just a fact.
The nurse is the one who insures a patient isn’t being set up for failure at discharge, making certain educational needs are met, medications are affordable, needed equipment is in place, social work needs are implemented, a safe environment is in place, and if a discharge home is appropriate overall.
What would the life for a patient look like if these needs were not met? Would you see readmission rates soaring? What about mortality rates following discharge?
Let’s say my patient was also started on new cardiac meds for his heart rate and rhythm, because he was. But let’s also say that all his previous, cardiac home meds were continued at the same dosage.
There’s a frequently misunderstood opinion by the layman that nurses simply give whatever medication is ordered by the physician, but this couldn’t be further from the truth.
Your nurse is actually the one watching your vital signs and labs to make certain a particular medication is appropriate and safe. Your nurse is the one checking allergies, drug interactions, and questioning doctor’s orders as needed.
Your nurse isn’t just a pill pusher; they’re your healthcare advocate. They’re making certain the medications ordered are needed, safe, and at the most appropriate dosage for your specific need. Then they’re relaying this to your physician.
What would life be like without nurses?
Would medication errors and drug interactions increase? I think so.
Who would be present at all times to answer questions after the physician quickly rounds?
Who would alleviate patient fears or offer emotional and spiritual support by holding the patient’s hand or praying with them when no family was present?
Who would remember to order a diet after a patient was NPO for a procedure that morning, or perhaps suggest that checking blood sugars might be a good idea for the diabetic patient on steroid therapy?
Who would notice the minute changes in mentation and suggest it might be the new medicine that is normally contraindicated in elderly patients?
Who would fight for pain medicines to be increased when they’re not working adequately, or call the doctor in the middle of the night when something didn’t look quite right?
Who would bring notice to abnormal lab results, acute changes on an EKG, or neurological decline before it became a bigger issue?
Who would do the little things that are actually big things to someone sick, like give baths, brush hair, or apply cream to a sore bottom?
When you think about it I’m not sure we could fathom a world without nursing, and while it honestly takes all members of the healthcare team working in conjunction to make patients better, the truth is a life without nurses wouldn’t be a quality life at all.
That’s certainly how my patient felt when I held his Beta Blocker and got the dose readjusted, or when I helped him obtain free samples of a much-needed medication prior to discharge, while preauthorization was obtained for his insurance. I’m sure he also felt that way when he received education for administering insulin before going home with just a vial and some needles.
One of my favorite things about being a nurse is when I am able to give my patient what they need to get better, when I am able to advocate, educate, and promote safe healing. I can’t imagine patient care without those things, and I don’t suppose my patients could either.