Yeah, yeah, I know. We all realize the field of nursing isn’t a cake walk. Everyone has heard about or experienced the long, exhausting hours. Anyone with eyes realizes that short staffing is a problem. Of course, the expectations often heaped on bedside nurses, whether by administration or from the patient and their family, are many times unrealistic. The risks for communicable disease is ever-present, the harm to your back and knees is unmistakable, the wear and tear of your mental and emotional state is huge, regardless of your capability to handle stress. And we all know this. It’s frustrating. It’s hard, but it’s been this way for some time. We know. But even all these things aren’t the big whopper of what makes my job hard. Nope, not it. There’s something far worse.
Most of us have seen the reports out of Vanderbilt Hospital, but if you’re not familiar, a serious patient harm occurred. I won’t go into details, but here’s the link if you’re interested. Basically, a nurse gave the wrong medication to a patient. The patient died. A horrible death. The nurse was wrong, and she now faces criminal charges. She made a mistake. A very huge mistake.
I think a lot of nurses, like myself, when reading the news reports were quick to think, “man, how did she make that mistake?! No way I would have done that!”
But on the tail end of that train of thought was another. One we didn’t dare to ponder too long. Like, a bad juju, not gonna think about it, makes you cringe thought. In that secret place we whispered, “it could have been me.”
Yeah, maybe I think to myself that I couldn’t possibly make a med error that huge. But would I be lying if I said I never made a med error? Would I be kidding myself if I tried to pretend I’ve never messed up and later on, with my heart hammering in my chest, locked in the bathroom, thanked the Lord my misstep didn’t cause any true patient harm?
But here’s the thing guys. We can’t make mistakes. Yeah, we all have made at least a little snafu, where we overlooked an order or forgot something. We’ve been lucky enough not for it to be a huge problem, but it could have been. And that’s the hardest part.
Nursing is a career where you can’t mess up. You can’t make mistakes, because when you do, people can die. Like, really die. Don’t pass go. Don’t collect $200. Just go straight to Heaven, die. That’s a big deal.
I can remember when I returned to the critical care bedside after a two year, much-needed hiatus to hospice nursing following the death of my mother. Suddenly I wasn’t helping people transition to death. Instead I was striving to prevent death. Y’all, I was scared to death. I wasn’t a new nurse. I was a good nurse, with experience, but I still felt fear over returning to a field of nursing that required a high level of skill from myself. I would stand in the shower before work and just pray.
I’d say, “Lord, help me to hear your voice and do no harm!”
You know what? I still pray that every morning. The fear has dissipated over time, but the reality of knowing I hold life or death in my hands has not. I take what I do very seriously, as I should. I give medications that can start your heart if given correctly, but ones that can stop it if given incorrectly. And a lot of times with this stuff there’s no take-backs.
There’s no “oops, my bad.”
There’s just, “I’m sorry ma’am. Your husband didn’t make it.”
That’s the biggest difficulty in nursing. The monumental responsibility, the weight of something so precious on your shoulders, and the knowledge that the space for error is a very tiny one.
There are nights I’ve had insomnia and it’s tore me up. I went through two different stages of newborn babies with marathon breastfeeding sessions. I would wake up to my alarm, blurry-eyed, and hope I didn’t kill anybody. That sounds terrible, but in part it’s true. You can’t go take a lunch break much of the time, so it sure ain’t kindergarten. No naps allowed. If you didn’t get enough sleep, too bad. You better wake up and stay alert. No mistakes. No do-overs. No be kind, rewind. You fall asleep at the helm and you’ll crash the ship. It could be worse than the Titanic.
No, I’m not being melodramatic. That’s my job. Nursing isn’t the only job that deals in life and death. Many of my medical field counterparts feel the same way. There’s no room for error, it’s not feasible to make a mistake, and the fact that you’re human, and you can, and you do, isn’t an excuse. Nah, that’s not stressful at all.
The biggest difficulty in nursing is trying to keep your mind so sharp that you don’t make a mistake, but not thinking about it so much that it causes you to cave. I mean, if I thought about all the unintentional errors that could make me guilty of negligent homicide, I’d probably crack. Instead I just tell myself not to mess up. And I don’t.
But there’s always that little voice in the back of my head that says, “you could, you know. Mess up. One slip, one overlooked assessment, one mistaken order. It could be you.”
And I guess that’s probably good. It’s probably good that voice is there. A little fear is likely prudent. After all, I never want to assume it couldn’t be me. That’s when it probably would be. When my own pride and cockiness caused me not to question my own actions each and every day.
It’s weird, you know. I work in a setting where my confidence in my knowledge and skill set needs to be pretty high, but I also must never place myself on a pedestal of perfect. I am human, after all. So while nurses are superheroes in our own right, and ICU nurses are B.A., for sure, I also walk into each encounter with my eyes open wide, my ears ready to hear, my mind prepared to learn more, and always ready to receive the advice of that still, inner voice that tells me to beware. That voice is never wrong.