I recently came across a horrendous story about a woman who went in for a C-section and woke up a week later with her legs amputated. Maybe you read about it, but if not basically she was in a coma after hemorrhaging and postoperatively developed clots that cut off circulation to her lower extremities. The amputation of her legs saved her life, but the story quickly explained that the problem could have been prevented had her extremities been properly assessed by the medical staff.
What an awful occurrence. As a mother, previous OB-GYN patient x3, and compassionate individual my heart went out to this poor woman and the unexpected and unfair circumstances she had experienced, but my mind also wandered to thoughts of her nursing staff. As I read the comments on the article my heart hurt even more for not only the patient, but those who had cared for her. That woman’s life would never be the same after this tragic situation, but neither would the life of her nurse.
The comments I read were so anger-fueled over the injustice of this happening and cries for retribution and the pursuit of a law suit were adamantly called for by most. Yet what I thought as I took it all in was, it could have easily been me.
And yes, I meant “me” as in a serious patient complication, but mostly I meant I could have been the nurse who dropped the ball and something bad happened as a result.
In nursing you are responsible for so much, and you take the life of your patient in your hands. It seems often that this little tidbit of information is taken for granted by the community at large, and they lose sight of how seriously difficult it is to be responsible for the well-being of another human being. Or six.
I work in critical care, so I’m typically responsible for the life of two people at once. That doesn’t sound too bad, right? Well, I’ll be completely honest with you. Sometimes two is one too many, and when I leave at the end of the day I’m just thanking God that nothing bad happened.
I’ve been in that situation where a crashing patient comes back from surgery and I cannot leave their side. You can’t even leave long enough to pee let alone go care for your other patient. In the back of your mind you’re thinking about them and hoping they’re okay. You have coworkers to help you, thank the Lord, but a lot of times they’re along side you helping you save the one who needs it most, or perhaps they’re in the same stressed situation themselves with their own patient load. Regardless, when something bad goes down with one patient you are only one nurse. You’re not immune to the laws of the universe, and you can’t be two places at once.
It’s regrettable, it’s unfair, and I certainly wouldn’t want to be the patient on autopilot, but on the other hand if it was my child dying I would want every competent nurse in the world in her room.
Some would say in those situations you reach out to your administration for assistance. “Get your patient reassigned, get more staff!” But the cold hard truth is that sometimes there’s no one extra to get. When you’re already working short you may just be at your maximum operating capacity, and you just pray nothing adverse occurs.
In critical care I am required to assess the circulation of my patient’s extremities every two hours. That’s best practice. Have I ever had a patient who I took to CT who coded in the elevator, then coded three more times before my shift ended causing me to perhaps miss a two hour assessment? What do you think?
The reality is that in a perfect world nurses can remember everything, never make mistakes, and not neglect their patients for even a moment. In this fictional world patients never fall (which happens in a split second), dosage miscalculations don’t happen, and nurses are never distracted from an assessment by another catastrophic event. Sadly I nurse in the real world.
In the real world no human being can be right 100% of the time, and mistakes happen frequently. You just don’t know about them because something horrible doesn’t result from it. But it could. So your nurse is the one who takes all that stress to bed with them. They cry in the car on the way home and utter, “thank you God that they didn’t die.”
It’s similar to parenting. You want to be the parent whose kid doesn’t fall out of a tree and break their leg or choke on a hotdog, but you look away one second and bam. The difference in nursing, though, is that you’re responsible for everyone’s kid, not just your own. So when you look away (cause sometimes you gotta look away) bad things could happen. Really bad things. Talk about stress on the job!
The thing is that nurses know the weight of their responsibility to the public, and they take it more seriously than you can ever imagine. They’re the ones who suffer under the irony of a calling that they love, but the fear that they will fall short one day. It’s a horrific tragedy when sentinel events like the one in the news story occur. In these instances a poor patient who placed their trust in their healthcare team is forever affected, but they’re not the only one. There’s also a caring nurse who loses their job, their license, their livelihood, and so much more.
The expectation on nurses is often times unrealistic, and when the ball drops it drops like a piano on the nurse’s head. Litigation ensues, careers are terminated, dreams are crushed, entire families are affected, and healthcare just keeps on trucking as one of its intregal, key members falls off the back. This is what every nurse fears. We all desire to be perfect, but deep down we know we could fall just as easy. When you’re operating at expert level with a beginner cache (because some circumstances make even the seasoned feel novice), it’s only a matter of time before you see Game Over flash across the screen.
So I read these stories like the one of that unfortunate fellow mom and I cringe. My heart breaks for her! But my heart also aches for the unknown nurse behind the scene who fell short his/her duties that day. I see the public outcry to tar and feather the healthcare crusader, and I ask myself again with trepidation, are you sure you’re up for the challenge? It could cost you everything you know.
*As a side note this post isn’t a debate of whether or not the nurse was negligent in this particular case. I won’t go there. This is a generalized post of the serious stress and responsibility nurses are under every day. That is all.