Nurses are probably doing more than it looks like at any given moment. To an outside observer, it may sometimes seem as if nurses are doing things a non-nurse could do, but we are like ducks. We appear to be gliding along the surface, but what others don’t see is our busy little webbed feet churning like crazy.
We are not just giving a bed bath because the CNA is lazy; we are doing a skilled skin assessment. We are not just popping medications out of a blister pack; we are pondering why this or that medication changed and wondering if our patient’s new symptoms are medication-related, and we are filing away our ponderings for easy retrieval when things go wrong.
In my job-shopping adventures lately, I have moved from pediatric long-term psychiatric nursing to juvenile corrections. Apparently, my patient population of choice is kids with issues, in various nursing environments. I chalk this up to another thing on the long, long list of things I never would have experienced or known had I not entered that life adventure called nursing.
These are, by design, very different environments from the critical care hospital environments I spent the first 5 years of my career pursuing. In my interview for my current prison job, the Director of Nursing said, “Tell me your thoughts about the fact you will feel as if you are moving backward sometimes in your learning and career after the excitement of critical care.”
I responded without hesitation. “No learning is ‘backward.’ By definition, learning new things is moving forward.”
Yes, we chart all on paper. Yes, there is a lot of red tape. It’s a prison. Yes, there is a lot of low-acuity silliness.
When it comes down it, though, aside from the high-tech toys in the ER, there too I dealt with a similar amount of ridiculous paperwork (even though it was online) and arguably even worse low-acuity silliness. At least in the prison, no one is claiming that his acne is suddenly an emergency.
By the time I left the ER, I faced serious, concerning burnout because of the number of patients flooding in with totally bogus chief complaints. In the last month before I left, I triaged a patient who had sore feet because her shoes were too tight and was kicked hard by a patient who did not get Percocet for her mildly infected “spider bite.” In the ER, you have to see these people and worry about patient satisfaction and reimbursement. In the prison, I have autonomy to triage these complaints.
It apparently seems as if I have moved backward from shiny machines that go “ping” to being a med monkey, judging from the comments I receive from former coworkers, and I decided to write this post to encourage other nurses to try new things despite those attitudes. On analysis, stories like the tight shoes show that these jobs are often not very different at all.
I am definitely using my extensive critical care experiences, even if I look like a sedate duck. Yes, most of the things I see are low acuity; however, because I am a triage ninja, I can zero in on things that may be serious. You never know when an emergency will happen, either, and I can handle those. A kid coded at the psych facility I briefly worked at, and it was their first emergency in the history of the place. Critical care skills: used.
My objective is to make people think before judging themselves or others. If you are a good nurse, you can be an asset in any setting, regardless of your or others’ preconceived notions.
Photo credit http://www.flickr.com/photos/bithead/ via Creative Commons license