This week I feel a bit more anxious and ready to start doing my own work. Thursday, I worked with a great nurse, but it was more “shawdowing” throughout the day. Since we don’t have access to computer’s yet, I’m forced to look over the shoulder of the nurse I’m shadowing, in order to get pieces of information as they appear on the screen. I could ask the nurse to pull up certain things on the computer for me, but I know the nurses are busy and need to get things done in a timely manner. So, in order to keep from stalling the nurse during her very busy day, I just peek over her shoulder and ferociously right down every little bit of information I can get from the computer screen…before it disappears from the screen. I know they have so much to do.
Don’t get me wrong though, I did learn a lot, and the nurse I was with gave me and Sam a lot of great pointers. But, I more or less tagged along behind her, as she checked off her to-do’s. One thing that occurred to me though (and that I later applied to my shift on Friday) is that I can break away, and get in there and talk with my patient’s. I can get information straight from the source. Sometimes it’s easier to bypass the patient and run to the computer for pertinent information. We forget that the best source is sitting and breathing, right in front of us. As long as the memory and brain remains intact, the patient has more information stored for recall then the information in the computer, that another person entered (and could have entered incorrectly). Of course, the patient may not know lab results or have the results from the urinalysis (which is changing, as the patient is gaining access to their own medical records via their online chart), but at least 80-90% of the information needed, like PMH, home meds, admitting dx, social history etc., can be obtained from the patient.
With those thoughts, Friday was a better day. With my lack of access to the computer, I forced myself to get into my patient’s rooms, and ask the best source (the patient) for pertinent information. And, I got exactly what I needed. This was a great process for me to go through, because as a nurse, this is how I want to operate.
In the second semester of nursing school, I had the same revelation, when one of my patient’s was trying to tell me and another nurse about the meds he was taking at home. The nurses from the night shift had disregarded what he was saying, because he was known to be confused at times. That night nurse paid the price for giving more attention to the computer orders instead of what the patient was trying to say. So, at the beginning of the shift, the nurse manager was in the patient’s room, instructing us to only give half dose of glyburide, to check his blood sugar prior to giving the med, and to make sure that he had food in front of him before administering the med. The patient was furious that his blood sugar had dropped so low during the night, and even more upset that no one had listened to what he was trying to say about his medication dosage. That experience taught me to listen to my patient’s, over what the computer screen or orders say. I realize that I can’t take matters into my own hands and give the dosage of med that the patient requests, but I can call the doctor about it, and advocate for a change. Most of the time the patient knows.
Not only can we as nurses, obtain a great deal of information about our patient’s when we take time to listen and ask questions, but it also allows time for us to build relationship’s with them, and show the patient that we care. Additionally, there may be crucial things they share with us, that they “forgot” to mention in triage. How may time do we ask about allergies, and the patient states, “I have no allergies, that I know of”. But then right before surgery as the patient is being transferred onto the stretcher, and we ask once again about allergies, the light bulb suddenly goes off in their head, and the patient says, “Oh, I forgot to mention that I’m allergic to some kind of anesthesia…..I think it’s called….propo…..propofol…or something, oh and I’m allergic to latex too.”
So, even with my lack of computer availability, I’m reminded once again to get to my patient’s, ask questions, and listen to what they have to say. Just like the good ol’ days, before computers.