Monday, July 26, 2010

Give a nurse a break…

As a soon-to-be nurse, I am already feeling myself becoming more sensitive to trash talk about incompetent doctors and nurses.  I understand that there are plenty of actual incompetent doctors and nurses, in the field, but, it seems to me, that people’s expectations for professionals of the medical field are a little off.  A bit much. 

So many look to doctors to fix them.  To heal them.  To make all their troubles go away.  We expect 100% perfection out of a profession, that is run almost exclusively on human power.  No computers to program to ensure consistency.  Even if computers are now used to dispense medications and such, there is still a human prescribing it, and administering it.  Plenty of room for error!

Humans fuck up.  They just do. 

The more time you spend in a hospital, the more you realize how common medical mistakes can be. 

In Joey’s short life, there were a few major mistakes made with his care. 

I noticed on ultrasound that Joey’s herniated bowel looked different than it had the week before.  The doc said it was nothing, in spite of my arguing.  Turns out, it was something, it was the bowel twisted on itself, and beginning to die.  I can’t help but wonder if it would’ve been different, had the doctor realized what I was seeing. 

In the grand scheme of things…it’s moot.  Mistakes happen…something was missed that may/may not have made a difference.

When he was three months old he was scheduled for a routine central line change.  The night before, when the nurse hung his TPN and lipids (his IV feedings), she mistakenly hung a paralytic anesthetic that is often used in the OR, to put patients to sleep.  The surgeon found the mistake the next morning when he saw us in pre-op. 

A mistake that could’ve killed my son at three months old, but didn’t.  Mistakes happen.

Then, when he was nine months old, just after transplant, he was in for another central line change.  One of the very well respected, transplant surgeons,(actually, the head of the department) did the procedure.  She nicked his lung, placing the line, and his lung collapsed.  It wasn’t evident until he was out of surgery.  To make matters worse, his body kind of freaked out, and went into DIC…which i don’t completely understand, but, he basically lost the ability to clot.  After surgery, transplant, and a collapsed lung, the ability to clot is pretty imperative. 

He bled out of of every single opening in his body.  Every wound he had, every healing scar, was oozing blood.  The site of the recent chest tube placement, to save his collapsed lung, was pouring blood.  The ICU nurse enlisted me to help put pressure on the bleeding sites, to try to get a few more hands to help.  They couldn’t work fast enough that night, no matter how hard they tried.  She was pushing huge syringes of blood into his body as fast as she could to keep his count up.  They encouraged me to call Jake, to let him know that his boy was dying. 

All of this stemming from a tiny mistake in the OR. 

In the grand scheme of things…it’s moot.  Mistakes happen, and he died two months later, rather than that day.  For which, I am thankful. 


I think what bugs me most, is that when some people (not all) do get that healing that they were expecting the medical profession to deliver them, they, then, give all the credit to God.  They sings his praises, and claim that the doctors and nurses were mere pawns in his game.

Which is cool…that’s  a mighty fine perspective, but, in the same breath, please don’t badmouth those same “pawns in his game” for a mistake that they might’ve made, or a diagnoses they might’ve missed. 

I know I’ve got a long way to go with this, and I’m sure my thoughts and feelings on the subject will evolve, once I’m a member of the team, and see things from the inside, looking out, but for now, I say…give a nurse a break. 

I’m sure I’ll need it!!


Tracy said...

I don't even know what to say. I have to disagree. I think of a mistake and I think of writing something down wrong in my checkbook, or forgetting to get eggs at the store. Not giving a baby the wrong IV bag.

We trust doctors and nurses way too much in my opinion. But I won't get into that.

Laura said...

A mistake that comes when you write or read something in your checkbook doesn't kill anyone, but it's the same *type* of mistake. You read something wrong or write something wrong. That's why there are safeties in place, but in our profit-driven healthcare system, healthcare facilities don't always hire the number of people they need to implement every safety. Doctors and nurses and staff WANT to give good care most of the time. There are so many systemic screw ups, you would be amazed. Usually, they go unnoticed or happen often enough to be written in a consent form under complications.

(Note: in the following rant, "you" is a general you.)I hate it when people feel like medicine should be 100% perfect. People feel that they have a RIGHT to go into a hospital and have a pain-free, perfect recovery. In reality, yeah, sometimes nurses have to turn you even if it hurts your broken hip (example from a lawyer friend who blamed the doctors and nurses for the pain his mother in law was in when she hurt her hip), and sometimes your symptoms aren't textbook. Get over it. Where would you be if you hadn't gone to the doctor at all? It really pisses me off. People think doctors are out to get them. There are some terrible ones, but stop expecting doctors to be God. If you're going to praise God when things go right, don't blame the doctors and nurses when things go wrong.

Okay, going to end rant before I write a book.

Christinie said...

I'm a nurse and I almost died from an ER doctor who was arrogant and incompetent, doesn't mean all doctors are bad, in fact another nurse saved my life by calling a doctor who was good. My personal doctor. All doctors and nurses make mistakes, and they aren't God. I personally check and double check myself when working, most doctors and nurses do.

It's kind of like cops some are bad doesn't mean they all are. Good luck to you!!

Kameron said...

Watching my mom spend SOOO much time in a hospital while I was growing up I saw many terrible nurses and doctors but I also saw many amazing ones too. No one is perfect, but when you are in a position where your daily tasks are a matter of life and death, you should be held to a higher standard. I know all people make mistakes, but when you know the impact your mistake can make, you have to be more vigilant than most.

I make pharmaceuticals. The samples I run and data I generate all go into final decisions on our product. If I am careless or don't double and triple check my results and report out information that is incorrect, patients can die. I take that very seriously. I'm not saying I don't ever f' up, but I am also accountable for my actions when I do.

Nikki B. said...

yeah...i didn't say all this to give myself an excuse to kill some dude who happens upon my shift.

i, of course, plan on being a responsible nurse, but, even responsible, double and triple checking nurses, are not above making a mistake, IMO.

i hope to god i don't ever make a life threatening mistake...but, i also realize, having spent so much time in a hospital, that mistakes do happen, and i would never consider myself incapable of it.

actually, if i did consider myself incapable of making a mistake...i think that would likely be more dangerous to my future patients!

Kameron said...

True dat Nikki! I know where you are coming from though. People do complain too much about their doctors and nurses. They are human after all. :o)

Dawn said...

As the mother of a medically fragile child, we've had our share of good and bad health care professionals.

Were there some medical mistakes made? Sure. Luckily none of them took her life. But I get what Nikki is saying. While we all make mistakes, most don't usually result in a life or death outcome. But we have to see that the doctor or nurse that made the error is still a human and humans are never perfect.

Also, I think there is a big difference between a mistake and negligence. That's where the distinction should lay in my opinion.