Stand Firm Even When Its Hard

I will preface this post by saying that, thankfully, no patient was injured in the making of this post. But they could have been, and I could have been in a lot of trouble. 

I want to encourage all of you young nurses to stand firm in what you were taught. 

I had a patient who dislocated his shoulder. No bid deal, we reduce shoulders all the time. But it does require conscious sedation, which means putting a patient under super fast-acting anesthesia, fixing the dislocation, and then waking them back up. It requires an ambu bag at bedside, it requires respiratory, the doctor, the primary nurse, and then hopefully another nurse or tech just in case. It requires serious drugs, good IV access, a monitor, oxygen, and consent signed. 

The other day, I went into the room to get everything prepared for the procedure so I could go get the doctor to perform the procedure. The doctor happened to see me go in there and he decided that I was ready, even though I was not. The patient was not adequately prepared and the consent was not signed. He asked if I was ready and I told him I was not. He said, "well that's ok, I'm ready and have a lot to do this afternoon." He took the medication, pushed it, and reset the shoulder in about 2 minutes flat. The patient woke up just fine and there were no negative consequences. The patient was discharged 15 minutes later. Happy ending, right? Yeah. But it maybe could have ended up differently. 

So what went wrong? 

1) The doctor did not abide by the policies and procedures put into place by the hospital (and the nation, but whatever)

2) The nurse (me) said she wasn't ready. But when push came to shove, I did not speak firmly enough. I let the doctor do his thing. 

3) The consent was not signed. What in the world could have happened to us, the patient, and the facility if something detrimental happened to this patient and it was discovered that the consent was not signed? 

Yeah, its serious stuff. There will be doctors in your career that will push you to do the wrong thing. Do not let them. You will (eventually) become a very respected nurse for standing your ground with bossy doctors. This doc was not in the right at all, he was very much in the wrong and did not listen to his nurse. 

And the patient could have died because of that. 

Don't be the nurse I was the other day. I didn't advocate for my patient in a time when the patient really couldn't speak for himself. And I feel terrible about that. Don't let that weight loom over your own head, don't let it happen in the first place.