When tackling any challenge in life the best place to start is to think of your "WHY". Your "WHY" is the reason you dig deep when things get hard, or the thing you look to when you are faced with difficult decision making. It was the first question my mentor asked when helping me decide about starting my own business.
The first part of my answer goes back to why I want to be a nurse in general. When I was about 13, I had the opportunity to shadow a nurse at the Keystone clinic. There was a young patient that day who had been skiing alone. She hit a tree and was rushed in for emergency stabilization. Not knowing anything, I watched as the EMT’s took her vitals and got IV access. I watch as Doctors called out orders. I watched the nurse hold the patient’s hand, look her in they eye and explain everything that was happening. I watched that nurse see, not just a patient, but a scared little girl who needed all of those medical procedures, but who also needed to be seen and given comfort and reassurance in that moment. It was then, that I knew I wanted to be a nurse. My why was to be there for patients to bring comfort and help while they were having the worst moment of their life.
The second part of my why came when my dad was diagnosed with terminal cancer. I loved being a nurse, but I was aware of some pretty serious issues within the healthcare field. Knowing about the issues was one thing, but sitting on the patient side and watch if play out really hit home for me.
"How Are You Feeling?"
In going to appointments with my dad, I noticed they often started with the doctor asking, "How are you feeling?"
“Pretty good” my dad, who always looked to be positive and upbeat would respond.
In actuality, my dad was losing his appetite, his energy, his strength, his motivation. He was bloated a lot, having GI troubles etc. My dad was looking to be positive and confident, but that wasn’t giving the doctor any information, or data that he could analyze or work with to understand, treat or manage symptoms.
At this point I would press my dad into giving the doctor more details. My dad would gloss over his symptoms, not wanting to sound like he was complaining, and the doctor would, offer some options that might help and then move forward. I personally wanted a more in depth conversation around how alternative therapies for symptom management and comfort that I had researched, could either help or negatively interacted with his current radiation, immunotherapy and drug treatments.
15 Minutes Is Not Enough Time
Instead of in depth, the entire explanation of where my dad currently stood in regards to his cancer, the options moving forward, the "do you have any questions", and "how are you feeling about it all" always took about 15 minutes. 15 minutes to explain, understand, digest and move forward with life altering decisions that affected my dad and our family.
As a daughter I truly felt like my dad’s doctors cared. They absolutely wanted to help my dad fight for life and have as much quality in the mean time as was possible. I also felt frustrated when they didn’t push my dad for more honest answers, really try to understand his specific goals and make sure that he really understood the gravity and consequences of what they were saying.
But there were also a number of times that orders for meds or images got missed, and my dad wasn’t sure if he would be “bugging” them or making a fuss to question the error. As a nurse, I knew those doctors had 20 other patients to see that day alone. In the background they were likely pouring over my dad’s labs, images and looking into the latest treatment options, and clinical trials. On top of that, there was always some new charting system they were trying to understand and navigate. There wasn’t enough time to really dig deep into what my dad was saying and not saying.
I understood all of this because it is the same system I navigate every day as a nurse. I knew how to keep track of my dad’s lab and vital trends. I knew how to assess his change in energy day to day. I could translate, “I feel pretty good” into, he used to be able to ski uphill 5 miles just to start the day and now a 2 mile cross country ski wears him out for 2 days, at which point the doctors were able to provide education around energy conservation and utilization in cancer patients. I knew how to advocate for my dad to be a priority and how to question errors in the orders to make sure they were corrected. I knew what assessment information the doctors needed. I could ask the right questions from doctors for clarification. I also knew what my dad’s specific and personal goals around his cancer were. I was able to debrief with my dad as well as my sister and mom after appointments to make sure the whole family understood what the doctor had said and were on the same page. We were able to utilize our time with the doctor more efficiently because I was a nurse.
The sad thing is, when I actually am at the bedside, there isn’t enough time to do for my patients what I could do for my dad. I have always done my best, and am very good at patient care, compassion and connection, but when you are constantly distracted by call lights, emergencies, and other patients, it’s really hard to be able to go in depth with every patient.
This is bad enough in the hospital, but when you are at the doctor's office, once you leave, it is hard to get back in touch with someone for more information.
What do people who don’t have a nurse in the family who knows how to question advocate, translate and debrief with do?
The Benefit of a Nurse Coach
I would like to show up for those patients. My why is to be there for my patients in the way that I tried to be there for my dad and in the way I wish someone in the medical field could have been there for us.
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