At the risk of inciting the wrath of every one of my colleagues and fellow nurses in North America, I've decided to write a blog about a phenomenon I noticed that has caused me great angst.
I was sitting in on in-patient rounds this morning, and I swear they gave me a decaf at the very expensive coffee spot on my way there, because I was tired and I was grumpy. I'm hoping that will explain my distress and that perhaps I've missed something here:
The doctor said to our physiotherapist: "Mr. B. came in yesterday with shortness of breath and a new cough. He has an underlying diagnosis of multiple myeloma. He needs to ambulate. Can you get him up today? He needs to keep moving."
The same doctor then asked the spiritual care worker: "Mrs. S. was just informed she is palliative and is going to need lots of support. Can you see her today?"
Another doctor asked: "Mr. L. has lung cancer and may need home O2. We need an ambulatory O2 sat on him. Can we page the RT to get that done?"
It appeared to me that we were calling in a specialty service for every aspect of patient care and support. The PT, OT, RT, SLP, dietician, spiritual care, palliative care, and pain team. It seemed to go on and on.
"Are you kidding me?" I thought to myself. I am the first to acknowledge that these people are all valuable members of our health care team, and I am an inter-professional care advocate, but where was the collaboration with nursing? No one asked what the nurses thought about these patients, and not one nurse offered a suggestion!
Have we farmed out every last bit of our expertise? Which piece of the patient care puzzle needs to be put in place by nurses? Why wouldn't we, as active and engaged nurses, be getting Mr. B. up and about? Why wouldn't we be providing support to Mrs. S. and her family? Calling the RT to get an ambulatory O2 sat for Mr. L.? Don't even get me started on that. Not one of these activities seemed out of the scope of nursing practice to me.
It may be that I've missed the forest for the trees and that nursing has an overarching role in all of these elements of care, but I have to say I just didn't see it on this particular day.
Has anyone else noticed this phenomenon, and if so, what should we do about it?
I'm hoping tomorrow will be a full caffeine day and I'll be seeing the nurses' role used to its fullest, as it can and should be.