This post is on a different topic – kind of an eclectic mix of issues that have bothered me this week. To start, I know nothing about Microsoft, Bill Gates and how he managed the company or how Steve Ballmer manages the company but I heard something interesting regarding innovation and the ability of the employees to use innovative thought which helps with progress. The critique I heard was that Mr. Ballmer does not allow innovation and therefore Microsoft is not progressing. Regardless if this is true or not, I have no clue and I’m also sure this is an extreme oversimplification of the whole story.
Taking this issue to nursing, my career, I see this lack of innovation and total adherence to automation making it impossible for nurses to think anymore. Nurses are become robots, unable to analyze and be the advocate they once were. Hospitals are ruled by protocols which make it impossible to individualize care needed for that particular patient. Who makes all these protocols? I do not think it is the bedside nurse, the nurse who has the most knowledge regarding how to care for that individual patient.
Being paid not to think as a nurse is scary. I have been reprimanded several times for mundane issues - all because I saw a problem and wanted to investigate to improve the situation. Nurses are not allowed to do this. I was called into a meeting with 4 managers over the fact that I called the manufacturer of a product we use to inquire about removing the outer bag of the IV solution. The hospital protocol did not make sense and actually hindered patient care. I did find out the answer and I was right – I even provided all the information to the managers but that didn’t matter because the hospital protocol knows better than the manufacturer of the product. I was told that I had no right to contact the manufacturer to ask a question! And here I had thought that we should ask the manufacturer. Guess not!
Recently I was a patient in the hospital. I have chronic lung problems, part of my long term disability from being a caregiver for my child with intense 24 hour care needs. Every person needs to have and advocate for them when they go into the hospital. You must request that the nurses document things – if they are not written down, they were not done. I got in an argument with the ER Doctor regarding my oxygen saturation. Even though I could watch it go down into the 80′s and I knew I needed supplemental oxygen, this ER Doc told the nurse to take off my oxygen because I didn’t need it because my level was 98! That was one spot check after I had been able to clear my lungs and totally not indicative of my respiratory status. I started to get upset and he wondered why I was upset? I was upset because he was not listening to me nor was he listening to the nurses who told him I needed the oxygen. He just wanted to get me out of his ER.
I can’t tell you how many times the little red laser light read my bar code to put the medication that was going to be administered on the Electronic Medical Administration Record. Did the nurse look at the medication too and make sure it was the right one or are they all trusting the little red light and the bar code to do do the thinking for them. I don’t know but I’m not sure I like all this automation – makes the brain lazy!
Now, today, I heard the horrible 911 call from another nurse in a nursing facility. It is against the nursing facility protocol for the nurse to do CPR. The policy is if they find a patient unresponsive to call 911 and wait for assistance. The 911 dispatcher was pleading with the nurse to start CPR and even saying “you are going to let this woman die?” Turns out, yes.
What is this? What is happening? Are nurses so afraid that they will be in trouble if they do not follow the protocol that they let people die?
I just do not understand. I love being a nurse and I love nursing. Maybe though that is because when I started nursing, we were allowed to be innovative and were encouraged to think. Times have changed and I’m not ready to change with these idiotic policies that harm people.