| The following editorial was originally published in 'The Agenda' a newsletter for ambulatory services nurses published by the advice nurse peer group committee of Kaiser Permanente Medical Group at Oakland Medical Center. At the time, Nurses Day 1993, there was an exacerbation of the undercurrent of division between RN and LVN and CMA it was my attempt to bring to mind the benefits of working in a team approach. |
In my 18th year I worked a variety of jobs. Digging ditches with Luke at 6 a.m., me frozen and asleep, him stoned on Robitussin and whiskey. I begged him to let me use the pickaxe and gave him the shovel to save both our lives. Four teeth in his mouth smiled back, "thanks kid". I cleaned cars for Avis (tried harder) cooked for Howard Johnson (36 flavors) and surveyed sewers for the city (all down hill from here). These jobs bestowed on me work group experiences I've not forgotten.
In the Navy I learned a skill and got more specialized in my work. Now, unable to simply hand over my shovel for a pickaxe, I still remain critically dependent on my team for survival.
Nursing school was less of a team experience. Each individual was ferociously struggling to achieve success in an independent fashion. The emotional winter among this group only rarely thawed into a real friendship. Thus primed, I launched my practice into the least anxiety producing area of specialty, psychiatry. I'd been a bartender before so I was comfortable giving drugs to stoners and listening to the stories of their lives.
Several years in medicine at the County General hospital, nights (to avoid administration), it dawned on me that I'd become a nurse. I thought about what I did, but also moved through the shift with instinctual clarity. A new nurse was observing an ostomy dressing change I was doing on a fiftyish female three days post surgery. The patient fearful and in denial stared expressionless at the ceiling while I worked. As I work I'm chatting with both the student and patient. "Know anyone with an ostomy?" I asked. "The guy in the grocery store, old man Grover, I think" she replied. "What about Steve McQueen, the actor?" I asked capitalizing on a rumor. "No, really?" came her reply as we first made eye contact. "Sure," I said smiling an invitation to get involved. "Life ain't over yet".
The student finished the dressing and later cornered me to say that what I had done was magnificent. Her formerly withdrawn and sullen patient was talking , active and animated. I was shocked and flattered to have my workmate make the effort to share her positive impressions. Reflecting on this, I know I haven't made enough effort to express my appreciation and gratitude for all the knowledge I've gained from workmates. How not to get hurt by violent psych patients, how to effectively chastise apathy, all learned from members of my team, not only from RNs.
I began my practice in an urban HMO 17 years ago. Once again at the bottom of the ladder of knowledge regarding outpatient care and patient management. I knew that the people with whom I worked would provide the information necessary to develop expertise.
My willingness to observe and learn from all sources, and express gratitude for shared information has worked well. Last week and urgent care doctor at my station for the day overheard me hardselling the benefits of a screening sigmo to a nervous patient who requested to see the equipment. "I should listen to you more often, I'd get better at convincing my patients" she commented. I chuckled and thought of the new nurse and four-tooth Luke. "Thanks kid", I replied "we are all in this together".
I certainly believe that licensed personnel should accomplish certain tasks. Only licensed drivers should operate motor vehicles. But we, as drivers, are all going the same place...down the road. We, as nurses, all have the same objective...quality patient care. We need to renew our effort to share the road and the knowledge we have from all our work experiences and provide the best patient care possible.
Happy Nurses Day 1993. I feel a great deal of pride to be on your team.