By Carrie Mortrud, RN
“…Weird day today in that I have had to do a lot of advocating. Major delays and much confusion throughout the whole day. It seems as though everyone is new to this today…..”
On Monday, the husband of one of my best friends wrote these phrases in his update to all of us about his wife, who I’ll call “C.” She just underwent her 5th Trans Arterial Chemo Emobilization (TACE) procedure. C has a rare form of pancreatic cancer, glucogonoma, which has no cure, only a treatment for symptoms. C has been one of my best friends since high school. We played the the same instrument in clarinet in band and went out for the basketball team.
I felt bad reading his post but also defensive. I replied back that while it doesn’t seem fair, it is part of his role. He needs to help the nurses and other health care professionals take care of C. If only 1:1 staffing existed. If only I could actually spend the time you need me to, the patient needs me to the doctor needs me to with your loved one. The truth is, I may have as few as one and as many as five other patients whose family expects and feels the same way. I need you to be my second set of eyes and ears. I need you to question me. As much as I hate it, I need that. More often than not, I am the last line of defense before harm occurs. Nurses and all healthcare professionals want to perform flawlessly. We want a clean record. We do not want to give the wrong dose of medication. We do not want to give the wrong medication to the wrong patient, or the wrong meal tray to the wrong person. We do not want to have to answer the same call light three times before we can deliver the pain medications your loved one so desperately needs. We don’t want to do discharge teaching as you are walking alongside the wheelchair of your loved one being wheeled to the front doors. Unfortunately, the system we work under sets us up to do just that. It’s a “Fail.” Every day, more nurses than not leave feeling they have failed one or some or all of their patients and family members. We are not supported with resources to care for you and your loved one as you should be. I am supposed to treat you and care for you as if you are my only patient, but that is never the case.
Just the other day I was talking to nurses who mentioned they were actually enlisting patient’s family members to help with patient cares and tasks. Flipping a pillow or readjusting a bedside table is one thing, but giving a bed bath or checking oxygen levels is NOT. Nurses assess skin for pressure ulcers during a bed bath, and it is not okay for family members to take vital signs. I won’t go as far as saying they were delegating or assigning tasks to family members, but in all reality, that’s what it is. The nurses said, “I don’t have time to do everything I’m supposed to do!” “I can’t do it all, someone has to yet there is NO ONE to do it.” This is unacceptable. I am calling on all nurses everywhere to stop delegating patient cares and tasks to non-hospital staff and stop delegating nursing tasks and RN specific tasks to non-RNs just to get it done. It is unprofessional and unacceptable as patient advocates to pass off cares to others rather than work and demand we have appropriate resources to deliver the cares ordered and necessary for our patients well-being. The more we participate in this injustice, the more we perpetuate the staffing problems.
I will work to change this practice and to hold those accountable who have caused this to occur. Until then, please, be C’s advocate and make sure every person who cares for her, knows what you know and more.