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What is a NurseFail?  It’s a mistake. It’s a mess up.  Sometimes it’s a desperate attempt at perfection. Other times it is an accident.  Basically it’s a sad moment in nursing.  It’s a point in time where you have failed your patient, your hospital, your coworkers, your family, and your country, but managed to provide entertainment to the rest of the world.

10/28/11
1300

INCIDENT REPORT

EXPLANATION:

Ostomys can be a little tricky sometimes, that’s why I usually get someone to help me hold stuff down.  It was busy today & I couldn’t find anyone to help, so I just did it myself.  When I was all done gluing it on, I went to turn around & I didn’t seem to be moving?  I was stuck on something?  I looked down and saw the draw string to my jacket through the plastic ostomy bag, slowly being covering in ostomy juice, because I had obviously glued it in there.  A minor detail.

REAL FAIL: Gluing Yourself Into An Ostomy Bag

Looks like this mistake came with a souvenir?

PLAN FOR IMPROVEMENT:

Oh the old glued yourself into something dilemma.  Gloves, wrappers, old dressings, scissors, I’m sure it has all been done at some point.  I guess at least you had no choice but to notice this problem?  Good thing this wasn’t brain surgery.

Disclaimer: This piece of medical fiction is property of www.NurseFail.com.  This is a fictional work of the imagination of a sick individual, with the goal of making me laugh….And well?  You too.  This is in no way related to reality, think of it instead as a stretching of possibility.

If you were to be completely honest with yourself…is there a certain patient population that causes you angst, disgust or fear, without really knowing why? I had some reflection exercises recently in my Senior Seminar class that have caused me to look inside of my thoughts and my reactions to those very situations.

Boundaries come into use for many different reasons…safety, security, independence.

The exercise that recently got my attention was that of boundaries. While reading that section in our text, many different thoughts were running through my mind. The boundaries I have set with my mother in order for us to have a relationship, actually ended our relationship all together because she was unable NOT to cross those boundaries over and over again without regard. At that point in my life was unwilling to loosen the lines of the boundaries I had made out of stubborn pride and need…maybe now.

Boundaries come into use for many different reasons…safety, security, independence. There are physical boundaries like fences and doors to keep people in or out. Rules of conduct and behavior are boundaries in civil codes of behaving. The boundaries I set with myself in my own behavior have been helpful, but I didn’t ever think of boundaries as being a place of meeting and coming together—like the shoreline and the ocean…both needing each other to make the perfect picture of co-dependence in a good way.

The words that made me stop and think the most in my reading of, Heal Thy Self, was that our roles as patients and practitioners are similar…that we are not just in a role…we are in a larger field of human connectedness, of shared humanness. Shared humanness…interesting.

I tried to keep this concept in the forefront of my mind at work this week and it helped. When one of our beloved female ER docs—who is scattered and slow but such a wonderful practitioner and patient advocate—was driving me crazy because she was sooooo behind and patients were stacking up. I thought, “We are in shared humanness right now and I will not get upset.” I instead re-organized her charts and kept her on task…she realized what I was doing and smiled at me with a nod and said, “Thank you…” Prior to this I would have re-organized her charts and made sure she realized I had done it, and done it with some ‘tude….

Yesterday I had another opportunity to realize my misunderstanding and my need for and about boundaries. We have a population of alcoholics that frequent our ER. There is one man that can drive my emotions to a red hot steam in 5 seconds flat. I know this and I try to not take that gentleman and typically swap another nurse’s patient (one she is having a time with). As I saw the name of the patient coming in via ambulance—the immediate reaction that typically rises from me occurred—disgust.

I have thought about this over time and realized that this one man reminds me of my childhood and feelings of anger, repulsion and fear surface with those feelings. It took me a while to recognize this…Just as quickly as the feelings surfaced, the thought about shared humanness surfaced. As I recognize that for the patient’s best interests and mine, letting another nurse take him is usually the right thing to do…

Yesterday I chose another option. I took the chart and went to prepare the room for him. I prayed. I asked God to show me how to care about this person as His child…in our shared humanness…I asked God to show me what boundaries to place on his behavior and mine in our ER today without any of my own emotion behind them. Typically and shamefully I would do the bare minimum with him and give nothing of myself while doing it…I asked to see the boundaries as shifting and moving as needed.

When the patient arrived in his usual state and with his usual rude, foul-mouthed demands I watched him…I listened to my thoughts and let them pass without judgment…I felt my breathing quicken with my heart rate, I felt my face start to show disgust, but I said to myself…”Shared humanness.” I let the paramedics get him off their stretcher and onto mine and for the first time I noticed something in me—fear.

I could be him…my disgust came from the PTSD-type recall of seeing my father drunk and acting in this way over and over again while growing up…My fear was no longer that I could be harmed—because I was in control here—I had the power to make strict boundaries on this man’s behavior! The fear that I recognized now was that I could have ended up like this man…it was in me, the compulsion to drink….he could be me…shared humanness….

I prayed continually as I assisted him to change, offered him a washcloth and soap to clean up…and tended to the carrying out of MD orders. I prayed while he flung insults and threats at me and I continued to pray while I set boundaries that were fair and not out of my need…but both our needs…shared humanness…

I noticed that during my interactions with him I felt nauseous at times, SOB, and irritated. I felt my pulse race and my stomach clench. I prayed for strength…so much of this patient and my guttural reactions were related not to him at all, but to my cellular memory of home…BUT despite this, yesterday I was able to be present and focus on the care of the patient despite my need to flee. I noticed my thoughts, and reflected on them. I noticed the reactions physically and applied lavender oil to my wrists and neck…I breathed deeply and continued. I will most likely continue to swap patients when he returns again…but I am thankful for the exercises in this book I am reading for class that are allowing me to slowly chip away at the protective layer that I have built over time and to understand why it is there…and flirt with the possibility of thinning it out!!