Critical Care Exemplar

Question #1:

Theresa Brown’s experience during her first Condition A, a middle-aged woman with lung cancer, was surprising and troubling to me. The patient’s admission issues had already been resolved, so Theresa had a student nurse monitor her for the day, unfortunately the patient went into cardiac arrest and passed away. I think that dealing with a patient’s death in a similar situation would be very difficult for me.  The sense of guilt I would feel after approving a patient’s discharge, only to have them die a short time later, would be overwhelming.  As a nurse, I will have very personal yet appropriate relationships with patients.  Seeing patients die while under my care, after I have made a personal connection with them, will inevitably cause feelings of loss and responsibility.  In order to help deal with patient death, I will have to look at the big picture and understand that dying is a part of life.  Knowing that I have done everything in my power to help save the patient will help deal with loss. 

Question #3: 

In the chapter, Switch, Theresa Brown explains issues with how the hierarchy manifested on her floor, resulting in her request for reassignment to another floor.  She sums the situation perfectly in her quote, “But nursing is too difficult and too important a job for help to come with a hierarchy.” In one situation a difficult patient named David required IV antibiotics. Theresa called the IV team to put in an IV for David, they refused, even though it was essential for David’s health. Shortly after, the fellow on David’s case called the IV team, they responded and completed the procedure. The IV team choosing to ignore Theresa’s request could have complicated the patient’s life which is unacceptable. 

Egalitarian treatment in the book is shown in a different situation with David. The fellow treating David, Edna, needed to have a conversation with him about eating prior to a scheduled surgery.  David was adamant about getting some food, but if he ate, his surgery would not take place. Edna invited Theresa to come along for the meeting with David. Edna was effective in convincing David that it was better to not eat so his surgery could happen as planned.  Theresa was able to step in and did a better job at convincing David to not eat until after his surgery.  Although Theresa is technically lower in hierarchy, Edna still felt that including Theresa in this conversation would help the situation. 

Question #4:

A sentence that was particularly meaningful to me came from the chapter, Doctors Don’t Do Poop. Theresa Brown states, “The level of vulnerability, dependence, and fear experienced by patients in the hospital remains far outside the realm of normal, everyday life, and none of us want to imagine ourselves in that position” (127). Part of the job nurses must deal with is cleaning patients of bodily fluids when they are not able to do that on their own.  While these tasks may be difficult for nurses, they may be even more troubling for patients. People lose their dignity when having someone else help them do something as simple as go to the bathroom. Theresa Brown does a good job in simply summarizing how the patient can feel scared and vulnerable in these situations. As a future nurse, this is something that I will always take notice of when caring for patients. It will be important that I take care of my patient as a whole person with feelings and try to picture myself in their shoes. Having this empathy will help in creating a unique plan of care for each patient.

Question #5:

Throughout her story, Theresa Brown provides real life situations where she hates being a nurse, yet, also provides us with examples where she feels joy and pride through her practice. The thought of both loving and hating my future job is intimidating. I feel that the love and fulfillment of the job will overpower the difficulties of it.

Making connections as a nurse and being a person that your patients can trust to comfort them during difficult times will be very rewarding. The deaths of these patients that you have made strong connections with will be extremely difficult.  Along with creating relationships with patients, nurses also make connections with patients’ loved ones. Families of patients will often be appreciative of the support nurses provide to them when they are dealing with the helplessness of losing a loved one, but other families may express anger and place blame on nurses.  Both reactions from families are understandable but will affect my experience as a nurse differently.  Touching the lives of numerous patients as a nurse I will feel a sense of pride and accomplishment, but the workload of caring for over seven patients per shift may be extremely overwhelming.  Finding the right balance of caring for several patients, but not too many, will be another challenge in managing the love/hate relationship that I may have with my career.