the case that defined me as a nurse, how the case affects me and my practice
Introduction
As a nurse, we tend to find that the few experiences we encounter in our journey are more rewarding compared to gratitude from a patient or the patient’s family for the difference that one makes into the patient’s life. The nursing journey creates moments, which may be termed simple, but they act as meaningful reminders when it comes to the influence nursing practice has on people and the community at large and, ultimately, the nation’s health and beyond (Bodenheimer & Bauer, 2016). Nursing practice creates unique journeys, which makes it special and is usually made up of defining moments, which remain with individuals throughout their profession. Defining moments ranges from successes as well as failures that one encounters, personal experiences, and interacting with clients, among others. These moments can shape the kind of practice a nurse decides to pursue, the kind of care offered to a patient, and even the type of shift a nurse prefers to attend. This paper is going to discuss the case that defined me as a nurse, how the case affects me and my practice, and steps taken to overcome the stress of the event. The paper will also discuss the importance of debriefings, their application in the workplace, the people involved, the issues discussed, as well as how they help nurses deal with stress.
The Case
I was one and a half years of my nursing career under my belt, and this made me feel confident, especially in terms of skills and knowledge. During this period, I was volunteering at a local health center in a cardiac trauma unit. This unit focused on a target population of patients suffering from chest traumas, heart attack cases, stroke, heart failure, and chest pains, among other cardiac issues. Other nurses and I were in charge of monitoring the patients in our unit as well as complete their serial enzymes. During this period, I was working on the night shift from 6 p.m. to 2 p.m. I had three patients to monitor, a patient who had suffered a stroke, another patient with end-stage heart failure, and another patient who was admitted that morning because of chest pains named Judy.
Judy was an obese white woman in his mid-fifties with a history of dyspnea and hypertension. Upon her admission, her file read that her first set of enzymes and EKG tests were negative, and the suspected diagnosis was issued with the gallbladder. However, it was protocol to monitor the patient for a few hours and run some more tests. Judy was what we called a ‘manipulative patient,’ but on paper, she was the easiest patient I had. I found her in her room sitting down with four individuals, which I later learned that they were her children and one grandkid, eating French fries and deep-fried chicken. I thought that what she was eating was not the best thing to consume with her condition, but I did not mention it. Moreover, although she had more than the allowed number of visitors, I did not raise the issue, I just advised her to take some rest and to press the red button whenever she needed me or had any issue.
When I was giving my report to the nurse in charge, Judy’s red light blinked on my alert gadget, and I had to rush back to her room. She complained of chest pains, and I thought this was because of the fried foods that she consumed earlier. I knew that the pain emanated from her gallbladder and not the heart, although it was protocol to follow the necessary steps when the patient complains of chest pains. I conducted a thorough assessment of the patient vital signs, EKG, pulse ox, pain assessment, and so on, and I also called the physician. The physician ordered another enzyme test to be conducted, and when the tests came negative, he ordered the patient’s transfer to the medical-surgical unit.
However, there were no available beds that night in the medical-surgical unit, and Judy had to stay in our unit. Throughout the night, Judy kept calling me using her red button with instructions such as get me some water, adjust my bed, get me more pillows, heat up my chicken, and so on. This went on the whole night, and I was dreading to see her emergency light on. My shift was over, and I felt relieved. The next morning when I reported for my shift, I found Judy was not yet transferred, which was somehow disappointing. Upon seeing me, she called me to her room and informed me that I should organize a private room where she will be moved. I was getting tired of her constant nagging. I walked out of the room and proceeded with my usual duties attending other patients. After 10 minutes, Judy’s emergency alert was on again. I went back to her room, trying not to seem angry, and she complained about chest pains. Despite my judgment, I decided to follow the protocol and conduct an EKG test on her. When I turned on the ECG machine, I noticed a big ST elevation, and Judy’s heart stopped. I froze for a second, but I managed to shift to crisis mode, I called the physician, and we tried to manage her acute MI. Fortunately, we were able to save her, took her to the cath lab, where they found a total occlusion of RCA. I thanked God that I had made the right decision of not assuming her condition, and despite my judgment and decided to follow protocol since if I had ignored her situation, she could not have survived.
Based on the experience, I learned the power of following protocols, the reason as to why they exist, and the significance of following protocols at all times. Protocols in the health care center are essential since they eliminate the possibility of human error and ensure that one is able to practice as per the evidence (Kang, Goodney, & Wong, 2016). Moreover, I learned about making judgments and how they do no play a part in our profession, where one is supposed to be caring, competent, compassionate, and knowledgeable. I previously judged Judy by her behavior, appearance, as well as my own arrogance, but she taught me a lot. The patient humbled me as a nurse and aided me to realize that we are not always right, and we should work based on evidence. Since then, I have also learned that I should accept individuals for who they are, and it is wrong to make judgments since the patient might not be having the same knowledge as I have. As a nurse, I have learned that I should be able to teach my patients and become a positive influence when it comes to dealing with clients. We all go through such defining moments, and it is our duty as nurses to protect and take care of our patients, accept what they are feeling, and reserve our judgments.
Debriefings
Debriefings entail structured discussions that are voluntary with the purpose of putting a situation that is abnormal into perspective. They are usually carried out in a period of 3 to 7 days during the critical incident when health care employees have ha enough time to analyze a situation and take in the experience (Oriot, Alinier & Alinier, 2018). Debriefings are important since they help individuals to gain clarity when it comes to a critical situation, which offers the experience to come up with a process for intervention or recovery. The role of a nurse can be stressful at times and isolating, especially when there are no critical or serious situations happening. When such situations occur, they are a need for debriefings in order to come up with the best intervention to adequately handle the situation.
Debriefings mostly occur in a health care center, especially in cases of critical incidences. Critical incidences can result in certain symptoms for a nurse such as denial, shock, sadness, anger, terror, grief, muscle tremors, depression, panic attack episodes, and confusion. A debriefing process is the best solution to handle such incidences since it aids in coming up with timely intervention methods to be implemented (Cheng, Morse, Rudolph, Arab, Runnacles & Eppich, 2016). There are certain key elements implemented in a debriefing process, such as critical incident stress management (CISM). This element offers support when it comes to assisting individuals to recover from experiences of abnormal distress during critical conditions.
In my workplace, debriefings are usually implemented when handling a critical condition. When a critical situation happens, the center requires more than just the paperwork to be considered o handle the situation. It is crucial for a nurse or any other health care worker to recognize when the process of debriefing is required so as to make sure that the team has the support that it requires to handle the situation. In my center, we all play a significant responsibility for enhancing support as well as services for both the employees as well as the patients and the teams supporting them. Debriefings are among the critical components that are inevitable and necessary in this medical field. Health care professionals spend a lot of time focusing on the betterment of the clients and forget to take care of themselves, and that is where debriefings play a part. They contribute to maintaining the wellness of the nurse, which includes less burnout, prevents PTSD, less sick time, and promotes the capability of functioning positively as a member of our team.
Conclusion
In health care professionals, especially nurses, we all have that wake-up call, a defining moment that makes us realize our role as caregivers. My defining moment helped me to learn a few things, such as the importance of following protocols, maintaining patience, and recognizing the power of human error. Such cases can be traumatic to an individual, which requires a debriefing process to ensure that one is able to recover from a crisis. Debriefings are important in helping individuals learn how to cope when faced with traumatic conditions.