Hands On.....

“So you’re going to be a Clipboard Queen, eh?” It was a surgeon who asked me that. I was leaving my position as Charge Nurse in the Operating Room to be a Nurse Manager on a medical-surgical unit in the hospital.

Though it is a slightly derogatory term, he said it with a smile on his face. I am sure that, if he really thought I was going to spend my time carrying around a clipboard, and checking off chores as they were done, he would not have said it.

I don’t know why, but I thought of that comment again today. I am a long ways down the road from that comment… I have left nursing management altogether and gone back to the real joy of nursing: hands-on patient care. I am, at heart, a bedside nurse. I know now that I have always preferred patient care. Perhaps it is because I detest bureaucracy but, that’s another

blog.

Today, I was visiting a patient and sitting on the bed, next to him, cleaning and redressing his PICC line. He is blind, and speaks only a little English. His three children were standing in the room, watching everything I did to their father. The room was silent except for my comments as I told the patient everything I was doing—before I did it.

The first thing I did, when I got to his home, was to take his vital signs. I have a routine for taking vital signs, and I include temperature, heart rate, respiratory rate, blood pressure, and heart, lung and bowel sounds. It is probably the most important part of my assessment because there are so many other things to be seen and heard while I do it.

I noticed today that, when I am listening to breath sounds and heart sounds, with my stethoscope placed here and there tocapture sounds, I tend to have my other hand on the patient’s shoulder. I like that. I am not only assessing the patient, I am connecting with him, too.

And I thought about how much I enjoy giving nursing care in the patient’s home. Instead of being “held prisoner” in the hospital, he is in the comfort of his own home. Instead of fitting into the hospital routine, he is in his own milieu and I am the guest. He doesn’t have to do anything I ask him to do….and it is incumbent upon me to teach him what to do and try to encourage him to do it.

I am alone with the patient, family and caregivers in the home. I do not have the “hospital culture” to contend with. It is not necessary for a nursing assistant to take the patient’s vital signs, I can do that. In fact, I prefer to do that. I have the skills and training to interpret what I am hearing and feeling, not just record them and move on to the next task.

Each patient seen today had vital signs taken and some sort of nursing care given. I cleaned and redressed the IV site, changed the foley catheter, or did wound care for each patient. As usual, I did teaching with patients and families. I seem to be teaching throughout the visits, as I am doing my nursing care.

And, as I was taking care of my patients today, I thought about all of that. I thought about that comment, made to me so long ago. And I thought about how important my hands are in the healing process. Skilled hands to do the important nursing tasks, yes, but also hands to offer the simple comfort of touch. Healing hands.

Without a clipboard…