I have done what I do for over 30 years. I have learned more than I thought my brain would hold. I have had experiences that I wouldn't wish on my worst enemy. And times and things have happened that I truly wish I could recreate, over and over again.
One thing that has never changed? The buck stops here. And that is the hardest part of being a nurse. In the public's mind, a nurse is a nurse, is a nurse. White shoes, scrubs, stethoscope around his or her neck and voila! A nurse.
I remember working an evening shift many, many years ago. I was in nursing school, and I worked for the experience and for the money to pay for school. I was on the surgical unit that evening, taking care of patients who had recently had surgery.
Our nurse that evening was also one of our nursing school instructors. I admired her for spending her vacations from school working as a registered nurse in the hospital. She was keeping her skills current and that was the type of instructor I wanted to have.
Back in those days, the unit only had one or two registered nurses working the evening shift, augmented by an LVN, or LPN, and several of us nurses' aides. While those of us who were nurses' aides felt like we were doing the lion's share of the work, it was actually the registered nurse who was making things happen.
So, on this particular evening, as I was busy with my tasks, taking vital signs, changing sheets, taking dinner trays to patients, and dumping wastebaskets, I felt like I was very busy and working very hard. And so were my teammates, the other three or four nurses' aides. Actually, two of us were not nursing assistants, we were Student Nurse Aides: students in the nursing program hired to work on the nursing units as nurses' aides, gaining more experience.
The surgical floor can be a very busy place, as I was to find out after graduating from nursing school. Things happen in the blink of an eye and it takes a skilled eye sometimes to see the subtle changes.
This particular evening, nothing out of the ordinary was happening. One of the ordinary things that was going on was all the IV drips. Usually, more than half of the surgical patients had IV medications to be given, and that function was the exclusive domain of the registered nurse.
So there I was, working with and for one of my instructors. She told us we could call her Dianne, since she was working as a nurse and was not there as our instructor. I found some sort of evil delight in finding her and reporting: “Dianne, the IV in Room 23 is almost empty....” just to watch her scramble.
After doing so about six times, for six different patients, she looked at me in sheer frustration and asked me to slow the IV down. I had to remind her that I was only a nurse's aide and I could not do that. Even though I had done it many times as a nursing student, I was not there in that capacity and I simply could not touch the IV.
Should I have slowed down the IV drips, to help her out? Well, maybe I could have, but then, you have to remember: she was my instructor, and I was afraid of being kicked out of school for performing duties beyond my scope of practice. Not an imagined fear, either, as it had happened to another student in a similar situation.
That was back in the days when IV fluids were in glass bottles. Any additives had to be added by the registered nurse before hanging the bottle and connecting it to the patient. I did help her out by gathering supplies for her: putting the right additives with the right IV solutions, and setting out syringes and alcohol swabs for her. In the end, she was the one who had to make sure that the IV solution was correct, the additive was correct, and the drip rate was correct.
And frequently, rushing into a room to hang a new bottle of IV solution meant finding an IV that had to be restarted. Also a job for the registered nurse.
It soon dawned on me that, as a nurses' aide, I could see things, and report things, and assist the registered nurse as she did her job, but I always had someone else to report to. I always had someone higher up on the food chain to hand off the problem to. And so, I learned an important lesson that evening...
In the world of hospital nursing, the buck stops with the registered nurse.
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