Friday, January 4, 2008
Run While You Can
I was advised to stay away from the office today when I came in - it was nothing I did but there was a massive thunderstorm brewing and it's best to seek shelter (elsewhere!) at times. So I quick finished up things with Susan and hit the road again. I say again because I was out at 7 am this morning doing labs as one of my patients had labs due a couple of days ago and it would have been nice if the facility had let SOMEONE know. The only ones who knew were the pharmacy who were looking for the results and made the person in my office anxious and that person wanted me to go RIGHT NOW yesterday afternoon and do the labs. I deferred that and called the pharmacist and figured out a situation that everyone was happy with. I find the wheeling and dealing of my job interesting, home care nurses have a lot more autonomy - a lot of doctors let you do what you think and they'll sign the order. It's changed my practice a lot, in the hospital you wouldn't think of doing things and then calling the doctor - but when my patient's central line broke - I pulled it, reinserted a peripheral so she could continue with her treatment, then called the doctor's office and negotiated a new plan of care until they could get a new one put in and then called the pharmacy to update them. And it's expected I'll do that. Part of the reason I love my job is it really makes you think - I have to come up with an appropriate wound dressing for a dialysis/cardiac patient this weekend as I was told to decide and write the order. And you learn constantly from the patients the best way to do a wound dressing or how to use an apnea monitor - I've passed plenty of information on to other patients and even doctors when I see a good idea or a better way to do things.