Speak Up, Nurses!

March 27th, 2015 by

Successful NurseWhen the one who speaks the loudest and gets the response of the team is not providing safe or ethical care, whose responsibility is it to take the lead and advocate for the patient?

Is there a doctor on board?” 

I was on the flight to our honeymoon destination when the question crackled out over our heads.  My heart rate elevated.  I’m a nurse, not a doctor.

I waited.

“Is there anyone on board who has any medical training?” 

I looked at my brand new husband, who nodded in encouragement, so I got up out of my seat, nervous. I headed toward the nearest flight attendant. “I’m a nurse. Can I help? ” I say. In my head I’m thinking,  “I bet there is a convention’s worth of doctors on board right now and they’re all just gonna sit there and watch me blow it.”

“I think this girl is having a seizure.”

There she sat, a woman around my age, fair skinned, blonde hair, head turned to the side, staring, glistening mouth agape. It sure looked like a seizure. What do we do for seizures? Time them. Wait them out, and call 911 if they last longer than 5 minutes. In the hospital setting, we administer medication, if we have orders. What we do not do is what happened next.

A burly man appeared behind me shouting “I’m a retired EMT, I’m a retired EMT! Get something in her mouth! Does anyone have a tongue depressor?” He started grabbing for her face, pushing as near to her as he could. The flight attendants began to respond to his request despite the absurdity of the idea that someone would be carrying a tongue depressor in their bag.

Not confident of my skills at this stage of my career, from my squatted position by her seat,  I quietly said “No. Just time it and keep her on her side. Her pulse is fine.” Luckily, the girl’s eyes closed, she swallowed.  Pat, pat, pat. “Do you have seizures?” Her eyes welled up and she nodded. “It’s over now. You are ok. It was just a petit mal.”

The point of the story is this: 

the one who acted like he had the authority, got it. I, an active member of the ambiguous club known as “health care professionals” did not. I was afraid. I did not want to be the one taking charge- but I was the one who was qualified to do so.

It’s important for skilled nurses to take the lead when appropriate. It’s in our contract to report unethical and negligent practice. 

In this example, the quick end of the problem meant that I could just “let it go” when someone tried to initiate an outdated methodology.

What happens when a coworker’s practice is putting a patient at risk? In considering whether to speak up, we worry about our relationships with our coworkers, we worry about retaining our jobs and our licenses, and we worry about our emotional health as well. However, it is a requirement of our license to report unethical or negligent practice.

Even in a low risk, non-clinical setting, it’s important for skilled nurses to take the lead when appropriate. I may be the only person on earth who remembers that situation on the airplane, but if I had spoken up- perhaps that EMT would have learned something. (He also may have just shouted me down, but, even then, in the long term, what is that to me?

Who cares if I get yelled at?

If I’m in the right, then I’m not the one looking like a fool in that situation, and the patient get safe and appropriate care.) Perhaps if I had used my voice, the people in the surrounding seats would have learned something.

Perhaps they would have seen a person who was strong, and unafraid to defend the right of someone who could not speak for herself. They might have learned something about nurses and what it is we do and how we help. It’s time to recognize our worth, nurses. Stand up for the right of your patient to get the best care.

 

 

About the Author:

Sarah Heroman

Sarah Heroman is an RN, BSN who has found her niche as a school nurse in Texas. With almost 20 years of experience, Sarah is still passionate about the nursing field and enjoys mentoring and helping nurses continue to find the joy in their careers. She believes that a good nurse is able to combine the science and the art of nursing and find fulfillment in providing the best care for their patients.

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