"Wrote some orders then charted vitals, meds and even I&O's. Felt like a real nurse again! But then tried to tell the doctor that my patient smelled ketoacidotic, received a very blank stare and the feeling promptly went away."I really miss being a nurse. I know, I'm still a nurse. But very little of my time right now is actually functioning in that capacity. In the states if I had told a patient's doctor that I was worried about ketoacidosis we would have had a dialogue, I would have possibly received some orders and I would have then done what I was told to do. Here, I first had to explain ketoacidosis, then explain why I thought the patient had it. Then I strongly suggested the things I thought "we" should do. Then I had to assure the doctor I would pay for those things. Finally, I could get around to doing the things that needed to be done.
So, what I actually miss is just following orders?! Seems strange but I guess it is true. I don't want to diagnosis and prescribe. And I don't want to doubt every order that I do get. But far too many times the meds they write for are a poor choice or they are missing key things that should be considered or addressed. They aren't looking at lab work or considering things like getting an EKG. They are content to wait 24 hours "to see if the condition worsens" to do things like an ultrasound.
I started this post early this morning but needed to stop to get to the hospital. Arrived there to find no doctors on. So I rounded on the patients I brought in and got updates from the night nurses on how things were. Wrote orders for labs, adjusted meds, updated family members and gave Mary her morning tube feeding. So, one of the many things I did this morning was actually a nursing responsibility.
Seriously tempted right now to see if Saint Mary's has any open nursing positions.......