Last night during a much-needed soak in the hot tub at Bear Creek Lodge my solitude was pleasantly disrupted by a six-year-old fellow lodger. Amidst technical debates over water-gun engineering and musings on the existential dilemma of needing two hands to add up one’s age, my new friend proudly announced, “And I just finished ski school….. I can do the “pizza!”
Ah yes, I thought, the ol’ snow-plow technique (that is, forming a wedge or pizza-shape with one’s skis to slow and control one’s descent down the mountain). I imagined the old familiar sensation with a smile. After the young man left for dinner with his family, I still could not shake the image of the snow-plowing skier from my mind. I have not skied in years, but… it was then I realized that I have been living with the sensation of digging in my heels all throughout my previous year of nursing school and that this tension I had carried around all year was…….gone! And it was not just the muscle-relaxing magic of the hot tub. I realized that I had found a sympathetic community here at Telluride and that I was feeling….. comfortable. Comfortable with myself as a “slow” student nurse!
Being perceived as “slow” in nursing school was a first for me, and though at the time I felt it was a short-sighted characterization I also did not feel like I could argue with it. I do like to take my time. Each near-miss or close-call feels like a mogul to me, scattered around the field of my workday, and I carefully snow-plow my way around each potential disaster. So many factors work against me in my pursuit of providing quality patient care. Surely I should not tolerate “being rushed” to become the cause of a nursing error!
I do feel the pressure in nursing school. We students idolize the speed and skill of rapid response nurses. When performing many of our procedures (such as catheter insertions of all kinds…), swiftness is merciful. But I feel there are times to race and times to put on the brakes. I love it when a hospital unit I am working on is quiet, peaceful, and….ahem…. boring. C’mon nurses, let’s admit it….. “slow” is a four-letter-word to some of us!
Yesterday John Nance paraphrased a nurse when he stated (referring to a cognitive strategy when dispensing medication from the Pyxis), “This is poison and going to kill my patient in 5 minutes if I don’t double check this!” The 3 Checks, The Six Rights, and other procedures designed to slow nurses down are not glamorous parts of the job, but they save lives. What could possibly be more important?
What I am suggesting is a cultural change. Florence Nightingale wrote, “The very first requirement in a hospital is that it should do the sick no harm.” I was involved in three good catches last semester, all of them clearly related to the need for others to slow down. High acuity and large patient workloads are indeed very real issues that constrain our time however my observations lead me to believe there are other factors at play such as a cultural norm of speed often at the expense of safety (for both the patient’s and often the nurse’s safety!).