Tag Archives: medicare

Nursing : A ministry of dignity

Nakieshabedside(image credit)

I’m up late. Tomorrow I’ll start working night shifts at the hospital where I work as an Acute Rehabilitation nurse. It’s just temporary through the end of the year when I’ll complete my BSN… finally ( it only took 18 years).

I’m up late doing research for my Capstone project. It’s about how the nurses at my hospital can implement change to prevent our often elderly patients from acquiring pressure injuries (A.K.A. bedsores).  And all this research has me thinking about what motivates nurses and how much healthcare in the U.S. depends on nurses.

Nursing is not a lesser version of practicing medicine. It’s a way of honoring the dignity and worth of another human being through giving wholistic care, instruction and resources for the person’s good. But so often, especially bedside nurses, loose sight of what it is they do, or rather they’re disillusioned by what they do.

The pressure on bedside nurses from  hospital managers and administrators is to perform complex, fast-paced deliver of tasks and medications and education… endless requirements all documented to a T in 12 hours. The pressure from the bed (patients and family members) is often (not always- there are many thankful and inspiring people in those beds) to provide 5 star resort pampering. The pressure from our peers is often to act like we have it all together, like we don’t need help, like we can do anything. And all this pressure has many nurses loosing sight of what’s really important: human dignity. Our own, and our patients’.

This is where, for me, being a Christian nurse is so freeing. The yoke of hospital nursing in America is heavy, but Jesus’ yoke is light.

I don’t have to please the system, or please the patient even, I have to honor the Imago Dei in every one of my patients. When I make human dignity the aim of my nursing care, all the rules and regs and complaints fall like broken chains.

There is a healthcare crisis in the U.S. The fastest growing portion of the population are over 65 and many don’t have the resources or support to get the care needed to live and die with dignity.  There is a shortage of nurses in the U.S. and many are part of that fast-growing retirement age. Chronic disease plagues half of our populous and many don’t get the treatments, medications, appointments and care they need. Center for Medicaid Services has lists and codes and rules that make navigating the healthcare system a daunting task.  Amidst the dark maze of U.S. healthcare, nurses who value human dignity are respites of light.

Dear nurse, I know you feel overwhelmed. I do too. But stop and remind yourself, you’re a nurse. Not a doctor. Not a medication-technician. And you’re not a slave to the hospital or healthcare company you work for. You’re a nurse. A minister of help, hope and heart. You are a minister of dignity. Our healthcare system is a mess, but that person in that bed, no matter how nice or how cranky, how dependent on drugs or how debilitated with cancer, is a person made in the image of God.  And like Daniel Darling wrote referencing his surprising response to Horton Hears a Who:

‘Yes,’ I thought, “every person really is a… person, no matter what their usefulness to society, no matter how seemingly insignificant they are, no matter what their stature.”
A person’s a person. What a thought for our strange and confused age. – Daniel Darling, The Dignity Revolution. p.14

 

I’m not a medication technician. I’m a nurse.

hospital-840135_1920.jpgI met him at the time clock.

“How are you?”

“Great, now.”  He smiled reaching for the barcode side of his badge to swipe out.

It was the end of our shifts. He worked the observation unit where patients stay in the hospital for less than 24 hours.  He admitted 4, discharged 4, so had a total of 12 patients that shift.  “Not that bad actually…” he reasoned.  Usually it was more like 16 or 18 patients a shift with the rapid turnover, or thoroughput as the hospital administrators like to call it.

We walked into the elevator together lamenting the fact that we have degrees in nursing-which is a theory of practicing healthcare that is born out of service and caring for the whole person- but we are defacto medication technicians.

We pass meds, answer call lights, document idividualized plans of care, Braden scores, BMAT’s, NIH scales, head to toe physical assesments (that we’re basically filling in the blanks for cause we literally had 55 seconds in the room before being called out to talk to Dr. So and So), intake and output, vital signs (because we’re short on nursing assistants), Functional Independence Measurement scores (in perfect detail after noon and before the end of the shift because Medicare thinks we’re forecasting care if we capture it in a chart before noon.  Newsflash Medicare: WE ARE FORECASTING. IT’S THE ONLY WAY THIS REQUIREMENT WILL GET DONE)… I could go on and on. But all the time we spend with our patients is mostly given to documentation and passing meds…. we barely get time to squeeze in a really good asessment, much less time to educate our patients, listen to them, and collaborate with others for their good.

We’re nurses, not medication aides.  But at the end of a 12 hour shift of being interrupted every 55 seconds we cling to making sure our patients all got their medications and all the required charting is done as the evidence that we did something meaningful all day. And we hate it. We don’t want to just pass meds and chart. We want to nurse.

Nursing is not an assistant to practicing medicine.  Nursing is a way of practicing healthcare. It’s wholistic. It listens. It touches. It serves. It cares. It instructs. It encourages. It finds resources. It researches. It collaborates. It leads. It values the image of God in people.

The healthcare delivery system in America, especially in hospitals, lays a heavy burden on nurses’ shoulders.  But if we can see the value of what we’re doing and go to the person in that bed in need of a person to help them get better and go home, or die with dignity, we’ll drop the baggage of the U.S. healthcare system and become lightbearers.

At the end of a long day spent, I pray I can say my focus was the person, not the system.

I’m not a medication technician.  I’m a nurse.