Week 8

Responding to Mary's comments: In what ways do you think this situation would have changed for the better had you really taken the time to find out what the underlying situation was? I wonder if the situation would have changed if you took the time to listen. Do you think that would have gotten him more agitated? Do you truly think it was your "instinct" to let him go AMA?

I think that my frustration level (not to mention the patients frustration level) would have been reduced if I'd had the time earlier in the shift to sit down and talk with him. If I'd found out his concerns at that time I could have called his friend earlier and that may have reduced his anxiety so that he could have slept. If he'd been asleep I would have had more time to spend with my other patients, alleiving their anxiety! I don't think he would have become more agitated, but that is a possibility. He was very tense and maybe wouldn't have been so ready to share his feelings with me earlier in the shift.

Was it really my instinct to let him go AMA? No, but you know how your mind works when you're frustrated and irritated? It would have been the easy way out, for me at least. As I said before, then my night would have run a lot smoother! But that's not the point of nursing care. Our focus is not on what will make things easier for us, it's what is best for our patients.

And, on that note: nurses are notoriously bad at caring for themselves. Look at our pay scales, our staffing issues, our general health! I think that most of that arises from our tendency to always take care of others. We feel we don't have the time to take care of ourselves, and we push our needs to the background. How many shifts have you skipped your meal break? How many shifts have you spent where you didn't even get to sit down or take a bathroom break? Some mornings I'll be driving home, wiggling in the car seat and realizing that the last time I voided was before I left home for work the night before! None of that is good for our bodies, our minds, or our souls. Reflective practice gives us a chance to look at situations once the immediate stress of the situation is over. It lets us really think about what our choices were and how a different choice may have led to a different outcome. It also gives us a chance to care for ourselves, mentally and emotionally, by releasing some of our emotions, thoughts, frustrations and irritations that might fester if not given a place and time for release.