Monday, September 14, 2015

NP Notified.

NP notified.

It’s a short note written by nurses to legally cover themselves from negligence. It’s a note that means that the nurse noticed something that wasn’t right or “normal” and the Nurse Practitioner was notified of this information, this change. It’s a note that means the Nurse Practitioner now has additional information they need to act on. It’s a note that means if nothing was done and the patient experiences harm that the Nurse Practitioner was liable, was negligent.

NP notified.

Critical lab values, vital sign changes, urinary output, ST changes, med reactions, etc. etc. etc.

NP notified.

As a nurse I had given the drug lasix tons of times. I never thought much about it. As a nurse practitioner, it was the first drug I ever ordered. I debated: Should I give it? Should I just give more fluid? If I give it will I hurt their kidneys? If I don’t give it will I hurt their heart? their lungs? How much should I give? How much is too much?

I don’t even remember that patient. I don’t remember who they were, why I gave lasix, or if they peed. I do remember that debate, though.  The first time I felt the burden on my shoulders.

NP notified.

Throughout my time as a nurse practitioner, I’ve had an average of 15 patients per shift. Let’s say that only 1/3 of those nurses charted that I was notified of something during those shifts. That means for every shift I’ve ever worked, there are at least 5 legal documents that say I was made aware of information and was legally responsible to act.

NP notified.

When I get to work I like to round. I like to see and examine ever patient. Look at their face, touch their body, see their wounds, observe their breathing, listen to their heart, see their monitor. I like to have a clinical idea of their body, of who they are.

Rounding takes time. Depending on the night it can take me anywhere from 1-4 hours. The other night  when I finished it had taken 3 hours. I finally had time to respond to all the calls, all the notifications that I had received during that time and I entered orders on all the patients.

NP notified.

Despite all the notifications, the calls, the exams, I miss things. Despite the legal responsibility and the expectations, I miss things. We all miss things. Sometimes they are small things, sometimes they are not. Some things are easily forgotten and we move on. Other things are not forgotten but can become a haunting of sorts. One that will visit us for a time, a long time. These haunting teach us and change us. They notify us that we didn’t act as we should have. The burden shifting its weight on my shoulders.

NP notified.

No comments: