Huff Post Nursing Article

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touchpause13

touchpause13

nolite te bastardes carborundorum
10+ Year Member
http://www.huffingtonpost.com/kateri-allard/just-a-nurse_b_3881551.html

This came up on my news feed and I was curious what some of your thoughts on it were. This was the part that I really didn't quite get:

A friend cut their arm and hours later still struggled to stop the bleeding. I assessed the wound and created a pressure dressing out of the supplies you have available in a frat house cottage. I reluctantly informed the friend that the wound would likely need a stitch or glue. It wasn't large, but it was deep and wide and would likely heal poorly, if at all, and even if it didn't become infected would leave a decent scar. I am not one to jump to big medical interventions; if anything, I ride the line of noncompliant and under-concerned.

My opinion was shared but another guest, a doctor, decided it would probably be fine with a Band-Aid and heal without issues. He may be right, or I may be right. But a close family friend who I have known almost my entire life chimed in.

"No offense, Kateri," he said, "But obviously we're going with the doctor over the nurse for this one."

"You're just a nurse," he might as well have said, although he didn't.

I felt like I had been smacked in the back by a two-by-four. My best friend knew this would be my reaction and turned in horror as the color left my face and the posture left my shoulders. Something inside of me sunk.

Too me I think she's being over sensitive. My nursing friends are eating this article up like halloween candy. Am I just being callous?
 
It is an overreaction. When dealing with a diagnosis, you go with the doc over the RN. For an arm cut, maybe not the radiologist over the 15yr NP from the ED fast track. But a doc over and RN? All day

And no, doctors and nurses don't work on a plan together.

And no, loving your patients as a nurse doesn't make you any more special than all the other fields that love their patients.
 
Nurses are obviously vital to health care. I'm sure the vast majority of nurses are intelligent, hard working, and caring, and I'm sure some people would legitimately be more fulfilled by being a nurse than doctor. It would be nice if the nursing profession could accept what and who they are instead of constantly trying to compare/equate/whatever themselves to doctors (this article, many more articles/countless studies, nurses having a white coat ceremony etc.).
 
I was kinda offended by "we're gonna go with the doctor over the nurse for this one." It implies that they wouldn't for everyone. **** them.
 
JP2740 said:
I was kinda offended by "we're gonna go with the doctor over the nurse for this one." It implies that they wouldn't for everyone. **** them.
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Wouldn't you almost always take the doctor's plan over a nurse's?
 
touchpause13 said:
http://www.huffingtonpost.com/kateri-allard/just-a-nurse_b_3881551.html

This came up on my news feed and I was curious what some of your thoughts on it were. This was the part that I really didn't quite get:

A friend cut their arm and hours later still struggled to stop the bleeding. I assessed the wound and created a pressure dressing out of the supplies you have available in a frat house cottage. I reluctantly informed the friend that the wound would likely need a stitch or glue. It wasn't large, but it was deep and wide and would likely heal poorly, if at all, and even if it didn't become infected would leave a decent scar. I am not one to jump to big medical interventions; if anything, I ride the line of noncompliant and under-concerned.

My opinion was shared but another guest, a doctor, decided it would probably be fine with a Band-Aid and heal without issues. He may be right, or I may be right. But a close family friend who I have known almost my entire life chimed in.

"No offense, Kateri," he said, "But obviously we're going with the doctor over the nurse for this one."

"You're just a nurse," he might as well have said, although he didn't.

I felt like I had been smacked in the back by a two-by-four. My best friend knew this would be my reaction and turned in horror as the color left my face and the posture left my shoulders. Something inside of me sunk.

Too me I think she's being over sensitive. My nursing friends are eating this article up like halloween candy. Am I just being callous?
Click to expand...
So a nurse is shocked, that a patient believed the physician whose job is to diagnose and treat over a nurse, whose job is neither of those things. If "he may be right or I might be right", then why are you offended when the patient thinks that you are wrong? You should care about what's best for the patient - not your ego.
 
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Sounds like every uppity PICU nurse I've ever met.

And as to the laceration at home, whose opinion to trust - doc vs nurse. I'd say it depends. Surgeon or ED doc over RN? Definitely. ED RN vs most other medical fields - probably would go with the nurse actually just for sheer experience.

However, her wound assessment skills were made apparent to me when she described crafting a pressure dressing. The only pressure dressing needed in a situation like that is gauze/towel/whatever and sustained direct digital pressure. It's a nurse special to put giant (ineffective) pressure dressings on wounds.
 
touchpause13 said:
I've read that before and really enjoy it. That pretty much sums up all my feels about being call a nurse
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Yes. The comments on that one (not just on slate as it was copied on other websites) are hilarious. Yes, a physician who did 4 years of college + 4 years of medical school + 3-7 years of residency, would rightfully be pissed for being called a nurse (assuming a BSN or RN), solely based on her gender.
 
SouthernSurgeon said:
Sounds like every uppity PICU nurse I've ever met.
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Yes, but she's a Pediatric ICU RN, WITH a social media presence on Twitter and a Huffington Post article to boot (I wonder if she was a physician if she would have gotten the article printed --- then the Huff Post editors would have to weigh offending one special interest group, women, over another special interest group, nurses (specifically unions).

Give that woman a NY Times opinion health column!
 
DermViser said:
Yes, but she's a Pediatric ICU RN, WITH a social media presence on Twitter and a Huffington Post article to boot (I wonder if she was a physician if she would have gotten the article printed --- then the Huff Post editors would have to weigh offending one special interest group, women, over another special interest group, nurses (specifically unions).

Give that woman a NY Times opinion health column!
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Psh. She has fewer twitter followers than I do, and I don't pretend to be a blogger or market myself as such.

Huff Post publishes a lot of click bait.

Color me unimpressed.
 
SouthernSurgeon said:
Psh. She has fewer twitter followers than I do, and I don't pretend to be a blogger or market myself as such.

Huff Post publishes a lot of click bait.

Color me unimpressed.
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Yes, I was being sarcastic. I figure if Teresa Brown, RN can get a NY Times column (writing about bullying by doctors, not realizing she's bullying them by putting an incident that happened at her hospital in her column) then the standards are quite low.
 
DermViser said:
Yes, I was being sarcastic. I figure if Teresa Brown, RN can get a NY Times column (writing about bullying by doctors, not realizing she's bullying them by putting an incident that happened at her hospital in her column) then the standards are quite low.
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Sigh. I made the mistake of looking up her blog.

She defends her "just a nurse" article by clarifying that in her role as a PICU nurse she has more experience evaluating patients than any resident and more than most first/second year fellows.

Typically arrogant and lack of awareness of how much training we get. Everyone wants the expertise, they just don't want to work for it.
 
SouthernSurgeon said:
Sigh. I made the mistake of looking up her blog.

She defends her "just a nurse" article by clarifying that in her role as a PICU nurse she has more experience evaluating patients than any resident and more than most first/second year fellows.

Typically arrogant and lack of awareness of how much training we get. Everyone wants the expertise, they just don't want to work for it.
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The comments are hilarious:

Thank for your post! I am a RN also and I got tired of the “just a nurse” image. Long story short, I was at the top of my class in nursing school so I decided to go to medical school. I got into a respected DO school but I decided last week that I won’t be returning for my second year. I now fit the saying “couldn’t cut it in med school” but who cares! I doubt any of my classmates could cut it as a good RN!

An IM resident who posted:
“My handwriting is too good, and besides, I like doing actual work.” Actual work? I wish I could do 3 12-hour shifts a week taking care of 3-4 patients each shift, instead of pulling an 80 hour week taking care of 20 patients at any given time. Go f[redacted] yourself, people like you just make nurses look silly and like they have massive inferiority complexes. Signed, A Doctor

The rest of the comments were all a different form of "You go girl!"
 
DermViser said:
The comments are hilarious:

Thank for your post! I am a RN also and I got tired of the “just a nurse” image. Long story short, I was at the top of my class in nursing school so I decided to go to medical school. I got into a respected DO school but I decided last week that I won’t be returning for my second year. I now fit the saying “couldn’t cut it in med school” but who cares! I doubt any of my classmates could cut it as a good RN!

An IM resident who posted:
“My handwriting is too good, and besides, I like doing actual work.” Actual work? I wish I could do 3 12-hour shifts a week taking care of 3-4 patients each shift, instead of pulling an 80 hour week taking care of 20 patients at any given time. Go f[redacted] yourself, people like you just make nurses look silly and like they have massive inferiority complexes. Signed, A Doctor

The rest of the comments were all a different form of "You go girl!"
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Good lord....
 
I know what could bolster whatever sunk inside you when you heard that: 4 years of med school & 3+ years of residency.

We live in a ridiculous cultural environment, where everyone needs to be treated atom for atom exactly the same, regardless of merit or virtue. You're a nurse, he's a doctor. You made your choice, as did he. Learn to accept that.

Edit: @DermViser beat me to it.
 
I don't really get the M.D. outrage on this thread. It's a blog post about some inconsequential incident that leaves out a lot of facts (was it an ER doc/dermatologist who said "put a band aid on it" or a radiologist/pathologist who hasn't dressed a wound since med school). She might have made the better call than the doc. Either way, who gives a ****? There are so many more controversial aspects of healthcare that you really have to go out of your way to have some semblance of outrage over this.

My $0.02
 
BurghStudent said:
I know what could bolster whatever sunk inside you when you heard that: 4 years of med school & 3+ years of residency.

We live in a ridiculous cultural environment, where everyone needs to be treated atom for atom exactly the same, regardless of merit or virtue. You're a nurse, he's a doctor. You made your choice, as did he. Learn to accept that.

Edit: @DermViser beat me to it.
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I think @southernIM hit the nail on the head. Everyone wants the expertise, they just don't want to work for it.

Reminds me of "Everybody wanna be a bodybuilder, but don't nobody wanna lift no heavy a$$ weight!"
 
Jabbed said:
I don't really get the M.D. outrage on this thread. It's a blog post about some inconsequential incident that leaves out a lot of facts (was it an ER doc/dermatologist who said "put a band aid on it" or a radiologist/pathologist who hasn't dressed a wound since med school). She might have made the better call than the doc. Either way, who gives a ****? There are so many more controversial aspects of healthcare that you really have to go out of your way to have some semblance of outrage over this.

My $0.02
Click to expand...

If it were one crackpot's opinion, it would be one thing. But I'd argue the blogger's attitude is emblematic of a much larger problem in medicine - the devaluing and tearing down of the physician.
 
I see there is still a pityfull discusion going on about who is the clever one. Now let me “read’ to you a important part of this fabulous blog again:
I am the eyes, hands, and feet of the physician.
I am not their eye candy or their inferior.
I don’t stand up when they enter to room.
I don’t follow their orders, I discuss the pathophysiology of the patient’s condition with them, and together we make a plan.
Often the things I suggest are the course of action we take and other times I learn something new I had not understood from this doctor.
They don’t talk down to me; we discuss things together.

I should frame this, it's so touching.
 
Jabbed said:
I don't really get the M.D. outrage on this thread. It's a blog post about some inconsequential incident that leaves out a lot of facts (was it an ER doc/dermatologist who said "put a band aid on it" or a radiologist/pathologist who hasn't dressed a wound since med school). She might have made the better call than the doc. Either way, who gives a ****? There are so many more controversial aspects of healthcare that you really have to go out of your way to have some semblance of outrage over this.

My $0.02
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Bc it's a pervasive problem esp. in an era in which the govt. is trying to cut down on healthcare costs across the board INCLUDING funding of physician residency training. What do you think the govt. is going to say when NPs and to an extent PAs, can say we can do what physicians do in a shorter time and we're cheaper? This example is emblematic of that problem - why did he take the doctor's opinion, when I'm a nurse, and I know more than that doctor?
 
The way I interpreted her friend's statement was that she'd "obviously" prefer to put a band-aid on it than stitch it up, not that she trusted the doctor more than her.
 
sb247 said:
And no, doctors and nurses don't work on a plan together.
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I don't know how it is where you are, but where I worked nursing and respiratory were expected to present during ICU rounds and contribute to the patient plan. The physicians had the final say about most things, and did a large portion of the plan on their own, but the the plan was certainly a collaborative effort. They literally would not round without nursing and respiratory present because they were considered essential for making appropriate daily plans of care.
 
This is the problem with all of the politically correct "flattening" of the medical hierarchy. Nobody wins. People at the bottom think they are more involved in medical decision making than they actually are, and are full of angst for not being recognized for the contributions they aren't actually making. Medical students are often guilty of this, too.

As a pre-med and pre-clinical student I was pretty critical of hierarchy. Maybe I have stockholm syndrome, but I'm all for the medical hierarchy now that I actually have patient care experience. The best patient care is delivered by a hierarchical team where everyone knows their role.
 
Mad Jack said:
I don't know how it is where you are, but where I worked nursing and respiratory were expected to present during ICU rounds and contribute to the patient plan. The physicians had the final say about most things, and did a large portion of the plan on their own, but the the plan was certainly a collaborative effort. They literally would not round without nursing and respiratory present because they were considered essential for making appropriate daily plans of care.
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We do this in our ICUs, too. But the nurses/RT/speech & swallow aren't there to provide input into the plan of care, they're mostly there to be informed and provide nitty gritty details about how the patient did overnight (how much drain/foley output? how was the delirium overnight? How many SBTs were attempted? Are they able to swallow now?) The docs decide what needs to be done, and having all the allied health providers on rounds means that the plan is implemented as soon as the orders are written without much lag time.
 
KinasePro said:
We do this in our ICUs, too. But the nurses/RT/speech & swallow aren't there to provide input into the plan of care, they're mostly there to be informed and provide nitty gritty details about how the patient did overnight (how much drain/foley output? how was the delirium overnight? How many SBTs were attempted? Are they able to swallow now?) The docs decide what needs to be done, and having all the allied health providers on rounds means that the plan is implemented as soon as the orders are written without much lag time.
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We do multidisciplinary ICU rounds as well. And the input from the RTs, pharmacists, nurses, etc, can be extremely valuable.

But there are also those who clearly relish the opportunity to "one-up" the MDs and make it miserable.
 
SouthernSurgeon said:
And because if they didn't, some nurse would get mad for being devalued and write a huff post article about it...
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It wasn't so much that as the fact that there was often a lot of information that wasn't in the charts, and a lot of things that needed to get done that straight up wouldn't get done if the nurse wasn't around to let the physicians know what was up. Things like sedation, restraints, social issues, nutrition concerns- they often either weren't in the chart or were on so many disparate flowsheets that they might as well not even exist. Having the nurse around made these things easier to deal with for everyone. Respiratory was kind of the same deal- the attendings generally only saw the patients twice a day, so they were only getting a snapshot of how a person was doing. How a person performed on their trials, whether they failed, why they failed, and what the best method of weaning/trialing might be for a given person were pretty essential things to know, as were the weaning parameters and other bits of information that were, again, practically nonexistent do to their being on so many different electronic flowsheets as to be practically unfindable by residents and attendings. Plus, when SHTF, respiratory knew about all of the weird vent modes and equipment that most of the residents had no real experience with, something that was critical to forming plans after hours when someone would start to crash or was failing to ventilate and we'd have to get creative.

How much input the allied health team gets really depends on how much the attending trusts them. Most of the time, I could get the orders I needed because my attendings knew I was solid when it came to my little niche. Nurses who've been around a while that actually know what they're doing tended to be able to provide a good amount of input about the plan as well. New RNs/RTs, RNs or RTs that were known to be "weaker," and travelers tended to just be there to take notes and provide bits of info. But when we had a solid, experienced team, things tended to run much more smoothly than they would have otherwise.
 
SouthernSurgeon said:
We do multidisciplinary ICU rounds as well. And the input from the RTs, pharmacists, nurses, etc, can be extremely valuable.

But there are also those who clearly relish the opportunity to "one-up" the MDs and make it miserable.
Click to expand...

Yep. We had a very green pharmacist who was constantly trying to narrow antibiotic coverage on every damn patient. It was painful watching the attending with 20+ yrs of experience repeatedly fending off reccs from a pharmacist who was 1 yr out from training.
 
touchpause13 said:
http://www.huffingtonpost.com/kateri-allard/just-a-nurse_b_3881551.html

This came up on my news feed and I was curious what some of your thoughts on it were. This was the part that I really didn't quite get:

A friend cut their arm and hours later still struggled to stop the bleeding. I assessed the wound and created a pressure dressing out of the supplies you have available in a frat house cottage. I reluctantly informed the friend that the wound would likely need a stitch or glue. It wasn't large, but it was deep and wide and would likely heal poorly, if at all, and even if it didn't become infected would leave a decent scar. I am not one to jump to big medical interventions; if anything, I ride the line of noncompliant and under-concerned.

My opinion was shared but another guest, a doctor, decided it would probably be fine with a Band-Aid and heal without issues. He may be right, or I may be right. But a close family friend who I have known almost my entire life chimed in.

"No offense, Kateri," he said, "But obviously we're going with the doctor over the nurse for this one."

"You're just a nurse," he might as well have said, although he didn't.

I felt like I had been smacked in the back by a two-by-four. My best friend knew this would be my reaction and turned in horror as the color left my face and the posture left my shoulders. Something inside of me sunk.

Too me I think she's being over sensitive. My nursing friends are eating this article up like halloween candy. Am I just being callous?
Click to expand...


Nurses live to create drama, Its funny. There is a nursing class at my med school they ( the nursing students) know EVERYTHING about the med students, but we don't even know they exist. I hear them talking all the time " did ya'll hear about the poor med school girl that fainted in gross lab" " did ya'll hear about ,x,y,z med students?" I can totally see them 20 years from now, 1oo pounds heavier and gossiping about what the doctors do instead of working.


And why are you friends with nurses? They'll always envy and hate you because of their own insecurities.
 
EMDO2018 said:
I live to create drama, Its funny. There is a nursing class at my med school they ( the nursing students) know EVERYTHING about the med students, but we don't even know they exist. I hear them talking all the time " did ya'll hear about the poor med school girl that fainted in gross lab" " did ya'll hear about ,x,y,z med students?" I can totally see them 20 years from now, 1oo pounds heavier and gossiping about what the doctors do instead of working.


And why are you friends with nurses? They'll always envy and hate you because of their own insecurities.
Click to expand...

FTFY.
 
SouthernSurgeon said:
If it were one crackpot's opinion, it would be one thing. But I'd argue the blogger's attitude is emblematic of a much larger problem in medicine - the devaluing and tearing down of the physician.
Click to expand...
DermViser said:
Bc it's a pervasive problem esp. in an era in which the govt. is trying to cut down on healthcare costs across the board INCLUDING funding of physician residency training. What do you think the govt. is going to say when NPs and to an extent PAs, can say we can do what physicians do in a shorter time and we're cheaper? This example is emblematic of that problem - why did he take the doctor's opinion, when I'm a nurse, and I know more than that doctor?
Click to expand...
I get it, I do. I just don't think that this situation was the one to point at and say "AHA! Nurses are trying to usurp our roles as providers of healthcare!"

More than anything it comes across as mindless dogma. It's very possible that the nurse could have been right in this precise situation. More importantly, who gives a **** about this scenario. It's completely different from a nurse trying to call shots with an ICU patient or openly second guessing a surgeon in the OR.
 
Jabbed said:
I get it, I do. I just don't think that this situation was the one to point at and say "AHA! Nurses are trying to usurp our roles as providers of healthcare!"

More than anything it comes across as mindless dogma. It's very possible that the nurse could have been right in this precise situation. More importantly, who gives a **** about this scenario. It's completely different from a nurse trying to call shots with an ICU patient or openly second guessing a surgeon in the OR.
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Future AMA leader here ****ing up our field. Whatsup bro?
 
I think this is just a result of the escalation of entitlement and "equality." Why the hell would a nurse think she'd have any precidence over a doctor concerning the medical treatment of someone. Why? Because recently, nurses have been fighting for "equality" to doctors, because after all, they obviously deserve it. Today we have nurses calling themselves doctors, saying they know more than doctors about medicine, and even having white coat ceremonies.

There's no way in hell this would have been said 40 years ago. Like @touchpause13 said, her nursing friends are eating that story up, which I completely believe. It's just ridiculous. Next thing you know flight attendants will want to be "equal" with pilots.
 
JP2740 said:
Future AMA leader here ******* up our field. Whatsup bro?
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IRL I'm the most outspoken person about how mid-level scope of practice has gotten out of control. All that I'm saying is that this banal article is poor evidence of that.
 
Jabbed said:
IRL I'm the most outspoken person about how mid-level scope of practice has gotten out of control. All that I'm saying is that this banal article is poor evidence of that.
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I've literally never seen your name before this thread. Let's keep the self proclaimed William Wallace of the group annoyed by mid level encroachment to a minimum.
 
RJGOP said:
I think this is just a result of the escalation of entitlement and "equality." Why the hell would a nurse think she'd have any precidence over a doctor concerning the medical treatment of someone. Why? Because recently, nurses have been fighting for "equality" to doctors, because after all, they obviously deserve it. Today we have nurses calling themselves doctors, saying they know more than doctors about medicine, and even having white coat ceremonies.

There's no way in hell this would have been said 40 years ago. Like @touchpause13 said, her nursing friends are eating that story up, which I completely believe. It's just ridiculous. Next thing you know flight attendants will want to be "equal" with pilots.
Click to expand...

Notice most nurses and flight attendants, are women.
 
SouthernSurgeon said:
Sounds like every uppity PICU nurse I've ever met.

And as to the laceration at home, whose opinion to trust - doc vs nurse. I'd say it depends. Surgeon or ED doc over RN? Definitely. ED RN vs most other medical fields - probably would go with the nurse actually just for sheer experience.

However, her wound assessment skills were made apparent to me when she described crafting a pressure dressing. The only pressure dressing needed in a situation like that is gauze/towel/whatever and sustained direct digital pressure. It's a nurse special to put giant (ineffective) pressure dressings on wounds.
Click to expand...


Aw c'mon now. I can't tell you how many surgeons tell me to just put a pressure dressing on a copiously bleeding wound that they don't have time to see. Be fair.
 
EMDO2018 said:
Nurses live to create drama, Its funny. There is a nursing class at my med school they ( the nursing students) know EVERYTHING about the med students, but we don't even know they exist. I hear them talking all the time " did ya'll hear about the poor med school girl that fainted in gross lab" " did ya'll hear about ,x,y,z med students?" I can totally see them 20 years from now, 1oo pounds heavier and gossiping about what the doctors do instead of working.


And why are you friends with nurses? They'll always envy and hate you because of their own insecurities.
Click to expand...
Well, now. I can see you are going to have a successful career in medicine by hating all nurses. Good luck with that.
 
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