A Culture of Safety

In honor of the last day of nurse’s week I wanted to write a post on the theme this year, A Culture of Safety. Today was one of the most challenging, and yet most rewarding days I’ve had in a long time. I certainly earned every single penny I made today. I came home exhausted, but with a joyful heart. And here’s why…

Iv pic

Not only did I have my usual four patients that I usually had on dayshift, I had an extremely complex patient requiring nearly five full hours of my time. Note: I an NOT an ICU nurse. If you are, I’m absolutely certain you are brilliant. But I’m more on the average side, which is usually ok as a novice, except for days like today. My patient had so many IV lines going he had all three of his IV’s going almost the entire day, which required six different modules on two different IV pumps. It seemed like all day long I was checking, and double checking the compatibility of meds so I could avoid a med error at all costs. In the mean time I was trying to keep vitals stable which included extra boluses and increased vigilance. On top of my busy day, every single one of my co-workers seemed to be running around, wiping sweat of their faces the whole day too.

So maybe you can see why I’m writing about a culture of safety here. Nursing is dangerous. A mistake could mean life or death. Missing a mistake another causes, could mean the same. If your a nurse, you know nursing is the third line of defense. 1st is physicians, 2nd is pharmacy, and 3rd is nurses. But often times, it doesn’t feel “third.” It feels very up front and center. Because when there is a mistake, it made it through all three lines of defense. The system is faulty. Humans are even moreso. So how do we create a culture of safety in this kind of environment?

I think my floor has done an amazing job at this. The leadership is phenominal. I’ve worked at Sanford eight months, NEVER, not EVER has a negative word been spoken about our director of nursing. Do you know how incredibly rare that is? In my previous jobs all we did was complain about management until the sun came up. But on 6000 (the floor I work on) the staff is so supportive and willing to lend a hand. The patient care techs are call light ninjas and literally amaze me with all the little and big things they do during the day (that really are not so little at all). The coordinators regularly check up on me throughout my shift which is so appreciated. My co-workers are usually always there to lend a hand (unless there are days like today, where there is literally no hand to give). We also have in place a rapid response team. If anything ever starts to look a little sketchy, I can call an get a second opinion. We have a pharmacists on the floor during the day, and it is so convenient to get questions answered there about my medications I have to hang. If there is an error, which there will be, as I mentioned before we are humans, there is a no fault system where you can submit med errors. They look at the system rather that the person and ask “how has the system failed here and what can we do to prevent this in the future.” In no way does this mean we can be any less diligent, but we have a safe place to turn in times of crisis. And believe it or not, our doctors are really nice (well most of them, I’v had a few minor run ins). I was terrified to talk to doctor’s on the phone when I first started. But we are a team, and we need to look out for the patients greater good, even if that is a 3am phone call. And trust me, we appreciate it. When I call at dinner time and I here your kids in the background I smile, and am grateful you are so giving of your time.

And now, even though this was a dreadfully exhausting day, why was it still so fulfilling? I worked hard, for my patients. I advocated, for my patients. I prayed, for my patients. I had meaningful conversations to comfort my patient’s family members. I reassured them. I gave all I had to give, all for my patients. And that my friends, is rewarding. I left today feeling like I had literally conquered the world. Jesus gave me the strength to get through the day and to be an encouragement to those around me. I was able to figure out and re-prime six IV lines—that’s an accomplishment for someone not used to such critically ill patients. I gave three new drugs I have never given. I made the decision that my patient needed another day in the hospital before a safe discharge. I made a difference. I feel like I want another challenge again soon, but maaaaaaaybe a few easier shifts in between 🙂

As always, thanks for tuning in. This post is dedicated to all my 6000 co-workers, so grateful for all you do! Happy Nurses Week!

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