Why am I sitting on my lounge with a stiff drink in one hand and a slab of mud cake in the other?
Well folks, that'd be a combination of my shift today and sticking my finger up at my food intolerances!
For me as a nurse, there is nothing more frustrating than not being able to deliver the care our patients deserve. This can be caused by staffing shortages and/or an increased workload, sometimes it's because the skill-mix isn't ideal (this includes our fab colleagues in allied health), and sometimes its because nursing usually constitutes us making a solid plan to follow on a shift that becomes a distant memory by the second hour on the clock that we try and adapt through ten percent 'winging-it' and ninety percent interpretive dancing from one bed to the next.
The biggest lesson we all learn as nurses is that the job is 'twenty-four hour care', and that the constant pursuit of perfection is an expression coined with healthcare professionals in mind. And generally, I'm okay with handing over tasks to the next shift knowing I did my absolute best. I work on a busy surgical ward and that's often the nature of the beast.
What doesn't sit well with me is triaging a palliative patient at handover as my 'priority', and not delivering the goods. Sure, pressure area care is done, pad is dry, regular mouth care is done; I have assisted them to eat, the patient is comfortable.
But have I spent real, 'slow down and listen' time with the patient?
Have I stopped to hold their hand and give them comfort? Do I even know the names of all their family members?
Are the family members happy with the care I've given?
Was I truly present for that patient?
No. The answer is no to all of the above.
In my ideal world, there would be a dedicated palliative ward in every public health facility at best, and at the very least solid education given regularly on every ward regarding the management of palliative patients. In fact, it is one of my dearest goals as a nurse to see this wishful thinking through to reality.
We have all experienced loss. Many of us have had family members or friends who received palliative or end-of-life care. The stress and grief we feel at times such as these can be greatly alleviated or escalated simply by our level of confidence in the primary care givers (us nurses). This is why it is so important that no matter how busy we get on a shift that's gone from bad to worse, when we are supporting colleagues and putting out fires, that we find the pause button to truly communicate with all of our patients and their families.
We want patients' and their families to feel safe and confident in our capable hands, because they don't know what's happening behind the scenes and nor is it their prerogative to; they won't know if you shed a tear for them behind closed doors.
Patients and families only know what they see and hear you do in one eight-hour window, and if it happens to be a someone's last few hours of life then we need to make every moment count with all the care we can give with the resources we've got.
That is our pledge.
