“do you think you can help mr. G get out of bed to chair again tonight? i know the physical therapist did it this morning, but it will be great if he can sit up again tonight.”

he was a good looking doctor, but it was not his good looks that made me want to do his request right away. it was the very nice way he asked. not all doctors ask that nicely, and i really wanted to say yes, but i can’t.

“i really doubt i will have time to do that, so i will not promise. but i’ll try.”

he nodded, and left. he didn’t look happy. so was i.

_________________
one of our clinical instructors in nursing school taught us that there are three H in nursing. in no particular order, they are:

Head.
Heart.
Hands.

to be a good nurse, one has to have the balance of three.
one must know enough, care enough, do enough.
too much of one and lacking of the others is not good.
the key is balance.
knowledgeable. to give informations to a patient who fears the unknown.
compassionate. to be there when a patient fears what he knows.
capable. to do things for a patient who cannot.

___________________

if i am too smart that i think cleaning butts is beyond me because i’m too clever, i am not a good nurse. i may have a big Head, but that doesn’t make me a good nurse. if i am too compassionate that i feel my patient’s pain when i push  10 meq potassium IV, not knowing its lethal effect, i am not a good nurse. i may have a big Heart, but that doesn’t make me a good nurse. if i have the ability to give five baths in 15 minutes, without caring if my patient’s dignity is violated, i am not a good nurse. i may have big Hands, but not a good nurse.

Head. Heart. Hands.
the key is balance. not too much of one. not lacking of the others.

_____________________

five RNs, 20 patients, mostly total care. no patient care assistant (PCA). in a nutshell, out of the 12 hour shift, i was on my feet for 11 hours. the total of one hour spent on the chair was spent to chart, to enter orders, to check labs. nobody talked to anybody. everybody’s patience was tested. everybody’s back, legs and arms hurt.

i walked into my 85 year old patient’s room whose mouth was full of lesions due to some form of cancer. she takes medicines ever so slowly, it ate up a lot of time. she would start crying in pain at every sip of water. my Heart ached at the sight of her, but in my Head, i keep saying: “hurry, hurry, i still have three patients to give meds to.”

i walked into my 38 year old brain injury patient’s room whose sacral wounds were soaked with poop. my Head and my Heart have different reasons, but they both want the patient cleaned ASAP. logically, there is the concern about infection. emotionally, there is the “what if that was my husband lying there helplessly” question. my Hands? a totally different story. i just cannot clean a 200 pounds contracted man by myself. it was not right, but the patient had to wait till i get some kind of help.

________________

the key is balance. when i know enough, i can care enough. when i care enough, i can do enough. the three H makes sense. it made sense to me then when i was a student nurse. it made more sense to me now that i’m an RN. i know i would be a better nurse if i practice with my head, my heart and my hands.

i wonder if this makes sense to the management.
i am guessing it doesn’t, because if it does, why would they come up with this new “no PCA for a census lower than 22″ policy?

_________________

all the nurses went home weary.
our Heads hurt.
our Hearts heavy.
our Hands sore.

we did not really care that we were not good nurses. for the most part, we just felt sorry for the patients.