Tuesday, March 24, 2015

Big Guns

People joke about being nice to your nurse. "We decide what size needles to use, tee hee." It's not really meant seriously. We have a lot of options for how to manage your care, but nobody casually suggests we go around abusing our control.

There are good reasons that nurses are the single most trusted profession in the US. We are in this job because we care about helping people. Nobody lasts long as a nurse unless they truly do want to do the right thing for patients.

Plus, it's not easy to upset us. We develop thick skin very early on, because we really do meet a lot of mean and nasty people. A good nurse can take the meanest insults and the nastiest shouting with barely more than a shrug, and still do her best to make that patient comfortable.

However.

All that being said, I don't think most people realize exactly how many control options a nurse really does have.

If you are aggressive, out of control, and present a danger to me or to my staff, I am permitted to:

  • strap you down spread-eagle on a gurney
  • tie a spit mask over your mouth
  • cut off all your clothes
  • shove a short tube up your nose
  • shove a long tube into your urethra
  • have all your visitors forcibly removed
  • prevent you from contacting anyone else
  • inject you with sedatives
  • and isolate you all by yourself in a very dark room where nobody can hear you shouting.

Of course such measures are never taken casually. Not a single one of the above things would be done unless it were necessary for our physical safety, and rare indeed would be the situation requiring all of them at once. And in truth, I can only maintain any of the above for a certain period of time without getting a physician's approval. If I were to make a vindictive judgement or even a bad call, I would immediately be made to answer for it. There is a lot of auditing and oversight for such things.

Nobody is ever, ever threatened with these major interventions just because they're mean and nasty.

Still, we really do all those things sometimes, and it makes me wonder. If people were aware of the kind of discretionary weaponry that gets issued with the letters RN, do you think they would choose to be nicer?

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