whitewriter (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
whitewriter) wrote2021-01-19 08:58 am
whitewriter) wrote2021-01-19 08:58 am
Entry tags:
Small things
Almost three weeks after my first shift returning as an ICU nurse -
about my actions taking the baby from SCN without a SCN nurse to care for it, to visit it's mum in ICU (who, by the way, was ward ready and literally just waiting for the bed to be cleaned).
The baby too, was only in SCN because it was a boarder baby: not because of another reason (albeit, it was 2.4kg which, in most places means admission to SCN for blood sugars and temperature checking to ensure that the baby can transition to extrauterine life okay despite being at a low birthweight). It was day 3 however, and classified as a boarder baby, having passed all those checks, and was literally waiting for mum to land on the postnatal ward: before being discharged and reunited.
I hate the idea of separating mother and baby. In midwifery it's drummed into you about how its so bad for the mother (psychologically) and the baby -- it effects milk supply, feeding, bonding. All these things.
As a new graduate (midwife, not RN), I'm so acutely aware of gold standard that I forget that I need to protect myself as a professional before I think of the woman/patient. Whilst as an experienced RN, I am now better versed in how to take care of myself as a professional : rather than always putting the patient first.
I always want to do the best for my patient.
That's why I work in intensive care. Because we are mandated the ratios to be able to do that.
Sometimes that makes for an almost "boring" day. Which then, if it occurs, theoretically enable me to do more education or studies to improve my clinical knowledge (which, rarely, it does because I am a lazy student: the one that studies to my aims (to a pass or A level) rather than studying to learn).
In anycase, that day. I made a mistake and I knew it, slightly just after I made it. When I was faced with the fact that oh yeah I also have a second patient, and now I have just taken on a second patient without running it by the incharge. Whups. But no one came to tell me anything at the time I made the error. So I just decided:
in the scheme of life, I'm doing whats best for mum and baby, and in the scheme of risk: its low risk considering she's wardable and if TPTB just got their ducks in a row, these two (mum and baby) would be together on the ward, without rules that don't suit their situation having to be applied (baby shouldn't be there without an SCN nurse)- and it's not like I don't have SCN training, but in my current role, as RN in ICU: I'm not an SCN nurse and technically: not a midwife.
The conversation was short and sweet. It went like this:
Rita I want to talk to you what happened with the woman you took care of and the baby coming from SCN.
Yes I know I made a mistake that day.
Yes you did.
I should not have taken the baby from SCN without a SCN nurse to be with the baby the whole time.
Yes Rita that's precisely it.
(and then she waxed lyrical about how I will struggle with my two identities as an RN and a midwife, and how its great I'm a midwife now too but that I need to remember to prioritise being an RN, because that's what I'm hired to do here, and that's my priority, and whilst my midwifery skills will help, that not to forget: I'm an RN).
I wanted to butt in and say "well she was wardable, and the baby was a boarder baby) but she didn't really let me and I'm really good at agreeing and nodding (after all, I did agree) and remembering that in this scenario (manager v. floor staff) I need to remember my place.
It's funny because I remember at SSH only being allowed to start once I had my RM rego sorted,-- but on my ID tag it does say: registered nurse and registered midwife (both, not just one).
I was hoping to get midwife onto my ICU tag also, but now I'm not so sure.
That being said, it was the acting NUM (not the actual)- who had been there literally all of 3 weeks: and I remember when she was just starting in ICU, I was a baby senior around then.
I wonder how hard that discussion was for her to have with me. Her knowing that I had been around, and it's not like just talking to a junior, which I myself find easier as well, rather than having a 1:1 discussion with a senior like that where literally you are sort of (rather gently) reminding (not telling) that they need to - do their job or whichever.
It was 3 weeks after the fact - How long had she carried this notion that she needed to have a quick chat with me for. That was what bothered me more than the (super short) discussion itself.
I guess I'll never know.
I wonder if this was why I wasn't allocated the last midwifery patient, because the acting manager wanted to have this discussion with me before going forward. I'm a very easy person to have a discussion with I think - so I don't think she stewed about it for very much- but rather; was just waiting until she saw me next and that there was a 5 min gap in time that gave her the chance. Just that this moment happened to be 3 weeks after the fact.
I learn from making mistakes. Hopefully those mistakes remain small and manageable- as this one was.
about my actions taking the baby from SCN without a SCN nurse to care for it, to visit it's mum in ICU (who, by the way, was ward ready and literally just waiting for the bed to be cleaned).
The baby too, was only in SCN because it was a boarder baby: not because of another reason (albeit, it was 2.4kg which, in most places means admission to SCN for blood sugars and temperature checking to ensure that the baby can transition to extrauterine life okay despite being at a low birthweight). It was day 3 however, and classified as a boarder baby, having passed all those checks, and was literally waiting for mum to land on the postnatal ward: before being discharged and reunited.
I hate the idea of separating mother and baby. In midwifery it's drummed into you about how its so bad for the mother (psychologically) and the baby -- it effects milk supply, feeding, bonding. All these things.
As a new graduate (midwife, not RN), I'm so acutely aware of gold standard that I forget that I need to protect myself as a professional before I think of the woman/patient. Whilst as an experienced RN, I am now better versed in how to take care of myself as a professional : rather than always putting the patient first.
I always want to do the best for my patient.
That's why I work in intensive care. Because we are mandated the ratios to be able to do that.
Sometimes that makes for an almost "boring" day. Which then, if it occurs, theoretically enable me to do more education or studies to improve my clinical knowledge (which, rarely, it does because I am a lazy student: the one that studies to my aims (to a pass or A level) rather than studying to learn).
In anycase, that day. I made a mistake and I knew it, slightly just after I made it. When I was faced with the fact that oh yeah I also have a second patient, and now I have just taken on a second patient without running it by the incharge. Whups. But no one came to tell me anything at the time I made the error. So I just decided:
in the scheme of life, I'm doing whats best for mum and baby, and in the scheme of risk: its low risk considering she's wardable and if TPTB just got their ducks in a row, these two (mum and baby) would be together on the ward, without rules that don't suit their situation having to be applied (baby shouldn't be there without an SCN nurse)- and it's not like I don't have SCN training, but in my current role, as RN in ICU: I'm not an SCN nurse and technically: not a midwife.
The conversation was short and sweet. It went like this:
Rita I want to talk to you what happened with the woman you took care of and the baby coming from SCN.
Yes I know I made a mistake that day.
Yes you did.
I should not have taken the baby from SCN without a SCN nurse to be with the baby the whole time.
Yes Rita that's precisely it.
(and then she waxed lyrical about how I will struggle with my two identities as an RN and a midwife, and how its great I'm a midwife now too but that I need to remember to prioritise being an RN, because that's what I'm hired to do here, and that's my priority, and whilst my midwifery skills will help, that not to forget: I'm an RN).
I wanted to butt in and say "well she was wardable, and the baby was a boarder baby) but she didn't really let me and I'm really good at agreeing and nodding (after all, I did agree) and remembering that in this scenario (manager v. floor staff) I need to remember my place.
It's funny because I remember at SSH only being allowed to start once I had my RM rego sorted,-- but on my ID tag it does say: registered nurse and registered midwife (both, not just one).
I was hoping to get midwife onto my ICU tag also, but now I'm not so sure.
That being said, it was the acting NUM (not the actual)- who had been there literally all of 3 weeks: and I remember when she was just starting in ICU, I was a baby senior around then.
I wonder how hard that discussion was for her to have with me. Her knowing that I had been around, and it's not like just talking to a junior, which I myself find easier as well, rather than having a 1:1 discussion with a senior like that where literally you are sort of (rather gently) reminding (not telling) that they need to - do their job or whichever.
It was 3 weeks after the fact - How long had she carried this notion that she needed to have a quick chat with me for. That was what bothered me more than the (super short) discussion itself.
I guess I'll never know.
I wonder if this was why I wasn't allocated the last midwifery patient, because the acting manager wanted to have this discussion with me before going forward. I'm a very easy person to have a discussion with I think - so I don't think she stewed about it for very much- but rather; was just waiting until she saw me next and that there was a 5 min gap in time that gave her the chance. Just that this moment happened to be 3 weeks after the fact.
I learn from making mistakes. Hopefully those mistakes remain small and manageable- as this one was.