During COVID-19, it is the nurses who are predominantly in the front line. Doctors can come into a ward, see patients and then move on. The nurses stay there. They are the ones most exposed to infection. They put their lives on the line. And they are true professionals, to be valued and respected. Let’s celebrate them
It was early in 1967. I had been a doctor for just two weeks. I’d received a thorough medical education at Sydney University but little in the way of practical experience, no opportunity to be involved in decision making or in delivering care.
As a newly minted junior doctor, I was overwhelmed with calls from various wards to see my patients, other calls about patients waiting in the Emergency Department for me to admit to a ward, multiple drugs to be written up and the general anxiety that goes was trying to cope in a new situation where the stakes are high. The registrar who supervised me was not available, being in theatre for most of the day. I was asked to see a patient, let’s call him Mr Bedford, who had to be prescribed Digoxin. This is a very effective drug for heart failure when given in the correct dose. An overdose can be fatal.
I prescribed Mr Bedford’s Digoxin, but in my rush to get through the work, combined with multiple distractions, I failed to notice that I had put the decimal point in the wrong place. Mr Bedford was about to receive 10 times the recommended dose. He was about to die.
Fortunately, the senior nurse in the ward, who was keeping a watchful eye on this raw, young intern, checked the dose and asked the junior nurse not to give it. She saved Mr Bedford’s life.
What did I learn from this? I learned that errors are more likely when you are stressed, distracted and in a hurry. I learned to double check my drug orders. But most of all, I learned respect for nurses.
For many doctors, professional respect for nurses was not fashionable in those days. It’s still a problem. Later that year, a senior resident drew me aside and sketched a diagram the hospital hierarchy. At the top he put the senior doctors, followed by all the doctors, right down to the most junior, people like me. Below this he listed all the grades of nursing staff from the matron to the nurse aide. The message was clear. Doctors have the status. They rule the roost. I felt uncomfortable because I knew he was wrong. I knew that a far more experienced person than me, a nurse, had saved Mr Bedford’s life and possibly my career. I’d learned the hard way that nurses are an essential part of the team.
Years later, when I was CEO of the Children’s Hospital at Westmead, we employed Australia’s first Paediatric Nurse Practitioner. These are nurses who have done rigorous additional training and can then perform some procedures and prescribe certain drugs, all previously the domain of the medical doctor. The AMA at the time was up in arms about this new role for some nurses, seeing it as a threat to medical practice, so made its views known to the press. Our hospital had a different view. We saw it as a way to improve medical care. That day, I held a news conference to say how proud we were to have been able to make this appointment and how it would be good for children. The sky didn’t fall in. There are now over 1500 nurse practitioners in Australia.
In recent years, I have been teaching how to make health care safer, including the role of nurses as integral members of the healthcare team. We have been running an Academy for Emerging Leaders where future leaders in nursing, pharmacy and medicine work with national and international faculty, including patient representatives, to explore how we can make healthcare safer, including the value of respectful, cooperative teamwork. This is a mutual learning experience. Those selected for the program learn from each other and we, their teachers, learn from them. Importantly, the young doctors develop new respect for nurses. This is how it should be.
During COVID-19, it is the nurses who are predominantly in the front line. Doctors can come into a ward, see patients and then move on. The nurses stay there. They are the ones most exposed to infection. They put their lives on the line
So, with COVID-19 continuing into 2021, now is a good time to remember our nurses. We need to take time to thank them for their work and to respect them as true professionals. Let’s all shout out for our nurses.
Kim Oates is an Emeritus Professor of Paediatrics, a former CEO of the Children’s Hospital at Westmead, a former President of the International Society for Prevention of Child Abuse and Neglect and an elected Founding member, International Academy of Quality and Safety.
Contributions to Pearls and Irritations
Your contribution will fund quality independent comment and analysis in Pearls and Irritations
Contribute
