The pursuit of one’s goals and dreams are journeys that oftentimes take a lifetime to accomplish. There are those who reach the end of their lives not accomplishing what they wanted to do because they were either too intimidated by the prospect of even embarking on such a quest or they did not have the right opportunities in life. I have been working for a number of years and during that time I have had plenty of time to see my career develop as my life passed by.
Yet, there comes a certain point in one’s life when one experiences an epiphany of sorts, coming to a new understanding of something that one previously considered as a mastered art. For myself, this learning experience and paradigm shift came when I was apprised of the new regulation requiring not only verbal but also written information concerning a patient’s diagnosis. Well aware of the previous requirements and standard operating procedures in healthcare, I was always under the impression that the best type of service was the personal touch.
It came as a surprise to me then when I learned of the new requirement for written information regarding the patient’s diagnosis. While I am all in support for expanding the services provided in the medical and health care profession, there are certain boundaries that I feel are in place for practical considerations. At the time this regulation was imposed, I felt that there was a fine line delineating the responsibility of the physician and that of the nurse.
Certain tasks, while traditionally with physicians, can now be ably done by nurses and certain tasks should be within the purview and responsibility of physicians because of the training that they have received. As such, the area of written diagnosis, while just collected from the hospital’s database, should be within the scope of responsibility of the physician. Removing the personal factor, I would like to state that this is not because I do not feel that we are unqualified or that we are not capable but rather it deals with one of the fundamentals of nursing which is dealing with the expectations of the patients.
Healthcare is literally and figuratively a matter of life and death. Patients have a certain level of expectation with the healthcare service that they are provided and expect the highest standard possible. The healthcare industry is similar to a bureaucracy in a sense that there are levels and hierarchies to be maintained. There are roles that certain actors play such as nurse administrators and nurse leaders. These people are given specific tasks to ensure that the discharge of functions is proper and that the patients are well cared for.
At this level, there is patient contact but the main contact is done through the nurses and other aides. In this same vein, it can be said that the role of physicians is that they are in charge of the treatment and diagnosis of the patients. As such, the role of nurses is to carry out the various tasks related to healthcare that are not necessarily within the ambit of the duties exercised by the other actors. In applying the learning theories and practical application, a nurse is therefore said to be in the discharge of functions in administering aid and treatment.
While a nurse is also tasked with the diagnosis, it cannot be considered as the final say as it is properly the physician who should discharge such. A nurse can log in their observations and make the initial diagnosis but should not be in charge of writing down this information and making their own judgment in these cases, most especially in critical situations. With all of the technological advancements in health care that have indeed raised the standard of health care being provided in the United States, there are a few intangible factors that can never be replaced.
I have always seen my future role, as a member of the nursing profession, as being able to develop these intangibles. One important example is the special type of manner by which a nurse must conduct herself in order to be effective in performing her task. The bedside manners are very important and it is something that just cannot be taught in classrooms. Nurses need to be more than just machines that come in and punch in their time cards but rather professional registered nurses who show their passion and dedication to the profession through their approach and practice.
The human involvement that is critical in nursing makes it the ideal profession for me. This means that nursing contemplates a while new aspect. It is not simply about exercising mechanical functions but also employing discretion and proper judgment. According to the code of ethics and the handbook of rules, a nurse is allowed to exercise independent judgment in cases where the exigency of the matter demands a quick decision and also when it is considered as the best for the patient. Unfortunately, while this is something that is authorized and even encouraged, there are no guidelines for the exercise of such.
It is because of this that I see the problems that a policy that requires the preparation of verbal and written information on the patient’s diagnosis may bring in the future. The ultimate deciding factor in this case is the necessity of doing such. As the new regulation comes into effect, I am left with a feeling that is not indifferent. While I do agree and comply with the rules in that I respect the authority of the physicians, hospital administrators and nurse administrators, I also recognize that my duty, first and foremost, is the care that I must provide for the patient.
Oftentimes policy is mixed with politics and economics and it becomes challenging to carry out ones duty as learned in school. Yet, there must always be order in everything. The exercise of one’s wisdom and judgment is best left to other matters since there are guidelines for the exercise of such. I do not feel that they new policy is efficient and effective but I also see that in the interests of maintaining the integrity of the profession and the institution these things must be followed.
It is my place to question but it is not my place to disobey regulations. This, in my humble opinion, is what makes the professional system work.
References:
Breckinridge, Mary. Wide Neighborhoods: A Story of the Frontier Nursing Service. Lexington: University Press of Kentucky 1981. Collins, David R. “Mary Breckinridge: Nurse on Horseback,” in Great American Nurses. New York: Julian Messner, 1971. De Leeuw, Adele and Cateau. “Frontier Nurse: Mary Breckenridge [sic],” in Nurses Who Led the Way. Racine, Wisc. : Whitman, 1961.