Visions

Before the explosion of activity, when we were just covering the phones, C and I discussed why it was so difficult to hire and retain people in our role.  By just covering the phones, anyway, I had to deal with poison ingestions, and a choking child, and a missing teenager.  I suppose that could raise someone's blood pressure.

C. asked me what the allure is for me, and I said it was probably the same for her.  That we have a vision of how care should be delivered and we want to make sure that we get a piece of the action.  At the conclusion of our conversation we laughed and summarized it by saying, "No wonder no one wants to be here. It's too demanding."

We also spoke about how each of us guessed that one of the doctors we work with  was pregnant, way before others knew and in fact,  quite early in her first trimester.  "When Dr. A-S confirmed that she was pregnant, she said that we were the two people who knew right from the start." C. said, " I figured that you would know right away also."  I concurred but spoke about how C. and I come to concepts about health status differently.  I said, " You are like a cop and come to conclusions deductively. You ask a lot of questions and create a timeline  I am more impressionistic and just feel things."  After so many years of working together, we know this to be true.

The day got crazy as I said. There's still a huge amount of swine flu happening. C. and T. already passed through the illness and were good sources of first hand descriptions.  We also had to deal with injuries and many varied presentations.

A mother brought her son in with a fever bordering on 106.  He looked pretty okay considering the fever, but immediately the clinicians have to start planning for what they would like the resolution of the encounter to be.  I volunteered to manage this case and I am happy to report that within two hours I had done all the appropriate testing and  had gotten his temp done to 100.4.  I called out his temp to my co-workers in the end and got a brief burst of applause.  They too had helped me along the way by contributing ideas and even supplies to support my  game plan.

I realize that each time one of us sees a patient, we immediately create a vision of what we would like to the outcome to resemble.  The vision changes and wavers along with circumstances, but for me, the visions intensify as I get more input.  You can call it planning, you can call it experience, your can call it reasoning but it still converges on the same point.

This past week I watched a preview of a new Showtime series, "Nurse Jackie"  with Edie Falco.  I found the show troubling because for the very first time, there was going to be a series about the way nurses actually think.  It is not about dressing in whites, being saintly, or having outbursts.  This preview scared me because Nurse Jackie has visions of how care should proceed and she intervenes in ways to make it happen.