Wednesday, January 18, 2012

Don't worry, the patients will tell you what to do

When I graduated from school, my first job was in the Nursing Float Pool in Easton Hospital in Pennsylvania. Float nurses were oriented to work in all of the areas of the hospital with the exception of the operating room. Since I had to be prepared to work a wide variety of units, such as ICU, Med Surg, Pediatrics, ED, Labor and Delivery, and a host of others, my orientation was quite lengthy. I was not as highly skilled as the staff who regularly worked on a unit, but I could go there when there was a need and work alongside the "regulars" and help get through the shift without doing any harm and hopefully being helpful.
On my first day that I was to go to orient on the Psych Unit, there was a huge snowstorm. As often happens, many staff were unable to get to work, so the supervisors did the best they could with the people that were able to make it into work.
When I arrived at the entrance to the unit, it was locked. I knocked and Rick, the night shift Nurses Aide, let me in. Rick wore glasses with thick lenses which made his eyes look larger and two hearing aids and spoke in a high-pitched voice. I remember from studying Psych Nursing the importance of being observant, but Rick just didn't present the appearance of one in whom this was a strength.
Maggie, the night nurse, was the most senior nurse in the entire hospital. She was short, built like a bowling ball, had her gray-streaked hair in a tight bun and wore glasses with frames I believed they referred to as "cat's eyes". Maggie and Rick had apparently worked together for years, and they seemed to know what the other was thinking or wanted without much in the way of conversation.
Maggie informed me that I would be working with Cindy, one of the regular day shift nurses, but that she was having trouble getting here because of the weather and it would be at least an hour or two until she arrived.
While Maggie was finishing up some of her paperwork, Rick gave me a quick tour of the unit, and then I met with Maggie for report on the patients. There were 12 patients on the unit, all voluntary admissions. Maggie gave me a quick summary on each.
Realizing that I was going to be alone until Cindy arrived, I was quite anxious. I did not know any of the unit policies and procedures (I was there to learn them), I had no training on how to deal with Psych emergencies, or how to get help if I needed it or had a question. These were the days before the individually packaged unit-dose medications. The top drawer of the med cart was filled with stock bottles of pills, so I would have to go through all of them to find the right medications when the time came.
I would have appreciated it if Maggie would have volunteered to stay until Cindy arrived, but, when she reached for her coat, I knew it was not to be. Maggie buttoned her coat, dropped the unit keys into my hand, and headed toward the door. As she opened the door, she paused, turned to me and said, "Don't worry; the patients will tell you what to do." With that, she walked out and the door slammed shut behind her.
I obviously survived the experience, eventually transferred to the unit to work there full-time, and eventually became the Nurse Manager. I even found the tough, no-nonsense Maggie to bee quite nice, once we got to know each other.
Even though this was 30 years ago, I have never forgotten it, and it helped to make me more sensitive to others who were trying to learn how to work on a Psych Unit. For that, I thank Maggie and will always remember her parting words as she walked out the door.

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