How Protocols Take Freedom Away from Nurses
Nurses are one of the pillars of the health system. A good nursing team can support an entire hospital and make it one of the best while a poor nursing team can cause a hospital to go into chaos where lots of mistakes are made and patients get hurt. Nurses are a great asset to doctors as well. This is especially true for junior residents who are only starting out. A young resident may not know how to give an injection or insert a catheter and the attending may not have the time to teach him or her. A resident may also be afraid of asking their attending because they’re worried that these are skills they should already know and that by asking for help they’re demonstrating that they’re behind compared to their peers. A nurse could end up aiding a resident during his or her first three months.
Nursing protocols are new to the nursing world and to some they are considered an unnecessary inconvenience. Having to go through so many protocols and paragraphs just to find out something they already know can be very frustrating for nurses. It’s important to keep in mind, however; that this is all done for the safety and well-being of the patients.
Nursing protocols help nurses make decisions regarding patient care. A doctor will give instructions on medication, diet, and procedures, but the rest falls in the hands of the nurses. If a doctor orders an injection to be given to the patient, details such as what size and type of needle to use. This of course is unless specified by the physician. For instance a protocol may say a certain syringe should be used, but if a doctor asks for a different type of syringe then his or her orders should be prioritized. That’s because the size of the syringe may affect flow rate and a doctor may want the flow rate to be particularly slow or fast in this situation. Blindly following a protocol may result in hurting a patient.
Of course there are other items where a doctor won’t really give any instructions about and this is where a protocol comes in. For example patient safety protocols regarding bed rails would be something the nurse would depend upon because a doctor won’t usually give instructions regarding bed rails. Another item that is addressed in protocols is how to feed a patient or how often their bed linen should be changed. These aren’t things a doctor usually addresses either. Some nurses feel that these protocols are intrusive and get in the way of things.
A nurse who has been working for over 5 years already has tremendous experience. He or she will know so much about medicine already. They’ve been working with and observing doctors for years. They have already built so much on the knowledge they graduated with from nursing school. A nurse will often know the dosage of certain drugs to certain diseases just because they’ve given that drug so many times. Experience will also come in handy when it comes to nursing patients and taking care of them. They can read people and know which patients need what and what works with whom. It’s important, however; to note that experience isn’t everything. Knowledge is a major factor as well. There are exceptions to everything and not all patients are the same. Actually it rarely happens that two patients are exactly the same. Two patients may have sepsis but one of them is diabetic so needs modified management for the diabetes. That’s where doctors come in and why they give the instructions. A nurse may give the same injections the same way 10 times but on the 11th time the doctor asks her or him to give it differently because this patient isn’t like the other 10. So while experience is important and comes in handy plenty of times, it’s not everything. It does make life easier for everyone because if a nurse knows what he or she is doing based on their experience then everything runs smoothly, life is made easier for doctors, and patient care is definitely improved.
At the end of the day protocols are necessary. They’re not meant to undermine or degrade nurses at all. Doctors have guidelines as well. That doesn’t mean they’re not trusted to make their own decisions. It’s just better for everyone involved to have a set of guides or rules to follow. They are based on studies and will provide the patient with maximum benefit. They’re also a safeguard for nurses. If a patient is harmed then a nurse who followed the protocols has nothing to worry about. He or she simply followed instructions. Despite their necessity it’s still wise to common sense and logic. If something doesn’t sound right like the syringe example we described and the doctor forgot to instruct the nurse, then based on experience he or she should ask the doctor about the best course of action. By combining these protocols with experience and a team effort you get optimum result. Never forget that it’s all done for the sake of the patient after all. By time a nurse will begin to memorize the protocol and will no longer have to keep going back to it. It’s like doctors with guidelines. After a couple of times you know most of it and don’t need to keep checking it with every patient who walks into your office or hospital. Protocols aren’t made with the intention of making a nurse’s life worse. In fact it’s not really done to affect the nurse’s life at all. Everything in medicine is done for the benefit of the patient. If a patient will be nursed better and better dealt with at the expense of a few extra minutes of nurses looking at protocols then so be it. Like we said, sooner or later these protocols will be memorized by practice and a nurse will stop needing to check them every few minutes.
Nurses should keep in mind that this isn’t done to insult them. They should also remember that every profession has the experienced and the inexperienced. Just because something comes naturally to you and you don’t need any help that doesn’t mean that applies to everyone. If you started being a nurse over 5 years ago, someone else has only been doing it for 5 days. In a hospital everyone’s too busy to tell them what to do and what not to do, so the protocols will save a lot of time for everyone. This includes experienced and senior nurses who are too busy to teach the new guy/girl. It’ll also save trial and error experiences where the new nurse will learn by making a mistake. This mistake is going to be at the expense of a patient and should be avoided. Protocols are there to help the patients. It’ll also save doctors time because they won’t have to tell nurses every single detail regarding everything that needs to be done. If there are no special instructions then the nurse can simply refer to the protocols and with time they’ll know them by heart.
People need to remember why they’re in healthcare. The reason is to help people. That is the service that they provide even if it’s not why they joined. Based on how well they perform that service they will be judged and assessed. In medicine, however; there isn’t much room for errors because we’re dealing with human life which is the most critical thing in the world. Whether a nurse doesn’t like using the protocols or a doctor doesn’t like guidelines using them is not an option. It’s all for the safety of the patient and by time and as you become better professionals you’re going to need these rules and guides less and less.
