The March Reflections essay in AJN touches on several big questions:
- How can you tell if a patient presents an immediate suicide risk?
- What do nurses really mean when they speak of ‘trusting your gut’?
- And what are the limits of advocating for a patient when a nurse finds herself in potential opposition to a physician?
by Annelisa Ochoa for AJN
In “Mr. Blue and His Six Cats” (free until April 1), nurse Mariya Rader vividly and economically describes a series of tense events that occurred one shift in the ER where she worked early in her career.
The clock is ticking: should the patient brought in by EMS be discharged because he denies suicidal intent? We follow her persistent search for the right course of action through a series of encounters with the caring team of paramedics who brought him to the ER and are familiar with his ways, the inexperienced new resident physician, and the patient himself.
Trust your gut?
The author had always heard nurses say to ‘trust your gut.’ But what did it really mean?
Remember, I was still relatively new to nursing; I hadn’t yet learned to depend on myself. But I had this sick feeling deep down that I couldn’t shake. I figured it must be that “gut feeling” I kept hearing seasoned nurses talk about.
A sensitive portrait of clinical depression.
Of course, it’s a lesson that must be learned over and over, by nurses and everyone else. But it’s a wonderful thing to see a nurse gain confidence, grounded in careful observation and fact-finding, and act accordingly. This Reflections essay also provides a moving portrait of a patient in severe psychological pain.
We welcome your thoughts and experiences.
Sometimes the gut feeling feels that way because you aren’t working through the nursing process any more. You have had a patient with a similar diagnosis or issue, and you have experience. You skip steps in the nursing process because you just know what to do. For a nurse transitioning from beginner to experienced, this can seem like it’s a nurses intuition, but really it is just experience.
It’s the “fight ” nervous system response, it is the :alarm” we have internally when we “know” in our minds something isn’t right…yes do listen, feel your gut…clear your thoughts, then you are able to clearly define the why you need to advocate for your patient.
Our pupils dilate, heart rate and BP elevate, butterflies are welcome in our guts (blood flow to our GI system changes)…it keeps us on our toes, alert, and gives us the ability to focus our assessment and collaborate to change the plan of care. I tell others when my butterflies quit appearing, that means I am in need to plan retirement.