Wednesday, September 10, 2008

Protecting and Preserving the Nursing Profession

Since the dawn of yore nurses are thought of as mortal angels--- always with a lamp, caring, giving, and not thinking of one’s own ambitious gain. It is a service that has learned to endure various mockery and ridicules associated with it. Centuries have passed and science has evolved hundredfold, unravelling new ideas and innovative ways of preserving human life. And yet nurses remain a profession different from all others mainly due to a single entity commonly tagged as the mark of each and every nurse, the calling and the essence of being a nurse: compassion.

In the country alone, we have millions of licensed nurses. It has been a popular and sought after profession as of today. Some would think that the ballooning population must have been due to dire hopes of landing on a greener pasture; but for nurses like us who have come to love the profession despite of being forced by our parents, it is a calling. A calling so loud and clear it pervades through our very bones and is absorbed by our very soul.

The sad reality is that, in a country filled with world-renowned nurses, our very hospitals stink with its dark secrets. Secrets so dark they would have been thought of as absurd and fictional.

Tough luck for poor and pregnant moms.

"It's you again? Every year you give birth! After this you should have a ligation!" one health worker recalled hearing a male doctor scold a mother in the delivery room.

Getting no reply from the helpless woman, the doctor allegedly was heard mumbling to his assistants: "I hope the baby is dead."

"He got even more angry when he saw that the baby was alive."

The same doctor, graduate from a top medical school in the country, had also performed total abdominal hysterectomy on an unsuspecting mother after she delivered her sixth baby by cesarian section.

He had removed her uterus.

When the mother woke up, the doctor told her he had to perform hysterectomy because she was bleeding profusely.

"But she was never bleeding."

After reading the news article entitled “Dark Secrets Born in Delivery Rooms” published a several years back, I was speechless. Hundreds of emotions transpired in my Amygdala, ranging from rage to the health care professionals involved, then sympathy to the patients, and finally, disappointment to the current health care system. Flocks of nursing schools evolved in the past ten years. And it seemed as though only few of them has inculcated into their students the importance of being a conscientious and compassionate nurse far above the importance of passing the board exams and their NCLEX. Maybe, just maybe, if their Bioethics classes have somehow infiltrated their souls, these dark stories would never have been born at all.

In the pledge of the American Nurses Association, this is clearly stated: “The nurse’s primary commitment is the health, welfare and safety of the client.” Nurses should foresee the needs of the patient in order to restore their optimum level of functioning by eliminating all the expected and present stressors that can inflict harm to the patient health condition. As a health care practitioner, we also have an imposed obligation to promote health and welfare of the patient above other considerations. According to one of the Universal Principle of Biomedical Ethics which is Beneficence, nurses ought to prevent or remove evil or harm and promote good.

"I was shocked." he said. "It wasn't what we were taught in school about patient care. It was completely the opposite."

He recalled one instance when a mother delivered her eighth baby on a stretcher before she could be transferred to the delivery table. "The nurses got mad and said, Why didn't you tell us the baby was about to come out?"

To punish the woman, the nurses allegedly told her to move to the delivery table by herself.

Imagine the pain. You've just delivered [a baby] and you're asked to move with no assistance whatsoever.

In this case the patient is a multigravida, a mother in labour for the 8th time. Being a knowledgeable nurse, we learned that this condition of the mother, being a multiparrous, brought about several physiologic changes to the mother already. To enumerate some, a history of multiple deliveries may bring about weakening of the perineal muscles, a wider pelvic inlet and a shorter time for the dilatation and effacement to occur. Bearing these things in mind, the nurse should expect a faster rate of delivery. As what our clinical instructors once told us, we have to be faster than the fetus, because the fetus would not wait for us to get ready. He/She will come out when he/she wants to.

In the presented above factors, the patient has neither any account nor any liabilities in delivering the baby while she is still on the stretcher. No one has any control about that. Not even the nurse. So the nurse has no right to punish the mother for having a “fast and unwarned” delivery. To punish the mother by scolding, humiliating and telling her to transfer from the stretcher to the delivery table by herself after a spontaneous vaginal delivery is a perfect example of contradicting the Nightingale Pledge. It is a clear mockery to the nursing profession. The act is considered to be irrational and totally, irrevocably unjustifiable.

I am not an idealistic person, I am well aware of the flaws of the country's Health Care System. True, we lack technologies and the problem of medical supply shortage is something we have learned to deal with every day. But being a despicable and lousy excuse for a nurse is tantamount and even worse compared to all the aforementioned problems. I was not expecting a perfect world when I entered this profession. So did my batchmates. But we were all geared up with optimism: we can make a difference.

In nursing schools we are taught how to master our skills and memorize the theories. But far beyond this tangible things we have learned from our great mentors and life experiences during our clinical rotations to various hospitals that instead of finding for the setbacks, flaws and short comings, we should realize that as nurses we are privileged to touch every person’s life and help preserve the greatest gift of God which is life.

***the article cited above was from the PDI entitled, Dark Stories Born in Delivery Rooms published in May 30, 2005***

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