Stuff I Did not Know
We tend to become very comfortable in what we believe and how we practice our trade. When I find something that works, I am reluctant to change it. But what if it doesn’t work? Do you even know what works and what doesn’t? Here’s a quick quiz to help you answer that question.
When I am faced with something that doesn’t make sense in the context of my world, I like to step back and place an imaginary phone call to Sigmund Freud. This one would go like this:
Me: I am confused. My patients are contrary and refuse to comply with their treatment plans, are stubborn and say their meds are making them sicker and I can’t make them believe that I know better than they do what is good for them.
SF: Give me an example.
Me: Here’s one. I keep telling Ms. Jones that she has to keep her sugar low so her next A1C will be below 7.
SF: Why do you tell her that?
Me: Duh…. So her sugar will come down and she won’t have to go in the hospital.
SF: You know this to be true?
Me: That’s what I learned in Nursing School.
SF: When was that? Around the turn of the century, perhaps? Were they still using leeches then?
Me: I am not paying you to make fun of me!
SF: You’re not paying me at all. In fact, I am not even real. Let’s move on.
Me: If you say so.
SF: In order to move out of these infantile stages where you must always win the battle with your patient, you must be open to learning new things.
Stupid dead people but the shrink was right. The truth is that more people are harmed and hospitalized when shooting for a goal of tight glycemic control than are helped. Color me perplexed.
Hopefully, those of you who are dealing with patients every day are up to speed on these interesting twists that took me by surprise but I wonder. I think maybe we are spending so much time worrying about OASIS C1 and ICD-10 coding, denials, appeals and making payroll that we simply do not have the time for even one more thing.
Our priorities have been set for us by the very people who pay for the care that we aren’t giving. Work on your visit preparation and documentation. My bet is you can shave enough time off your day to fit in a short visit to Medscape or work with a co-worker to create some really cool education posters. Make it impossible to use the restroom without learning something in your office. Don’t wait until the end of the year when your license is due to start your continuing education if your state requires it. Your value as a nurse – and mine, too – goes down with each educational rung on the ladder and I am not referring to OASIS documentation.
I don’t know about you but I like feeling like I know what I’m doing (as best as I can remember).