Sunday, May 11, 2014

Miles for Moffitt 5k

I think that I'd heard of this race before, but it was never really on my radar (races in Tampa mean an hour's drive).  However, one of the trainers I have intermittently utilized has a son who has been fighting (it appears successfully, thank God) a rare form of Lymphoma and there was an effort  organized to raise money for his team and recruit runners.  I was so happy to be able to be a part of it.

Moffitt Cancer Center is where my late brother in law was treated, where my late father in law briefly received treatment and where my Pop received his initial staging and treatment plan before he could actually start treatment. 

Running in this race meant something to me.

I fucking hate cancer.

So, I was feeling good, I had schlepped all the way to north Tampa to pick up my packet so that I wouldn't have to get up super early for pre-race packet pickup.  I was ready.

Got up in the morning, hydrated, ate a banana, got in the car, plugged in the audiobook I'm currently listening to and hit the road.  Just as I got to the exit, I bib was at home on my dining table.


I actually thought about just calling it off, but only briefly.  And, any idea of flaking on it (since my time wouldn't be officially tracked anyway) went out the window when I heard someone yell, "Mel!" and turned to see RunnerGirl.  She's such an inspiration to so many people.  I hadn't seriously considered letting myself down (although the thought that I'd already paid, so it didn't matter did run through my mind) but I would NOT let RunnerGirl down. 

Not to mention, looking around, seeing all the folks wearing "In Memory Of" signs...I got a little weepy.  I miss my Pop so much.  And now Erica.  How I feel about them is so different.  With Pop, I miss him, but I also feel really angry at him sometimes because he could have very likely survived his cancer had he not buried his head in the sand.  With Erica, she got screwed.  She never had a chance.  And I just get angry with the fucking cancer that robbed her of the long life she deserved.  But, thinking of both of them, and of my husband's very sweet father and also my husband's brother (my Pop and the Rickster's brother died within a year of each other)...I needed to do this run.

So, I lined up with7500 of my closest friends and ran what felt like an easy pace (felt fast because there were SO many walkers and I just kept passing people and passing people -- I always start way in back because I run slowly).  But, I didn't really feel like I was pushing.  It was a very nice run, lots of cheerful support folks, beautiful area -- around the USF campus -- and I felt strong.  It was a smidge hot, but toward the end there was quite a nice breeze. 

I had arrived early enough that I was parked very near the start/finish line. So, I basically just turned off right at the finish instead of going all the way through the long finish shute -- again, I knew my time wasn't being tracked, anyway, so why go through the long shute, fight through crowds and then backtrack to my car.  But, I checked my running app on my phone and saw that I'd actually kept quite a good pace (for me).  I felt pretty good about that.  I was feeling that pride, walking back to my car when I saw RunnerGirl again, doing a little cool down jog through the parking area with (I presume) one of her track kids.  I smiled and did the "what's up" head nod and then headed to my car with a sense of accomplishment.

Then, I drove home where Chef Ricky made me a delicious plate of huevos rancheros and I saw my bright yellow bib, right there, on the table, where I'd left it.

Friday, May 2, 2014

Oh no, huh uh, not even a little bit.

I am watching some true crime show.  There is some "reporter" who is intermittently speaking about this nurse who was murdered.  One suspect was the doctor with whom the nurse was having an affair. The "reporter" says, "It was a bad idea for this doctor to have an affair with a nurse at the hospital where he worked, because she was his subordinate..."
No.  I am NOT subordinate to a doctor.  We are teammates.  We have different scopes of practice, but I am NOT subordinate.
If he had a private practice and employed her in that office?  Then, yeah, but in the hospital?  No.  No. No. No. No.
That idea went out with metal freakin' bedpans.

There are many times when I cannot perform a certain function without a physician's order (administering narcotics, for example) but as an ED RN, I have a vast amount of autonomy that comes with a hefty dose of responsibility.  In many circumstances I will assess, initiate care and order labwork, radiology exams and even some medications sometimes hours before a physician is aware the patient is even there.

I have been trained and educated and mantain several certifications and constantly strive to improve my practice.  In the course of treatment a patient may spend a total of 5 minutes in the presence of a physician who may spend a minute and a half writing orders for that patient.  However, I will be the primary person that the patient sees throughout their care and I will be the one who notices changes in their condition and will act on those changes independently.  I will notify the physician of changes and will potentially receive new orders, but I am under NO obligation to follow those "orders" if they are not safe and reasonable for the care of my patient. 

I decide, based on my education and experience and the standards of care whether the "orders" I receive are appropriate and safe.  If they are, I will carry them out.  But let me tell you how many times I have had to just say no.  How many times I have had to say, "Are you SURE you want me to do that?"

Nurses are not mindless automatons waiting for physicians to tell us what to do.  And despite shows like House that would have you believe physicians carry out the total care of their patients.  In the words of that title character, "I don't use nurses."  No.  He doesn't.  Because that's fantasy land.  No physician in a hospital setting can accomplish the care of their patient without nurses. 

Consider this the next time you hear someone say that nurses are subordinate to doctors:

I can completely and effectively care for any patient without the aid/direction of a physician when it is necessary (and have).  But, show me one physician in any hospital setting who can give total care to any patient without the aid (and sometimes direction) of a nurse.