The hardest part about being a nurse are the charts - not even the amount of them or the constant lawsuit looming over you. No, it's the fact that we have to put into words what we see - the incompetence, the neglect, the stupidity, the failure of a system (bodily as well as social) & the "mistakes" people claim to make. Within seconds we have to recognize all the presenting ailments & conditions & put them into words that the healthcare team will understand and react appropriately based on the severity. A bathtub too hot becomes an emergent circumferential burn requiring specialized transfer, a five hour delay to seek care because of fear becomes a call to child protective services, mac & cheese for dinner for a child with a milk allergy becomes an anaphylactic reaction nearly requiring resuscitation, a bottle of Tylenol results in a PICU admission, a croupy toddler weakly crying “I’m sorry mommy, I’m sorry” while an IV is started is instantly classified as delirious with air-hunger.
Putting it all in words gives it reality, gives it strength, gives it power. It has the power to consume you, to destroy you, to bring you down to your knees and break you down. The key is to learn how to be able to type “3 y/o with 2nd degree circumferential burn to the R foot with significant blistering & serous drainage” and not feel it. We seems insensitive when we say “the foot pain in 15A” but really we’re trying to distance ourselves so that we can do this all over again tomorrow night, and the night after that, and the night after that.
