Doctors and Nurses, Still Learning - Theresa Brown RN - NYT
In the book “Complications,” the surgeon Atul Gawande described the difficulties inherent in medicine being learned on the job: “The moral burden of practicing on people is always with us, but for the most part unspoken.” He explained that part of what blunts that moral burden is the supervision interns and residents get from more senior residents and attending physicians, who guide and instruct as needed. What Dr. Gawande did not say, and in my experience what also remains unspoken among nurses and doctors, is that floor nurses do some of that guiding and instructing, too. It’s an ad hoc, unsystematic part of medical education, but it can make a difference in patient care.
We all get emails, read journals and take classes, but still sometimes, in the hurly-burly of the modern hospital, crucial information can fall through individual mental cracks. At those times information gets passed on person to person: doctor to doctor, nurse to nurse, doctor to nurse, and sometimes even nurse to doctor.
Having doctors who are willing to educate nurses makes a difference, too. The fellow who took my suggestion about the fentanyl patch seriously enough to tell me it was a “terrible idea” cemented the information in my brain. When the issue came up again, I could raise it as a question for the intern, who then went to the pharmacy to complete his education.
There’s always more to learn, and no matter how hard any of us try, there’s rarely enough time for one person to learn it all.
another great essay by Nurse Brown.
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