Am I complaining in regards to the nurse?

I even have been a nurse for 30 years, with over a decade of experience as an intensive care unit nurse. During this time, I learned a number of things about myself. One of the habits I even have had for a few years is explaining my instructions. I noticed with horror that despite the caution I used to be taking with the tone of my statements, I may be participating in something much like one other social phenomenon with a quite negative attitude. Did I “complain to the nurse?”

Let me explain…

As a nurse, I received orders that I sometimes didn’t fully understand. Why was I doing this? Why didn’t I do it? I often encountered defensive explanations when asking the ordering supplier. I swore to myself I might never do this. There are some orders that require no explanation: vital signs, neurological tests, acetaminophen… But how do you select one blood pressure monitor over one other? Why will we do that CT scan? As a nurse working in an intensive care unit, I discovered myself explaining a few of my orders to nurses, to not justify them, but to involve them in the method. I feel it is important for them to know why I’m asking them to do certain things or why we shouldn’t do certain things. What are we searching for on this CT scan? Why is it so necessary that we go now? I prefer to close the communication loop in order that we’re all on the identical page.

Here’s a great example.

A patient with liver failure, cirrhosis and hepatic encephalopathy involves the hospital. His ammonia levels are elevated and he needs lactulose. We all know what’s going to occur next. Many times I might be asked to order a stool removal system. Many times I’m not capable of order it since the patient has severe portal hypertension and diagnosed esophageal varices. But as a substitute of just saying no, I explain why: “There is a high chance that the patient will also have rectal varices, which may burst if we place a large balloon in the rectum.” I sometimes recommend a rectal pouch, which is non-invasive.

Are these the nurse’s explanations? Am I offending anyone by doing this? How about I just provide you with the reasoning behind the orders? I asked this query to the nurses I work with.

Feedback from nursing colleagues

One of the advantages of this exchange is that sometimes nurses have a distinct perspective. I consider that open dialogue between all suppliers is essential. This can only improve patient care and achieve higher outcomes. What are your thoughts?