By THERESA BROWN, R.N.This year, a Seattle nurse named Kim Hiatt committed suicide. Ms. Hiatt’s death came nearly seven months after she had given an unintended overdose to an infant heart patient, a medical error that was said to have contributed to the child’s death days later.
Ms. Hiatt had been a nurse for 27 years and had often cared for the 8-month-old girl during the child’s stay in the pediatric intensive care unit of her hospital. She had probably drawn up the right dose of the drug hundreds of times in her career. But once, she made a life-changing error. A baby died, and she was suspended, then fired from a profession she loved. And now she’s dead.
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Friday, July 8, 2011
When Nurse Make Mistakes (Theresa Brown, RN) - NYTimes.com
Tuesday, May 17, 2011
Doctors, Nurses, and the Ethics of Bullying « The Nursing Ethics Blog
Bullying, or even subtler forms of interpersonal conflict, can be common in any kind of workplace. But it’s particularly corrosive, and dangerous, in healthcare settings, where effective teamwork really can make the difference between life and death.
See this editorial by Theresa Brown, for the NY Times: Physician, Heel Thyself
…while most doctors clearly respect their colleagues on the nursing staff, every nurse knows at least one, if not many, who don’t.
Indeed, every nurse has a story like mine, and most of us have several. A nurse I know, attempting to clarify an order, was told, “When you have ‘M.D.’ after your name, then you can talk to me.” A doctor dismissed another’s complaint by simply saying, “I’m important.”
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Sunday, May 8, 2011
Physician, Heel Thyself - NYTimes.com, Theresa Brown, RN
IT was morning rounds in the hospital and the entire medical team stood in the patient’s room. A test result was late, and the patient, a friendly, middle-aged man, jokingly asked his doctor whom he should yell at.
Turning and pointing at the patient’s nurse, the doctor replied, “If you want to scream at anyone, scream at her.”
This vignette is not a scene from the medical drama “House,” nor did it take place 30 years ago, when nurses were considered subservient to doctors. Rather, it happened just a few months ago, at my hospital, to me.
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Sunday, April 24, 2011
Nurse as Writer, Writer as Nurse Theresa Laurel Brown, BA, MA, PhD, BSN, RN, OCN®
Nurse as Writer, Writer as Nurse
Theresa Laurel Brown, BA, MA, PhD, BSN, RN, OCN®
The first column I ever wrote for The New York Times, called “Perhaps Death Is Proud, More Reason to Savor Life,” generated a firestorm of attention. Literary agents sent me e-mails, my piece hit The New York Times “most e-mailed” list, and within three days I’d been offered a book contract with a major publisher.
The column described a sudden and grisly cardiac arrest where a patient with lung cancer exsanguinated. I felt happy and lucky when The New York Times accepted it. I thought the piece would come out and my friends would read it, and that’s where the endeavor would end. Instead, from that one piece, I ended up becoming a professional writer about nursing. My book, Critical Care: A New Nurse Faces Death, Life, and Everything in Between (HarperCollins), was published in June 2010 and comes out in paperback in April 2011. In addition, I am a regular contributor to The New York Times’ Well blog.
Whenever I talk about my two careers, people often ask the same questions. I have answered some of those recurring questions here, in part, because that is what interests other nurses, but also because those questions get at the heart of how I combine these two very different jobs.
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Wednesday, January 12, 2011
Nurse and Doctor, Neighbor and Friend By THERESA BROWN, R.N. - NYTimes.com
“Something there is that doesn’t love a wall,” begins Robert Frost’s poem “Mending Wall,” about two neighbors who meet to repair the gaps and holes in the stone wall separating their properties. They walk on either side of it, picking up and replacing fallen stones as they go.
Jeff Swensen for The New York Times Theresa Brown, R.N.
The poem came to mind one recent day on the oncology floor where I work. It’s a medical oncology floor, where we tend to medical issues that go along with cancer, like giving chemotherapy and dealing with complications of metastatic disease. But it turned out that one of my patients had a serious surgical problem.
Surgical oncology is several flights of stairs below us. Even if they were next door, though, I imagine we’d still be inhabiting different worlds. There’s “med onc” and “surg onc,” and never the twain shall meet.
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Wednesday, January 5, 2011
Hospital care easier, faster with standing orders - CNN.com
My patient one day, a spry 80-year-old, started to cough and feel short of breath during a blood transfusion: classic signs of a transfusion reaction. I stopped her IV, but she needed a steroid to bring her breathing back to normal.
Unable to reach her primary physician, we called in a rapid-response team. An ICU doctor, respiratory therapist, two ICU nurses, a nurse anesthetist, and MDs and RNs from the floor all rushed into the room . . . . to authorize giving my patient this one needed drug.
The patient did not need rescuing, just a dose of solumedrol, and I could have given her that dose, without wasting the time and energy of multiple nurses and doctors, if we had a protocol, or "standing order," in place in my hospital for treating transfusion reactions.
A standing order is a kind of treatment algorithm used in hospitals to expedite care. Protocols are designed by doctors and nurses, implemented by nurses, and are typically used either in specific emergencies or to deliver routine care. A protocol for treating low blood sugar is an example of treating an emergency; putting silver nitrate in a newborn's eyes counts as routine.
Protocols make a lot of sense, according to Nancy Foster, vice president for Quality and Safety Policy for the American Hospital Association. The AHA supports the use of standing orders because, Foster says, "Standardization is an effective way to make sure we do the right thing for the right patient at the right time."
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