Texas Nursing Voice - October 2014

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Page 10 • Texas Nursing Voice October, November, December 2014 Get By With a Little Help from Your Friends Terry was 58-years-old, a husband, a father, and a grandfather. He was dying. He had been intubated in the emergency room when he was in respiratory distress. He was not awake enough to have a say in his care at that time. He was in need and we did everything in our power to save him. Now, Terry was awake and he was telling us to stop—he’d had enough. Terry was suffering from alpha-1-antitripsin disorder that had caused severe COPD. I’ll never forget sitting on the edge of his bed with his wife on the other side and my intern standing at the ventilator. “Take it out,” he mouthed around the ETtube. “You’ll die. You can’t survive without it at this point,” I said. His wife buried her face in her hands. “I know. I’m ready.” “Give us a little while,” I said. “There’re medicines we can try…” He squeezed my hand. “It doesn’t matter. It all ends the same. I’m tired.” I nodded my head, “Okay, Terry. It’s your body—your choice. We’ll stop.” Denton State Supported Living Center Looking for LVNs & RNs to serve individuals with Developmental Disabilities • Paid Time Off • Paid Health Insurance After 90 Days • Excellent Retirement Plan • Job Stability Denton State Supported Living Center 3980 State School Rd., Denton, TX 76202 940-591-3364 EEO/ADA Employer Apply Online Today www.careersatdads.com Texas Department of Aging and Disability Services He closed his eyes and relief flooded his face. He squeezed my hand again. “Thank you. Call my girls.” I stood up and walked to the door of the ICU room, where the nurse sat with the chart. Terry’s wife followed me out of the room. “Can you wait until our daughters get here?” “Of course.” She nodded and walked back in to sit with her husband. I sat down at the chart to write the orders to extubate Terry and change his code status to DNI/DNR. The nurse put her hand on my shoulder. My intern came out and asked if we were really going to let a man die who we might save. I explained that patients have the final say in what happens to their bodies—not us. Yes, we could fix this exacerbation, but he would have others. There would be shorter intermissions between the flares, but they were still possible. Ultimately, Terry would die of his COPD at some point. Fate and genetics had seen to that, but Terry had decided when it would happen. On Terry’s Terms We waited an hour for Terry’s two daughters to get to the hospital. When everyone was ready, the respiratory therapist turned off the ventilator and pulled the tube out of his airway. Terry coughed and took a deep breath. “Thank you—all of you. It’s okay. This is what I want.” We left him and his family to spend what time they had left together. We all hovered around the ICU room, waiting for the inevitable. The nurse, the respiratory therapist, the intern, and I all went into a nearby empty room and cried on each other’s shoulders. There’s nothing worse than helpers that can’t help anymore. We all felt completely useless. With the support of each other, and a little encouragement from Terry, we made it through the night. Terry rallied and survived about nine hours off the ventilator. He got some quality time with his family and he died on his own terms. I have seen bravery in many forms as a physician, but Terry may have been the bravest and I’ll never forget him. Death is Not Failure In healthcare, we often think of death as the unseen enemy to be defeated. The truth is, we can’t defeat death. Death is the house and the house always wins. We can keep death at bay for a while and we can give our patients time. Sometimes it’s minutes, sometimes it’s years, depending on the condition we are treating. We can do everything right and the patient still dies. Thanks to shows like “ER,” patients think we can run in with a defibrillator and resuscitate anyone and they’ll dance out of the hospital the next day, better than ever. Doctors and nurses are not God—we can’t perform miracles. Coping Together Our jobs are emotionally taxing, to say the least. The only way we survive intact is by supporting each other. We all have those days and cases that hurt us a little more than others. Alone, the feelings of inadequacy and doubt would overwhelm us in no time at all. Together, we can share our stories and feelings. It helps so much when someone can put their arm around you and say, “I know what you’re going through. I’ve been there. It hurts right now, but it will be okay. Don’t give up. This world needs your compassion. I’ll see you tomorrow.” Bonnie C. Carter, M.D., F.A.A.F.P., is a boardcertified family physician in Dumas, TX. Dr. Carter has practiced in Dumas for six years and currently serves as the Chief of Staff of the Moore County Hospital District. OUR LAWYERS DEFEND TEXAS NURSES! • BON Defense • Peer Review Assistance • TPAPN Assistance • Formal Charges • Malpractice • RN/LVN Reinstatements (800) 210-0126 Austin • Houston • San Antonio and throughout Texas BERTOLINO LLP www.belolaw.com
October, November, December 2014 Texas Nursing Voice • Page 11 Texas Wins Workforce Grant The Robert Wood Johnson Foundation (RWJF) announced in August that Texas has been chosen to receive a $300,000, two-year grant in Phase II of its Academic Progression in Nursing program (APIN), along with eight other states. APIN is advancing state and regional strategies aimed at creating a more highly educated, diverse nursing workforce. APIN is run by the American Organization of Nurse Executives (AONE) on behalf of the Tri-Council for Nursing, which consists of the American Association of Colleges of Nursing, the National League for Nursing, American Nurses Association, and AONE, which is leading the four-year initiative. The Texas Team, cosponsored by the Texas Nurses Association, is responsible for administering the APIN grant in Texas. The grant will allow the Texas Team to continue working with academic institutions and employers to expand their work to help nurses in their states get higher degrees, so they can be essential partners in providing care and promoting health, as well as more easily continue their education and fill faculty and primary care nurse practitioner roles. The Texas Team Action Coalition continues to encourage the development of strong partnerships between community colleges and universities to make it easier for nurses to transition seamlessly to higher levels of education. Great Progress in Texas “We’re making great progress here in Texas,” said Cole Edmonson, DNP, RN, FACHE, NEA-BC, co-lead of the Texas Team. “Thanks, in part to our efforts, universities saw an 87 percent increase in enrollment in their RN-to-BSN programs, and an 84 percent increase in RN-to-BSN graduates. Enrollments in these programs continue to increase, in particular among nurses from groups that are traditionally underrepresented in RN-to-BSN programs, including nurses from rural areas and those who represent diversity with regard to gender and ethnicity.” Cole said community colleges and universities have signed 36 agreements to participate in RN-to-BSN programs and the new Texas State core curricula for nursing have been approved. “We look forward to building on our progress with this second grant.” In its groundbreaking 2010 report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine (IOM) recommended that 80 percent of the nursing workforce be prepared at the baccalaureate level or higher by the year 2020. At present, about half of nurses in the United States have baccalaureate or higher degrees. While acknowledging the contributions of Licensed Practical and Licensed Vocational Nurses and associate-degree-prepared Registered Nurses, the IOM report said a better educated nursing workforce can help ensure that our nation’s population has access to high-quality, patient- and family-centered care and can meet the growing need to provide preventive care in schools, communities, and homes. As part of Phase II of this work, the Texas Team will develop a sustainability plan to ensure that the work to promote seamless academic progression for nurses in their states will continue beyond the grant period. During Phase II, each state also will develop a robust diversity plan and focus on academic-practice partnerships to expand and support the work to date. “Advancing a more highly educated, diverse workforce where nurses are able to practice to the top of their education and training is essential to achieving the Robert Wood Johnson Foundation’s mission to advance a culture of health in our nation,” said RWJF Senior Adviser for Nursing Susan B. Hassmiller, PhD, RN, FAAN. “In the last two years, APIN grantees have laid important groundwork to build that workforce. We are pleased to provide the financial support they need to continue their essential work.” For more information, visit www.texasapin.org. One Million Dollar Protection As Low As $102 Per Year! The NEWMalpractice Solution For Texas Nurses. Apply Today! Quick Application (5 Minutes Online) Electronic Policy Delivery In 5 Minutes Strong Coverage A++ A.M. Best Financial Strength Rating Up To $1 Million/$6 Million Limits Malpractice Coverage 24/7 Occurrence Form Policy Portable Coverage (For Multiple Locations) HIPAA And Licensure Coverages Included Insured Consent-To-Settle Provision $25,000 Workplace Violence/Assault Coverage Experience You Can Count On CM&F - Serving Nurses For Over 65 Years *Coverage with Medical Protective is offered through MedPro Provider Solutions, Inc. ("MPS"), a risk purchasing group and affiliate of Medical Protective. By payment of your policy premium, you will be joining as a member of MPS. Product availability varies based upon business and regulatory approval and differs between companies. All products administered and underwritten by Medical Protective or its affiliates. Visit medpro.com/affiliates for more information. ©2014 The Medical Protective Company. ® All Rights Reserved. A.M. Best Rating as of 5/9/14. www.NurseGuardPlus.com NurseGuardPlus® Since 1947, CM&F has been dedicated to helping nurses secure personal asset protection. We make it easy to apply for malpractice insurance - provided by Medical Protective - that’s affordable and includes the coverages you need most.* By combining Medical Protective’s affordable prices and vital coverages with CM&F’s peerless policy and claims services, NurseGuardPlus ® is the smart choice for another generation of Texas nurses! APPLY TODAY & SAVE. 99 Hudson St., 12th Fl., New York, NY 10013-2815 Tel: 1-800-221-4904 Email: rn@cmfgroup.com Most credits cards accepted. www.NurseGuardPlus.com
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Texas Nursing Voice - October 2014

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