{Internet URL to “Note from a contributing editor to the 2004 CCM standard of care”
I entered nursing school right out of high school when i had virtually no life experience and so was extremely eager to absorb everything our nursing instructors had to say.
The teacher in charge of the probationary students, Miss Etta McLaughlin, started out on the first day by talking about what it meant to be a healthcare “professional”. She defined this as abiding by an ethical standard that put the well-being our patients above our own. That meant before our own physical safety, since nurses are required to care for patients with contagious disease (TB), virulent infections (staph, strep, and now HIV+ now MERSA), combative alcoholics and acting-out psychiatric patients.
Professional ethics also meant putting our own personal convenience, economic advantage or career development secondary to the welfare of our patient. In that context, the nurse’s professional obligation was to protect her patients from all manner of danger, such as hospital-based sources of infection, being given the wrong drug, operating on the wrong patient, whatever. This included a duty to advocate for the patient’s safety even if that meant going against the “powers that be” – head nurses, hospital administrators and those famously arrogant surgeon-types. Wow!
This ethical obligation even meant protecting the patient against himself, for example, someone who insisted the doctor give him a shot of penicillin for a cold. Of course, medical professionals know that antibiotic drugs are not effective against viruses. Based on his professional duties, the doctor would be obligated to decline, even if the patient got mad and threatened to go elsewhere. I was really impressed by the idea that an altruistic system was the bedrock of what it meant to function as a professional.
Miss Etta’s second “pearl of great price” was told in the form of a story about a peasant woman who was a fish vendor. The story goes like this:
Every day this elderly woman sat at a small table in the middle of the village market. Next to her the groundwas a bucket of filled with an undulating mass of live eels. In order to prepare them for sale, she’d reached down and randomly grabbed a writhing eel and then used two large straight pins to tack each end of the eel down to her cutting board. Once immobilized, she took her knife and slit the eel’s body from end to end and removed all the meat.
Of course, the people in the village were used to this and didn’t think much about it, but one day a stranger came by and stood watching from afar. He found this process to be so disturbing that he asked if it wouldn’t be more humane to kill the eels first, or at the very least knock them unconscious before slitting them open.
Without missing a beat, she reach down for another hapless eel and as she nailed its body to the cutting board, calmly replied:
“Why I’ve been doing this for 20 years, they ought to be used to it by now”.
The obvious moral of the story is that everyday healthcare professions do fear-provoking and painful things to patients. However familiar these routines may be to the doctor or nurse, they are still anxiety provoking and painful to the patient. It was a story that had a profound and continuing effect on my practice as a nurse and other areas of my life, and informs my current practice of midwifery.
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