Meet Nurse Kit Jessop. She’s young and energetic, and she loves her job. Notice how she smiles as she walks the halls of her unit. She is holding her head up high because she has confidence in her nursing skills, and in her ability to make patient care decisions. Everyone, including the doctors and the hospital administrators, respect her as a health care professional. This book was written during a time when nurses were truly in charge of their units. We told hospital administrators what we needed to do our job, and it was the administrator’s job to meet our needs. Patient care was nurse driven, and the patients’ needs came before anything else.

Nurse Jessop wouldn’t be smiling today because, sadly, those days are gone forever. Nurses are marginalized, and are frequently ignored when they advocate for their patients’ needs. I admitted a patient last weekend that made me cringe. Due to HIPAA regulations, I can’t tell you the details, but let’s just say I wouldn’t want this individual hanging around a playground. I placed the patient on our highest observation level, and called in additional staff to watch the new patient’s every move. I was very concerned for the safety of the minors on our unit, so I called our medical director to tell him what was going on. Here’s a little bit of our conversation:

Doctor: (Yelling) Why did you place this patient on one-to-one observation? He hasn’t done anything while he has been on the unit. Take him off one-to-one observation.

Me: The best predictor of future behavior is past behavior, and we have children on the unit.

Doctor: (Shrieking): Give me one good reason why we should keep the patient on one-to-one.

Me: So we don’t get sued.

That comment turned the tide. Screw patient safety, it costs too much to bring in an additional staff member to ensure the safety of the other patients, but god forbid we get sued. This is crazy. Hospitals are turning into asylums because nurses aren’t in charge anymore.

Did I mention that I’m still looking for my dream job? I’ll keep you posted.