I recently celebrated 30 years in nursing and completed my fourth year as a certified wound, ostomy and continence nurse. Since I took my current position in November of 2014, I have conducted Annual Skin Care Skin Fairs, usually in the fall. In the spring, to coincide with Nurses' Week, I join the hospital nursing educator and host the mandatory equipment fair where the staff is required to put hands on the various equipment we use in patient care. Twice a month during nursing orientation I present the products used for skin care, basics of wound care, and ostomy care. The staff is encouraged to return during subsequent months during new staff orientation and reinforce skills with which they do not feel comfortable.
Recently, I was talking to one of the staff nurses regarding a patient's status and care, and the phrase "I don't know" was uttered. Because I know how much education and reinforcement regarding patient care the nursing educator and I do, I experienced a visceral reaction that luckily left me speechless, but inside, I felt anger and deep disappointment.
My deep disappointment occurred because I hold nursing in high regard. Nursing is a career that has taught us to be problem-solvers, to identify a need, to seek answers, to be resourceful when it comes to learning and knowing, we can ask the right questions. This nurse showed none of that, and I felt like I had failed.
The Fourth Annual Skin Care Skin Fair was conducted in November 2018 where a hands-on table was set up for stoma care. Models of various stoma sizes and shapes were created with colored play dough over Plexiglas, and all tools were available to demonstrate stoma cleansing, measuring, cutting, application, and closing and emptying the pouch. Competencies for completion of the tasks were filled and signed by the staff to add to their education file.
While I did not immediately recall if the nurse I was talking to had attended the fair or not, it was not the first or only time this activity had been presented, and in addition, I do not believe she is a "new" nurse not to have encountered a stoma in her career.
By the time I came back to my office and reflected on what had happened, and the many emotions I felt—anger, disappointment, failure—I decided I needed to come up with a plan and enlisted the help of the skin care champions on each unit to help me disseminate a new safe phrase for Fab: "Remind me!"
"Remind me" confirms and validates that this information has been presented before, that there is always the opportunity to refresh our skills and to even learn advanced steps. "I don't know" in this context denotes lack of initiative and lack of empathy in searching for information, resources, and helping with a patient in need.
I am still feeling very frustrated by this encounter with my colleague and question at what point do my educator responsibilities end and the professional individual nursing initiatives begin. What is the nurse's minimal level of competency, who is holding him or her accountable for maintaining proficiency, and where is the individual's desire to keep up-to-date and current in his or her skills?
For now, I have not reconciled my emotions, but I am feeling reassured that as long as the nursing staff need reminding, I will continue to educate. This is a good thing. "Remind me."
About the Author
Fabiola Jimenez is a Wound Ostomy Continence Nurse and Adult Clinical Nurse Specialist at Detroit Medical Center Huron Valley Sinai Hospital. She has been a nurse since 1988, when she entered the field after graduating from the University of Oklahoma. Throughout her accomplished career, her work has demonstrated a dedication to caring for patients and a lifelong commitment to educating herself and others.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, HMP Global, its affiliates, or subsidiary companies.