As a nurse of over 30 years, I have gotten really good at triage and tough conversations.
Triage is an art form as much as a science
Sending a kid to the ER because she didn't look right after falling off her bike- she had sweat on her upper lip... something was wrong, but what? She had a pneumothorax.
A step mom told her step son's arm wasn't broken after a fall, but she took him for an x-ray just in case. It wasn't broken
Having the advanced directives conversation with a family and telling them they should think about what they want to do if the worst comes... figuring out what they need to do or not do so that if their child
Sending a kid to a MOHs surgeon after an EB parent described over the phone that a wound on a foot that just didn't look right and it is Squamous Cell Carcinoma...
Telling a mom that when her beloved child threatens to kill herself, that mom cannot be the one to try and figure out if the child is serious or not. It has to be a professional. Because mom's can be wrong and if anything bad happened she would never forgive herself.
You learn what is common.
You learn what is likely.
And sometimes you have to be very direct...
Telling your cousin who doesn't want to take HTN meds that were newly prescribed that it beats having a stroke...
Telling you parent that "not being a good surgical candidate" is not the same thing as not needing heart surgery...
Telling your child you don't care if they feel fine, they passed out and hit their head and need to get checked out, like it or not...
All par for the course.
But when it is serious, it really sucks.
Being the first one to use the word "Autism"...
Being the one to say "It's stage 4"...
Being the one to say "Put down that it is a terminal illness..."
Telling the truth when asked, what is the worst case scenario?
But you have to do the right thing because it is the right thing to do.
Even when it sucks.
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