Nurses taught Stephanie Trifoglio, MD, an internist/geriatrician in Greenbelt, Md., a great deal about how to be a doctor. “They got me from book learning to actual practice.”
That’s just one of the reasons why doctors praise nurses. There are plenty more.
On the Ball
It was 2 a.m. and the ICU doctors had gone home, leaving mostly residents—Trifoglio among them—to prowl the floor. A nurse approached Trifoglio and said she was concerned about a 17-year-old trauma patient on a ventilator. “â€˜This guy’s chest looks funny,’ she said. â€˜His vital signs are all normal, but something seems weird.’” Trifoglio didn’t know much about medicine in those days, but she knew enough to have another second-year resident set his sandwich aside and take a chest X-ray. A barely visible line showed that the lung was on the verge of collapse. The residents and nurse ran to the patient’s bedside, and without a moment’s hesitation the nurse punctured the patient with a needle and filled his lung, averting disaster. “Twenty-five years later, I still remember her,” says Trifoglio. “If she had not been paying attention, we would have made the diagnosis on the postmortem X-ray.”
In the annals of medicine, doctors often get painted as heroes, but they know that it’s often nurses who save the day. Whether due to keen observational skills, experience or just an innate sense, RNs are frequently able to make diagnoses that doctors fail to catch. Several years ago, J. Randall Curtis, MD, a professor of medicine in the pulmonary and critical care division at the University of Washington Medical Center, had an AIDS patient in the ICU with acute hypoxic respiratory failure and bilateral opacities on his chest X-ray.Â “We were treating him for pneumocystis as well as bacterial and fungal pneumonia, but he wasn’t doing well and we were completely puzzled by his clinical picture,” remembers Curtis. “His bedside nurse came up to me after rounds and said, â€˜You know, the color of his blood looks odd to me and his pO2 doesn’t match his O2 saturation. I think you should make sure he doesn’t have methemoglobinemia from the dapsone.’”Â The problem hadn’t occurred to the team of doctors, but the nurse knew it and was exactly right.
Going the Extra Mile
Most nurses are dedicated to their jobs. Yet for some, well, let’s just say there are those for whom “dedicated” is an understatement. Leslie Cordes, MD, sings the praises of Susan Walsh, one of those nurses who consistently goes above and beyond the call of duty and who happened to be in Haiti when the earthquake hit. According to Cordes, a pediatrician on the executive committee of the American Academy of Pediatrics’ Illinois chapter, who has also worked in Haiti, Walsh stepped up and capably led a team with very few resources to save countless disaster victims. “As leader of the team, Nurse Walsh took the medical knowledge she had and did what she had to do at a time of intense trauma. She also took the time to learn about the people of Haiti and their culture. I very much admire her.” (Walsh shares her account of the devastation in Haiti in her book Walking in Broken Shoes: A Nurse’s Account of Haiti and the Earthquake.)
There are many ways that nurses go the extra mile. Benjamin Ticho, MD, a pediatric ophthalmologist at The Eye Specialists Center in Oak Lawn, Ill., and a clinical associate professor at the University of Illinois at Chicago Eye & Ear Infirmary, points to Debra Skopec, the retinopathy of prematurity nursing coordinator at Advocate Christ Medical Center/Hope Children’s Hospital. “Recently we had a 25-week-gestation, high-risk preemie whose teenage mother had difficulty bringing her infant in for critical eye exams,” says Ticho. “Nurse Skopec arranged transportation to the hospital’s outpatient clinic and got the doctor to come over from surgery. Her determination to get the job done right has prevented problems, in this case lifelong visual loss, for umpteen patients for years.” Ticho also admires how Skopec has been a great mentor to younger colleagues and students. “She has consistently demonstrated the â€˜best’ nursing qualities in all respects. I couldn’t do my job without her!”