This past week I read an interesting report on how human oncology nurses in a large public hospital established a new guideline-based antiemetic therapy. They did it by noticing that their chemotherapy patients were not getting efective antiemetic treatment and they used current guidelines coupled with their own observations to determine how treatment could be improved. What is interesting about this report is that it was the nursing observations that determined that the treatments were not always efective and it was the nurses themselves who took responsibility for addressing the problem by establishing their own objective measurements and collecting data about which patients were most at risk for not receiving efective treatment. While it is not the nurses who ultimately make decisions for what medication to prescribe, in this case, it was the nurse's evidence that assisted doctors to make better decisions about which treatments to implement. This collaboration of the medical team produced a much better outcome for the patients.
Proactive observations of one small group of nurses changed outcomes for their own patients but it also had a fow-on efect when they published their fndings to the medical community. This in turn led to questioning of the current treatment regimens and subsequently established better guidelines for future patients. One small team of nurses made a huge diference to medical science.
Many of us might be tempted to sit back and do what the evidence tells us and yes, that is important, but equally important is observing our patients, comparing outcomes, and asking questions. If medicine were an exact science, our jobs would be so very diferent. We would have set recipes for caring for patients and there would be no variability in outcomes. But that is not how it really is. Each patient is so unique that we can never predict an outcome with 100% certainty. Instead, we are always observing and looking at each patient as in individual. If there are undesirable side efects we manage them, if there is a bad outcome, we hold the client's hand, but what we don't always do is critically evaluate what isn't working and use that knowledge to determine if there is a better way.
Many of us will be familiar with using pain scoring, body scoring and care planning, but how many of us take action to create additional evidence based tools? Each one of us is capable of collecting our own clinical evidence and contributing to the scientifc community. In fact, our experienced observations are critical to the progress of medical science. We are an essential part of the medical team. We are the interface between patient treatment and outcome.
As veterinary nurses and technicians, we have the responsibility to evaluate efectiveness of treatments by asking questions, observing outcomes, collecting data and reporting to the veterinary community. By using that knowledge, we can make a diference, and we most certainly will be contributing to progress of the veterinary nursing profession.
In the words of Florence Nightingale, the celebrated founder of modern nursing: ‘For us who nurse, our nursing is a thing which, unless we are making progress every year, every month, every week, take my word for it, we are going back…’
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