Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Lesson learned: Pick your battles

Debbie Moore-Black, RN
Conditions
May 12, 2022
Share
Tweet
Share

It was a known fact — I was 4′ 11″ but I had a mouth on me to compensate. I was loud and noisy. Fellow nurses called me the “rebel without a cause.”

But I had a cause.

I knew I was David against Goliath. Almost everything became my cause. And I verbally fought my way through this iron-clad management structure.

I had to fight for the betterment of the patients, their survival, and the nurse being bullied.

I had to fight in front of an all management team that failed to uphold a safe 2:1 patient-nurse ratio.

Once, I was invited to a grand sepsis protocol debate.

This big meeting had everyone attending — critical care managers from ICU, neuro-ICU, coronary care unit, and the emergency department, pharmacists, physicians, etc.

And I was invited to this “think tank,” too … a little fish in this big pond.

“Code sepsis.”

And at this round table with all of the health care professionals who were accustomed to pounding their chests on how well they set up their sepsis protocol — I had to debunk it.

Sepsis was the newly named diagnosis, and if not treated rapidly and proficiently, a patient could die.

Our numbers showed that our patients were dying.

Cardiac patients have the golden hour; sepsis patients have the golden hour also.

Sepsis: a raging infection that consumes most organs from bacterial, viral, or parasitic infections.

Symptoms: shortness of breath, dizziness, confusion, rapid heart rate, and low blood pressure.

ADVERTISEMENT

At our institution, a sepsis patient stayed in the ER for hours. Strategic life-saving protocols were stalled, and when the patient eventually got to the ICU, precious hours had been missed.

We had to intubate these patients. Put in a central stat line and arterial line. Hang vasopressor drips, get stat labs and administer IV antibiotics. Not to mention adding liters of IV normal saline. The entire body had to be resuscitated.

I mentioned in the round table that we were doing it all wrong.

I recommended a “code sepsis” should be announced overhead.

The rapid response team (RRT) should respond to the ER stat.

A central line should be inserted stat and an arterial line. Stat labs. are to include a lactic acid level, ABGs, intubation, electrolyte profile, liver function tests and kidney function tests.

All in all, these procedures had to be performed immediately and simultaneously.

But they weren’t. Sepsis patients came to the ICU after being in the ER for several hours. Precious wasted hours. Precious minutes.

The round table got loud and argumentative.

But we began to settle on the truth: we weren’t being aggressive enough medically. And our patients were dying.

Protocols were rewritten and added too.

We fine-tuned.

As an aftermath of this think tank, “code sepsis” was called out on the overhead. The RRT showed up in the ER, and with a rapid succession of intubation and central line insertion, the patient was rushed to our ICU with the goal of one hour.

Feeling that I productively had added my two cents. I was called to the manager’s office two weeks later.

Our manager told me I was brilliant, and my ideas were also “their ideas.” But — she had to write me up.

Why? Because I spoke out of turn. I intruded amongst these professionals. I was out of place.

In years to come, I realized that they had to be the ones in control at this institution. They had to be the ones with the ideas.

I was just that brick in the wall, and they wanted me to close my mouth.

I carried on relentlessly for the betterment of the patients and fellow nurses — until I could no longer feel any support.

They wanted me to be a yes person — to serve, honor and obey.

Lesson learned: Pick your battles.

Debbie Moore-Black is a nurse who blogs at Do Not Resuscitate.

Image credit: Shutterstock.com

Prev

Your doctors don't keep track of what they're doing

May 12, 2022 Kevin 2
…
Next

Gender inequality is making burnout worse

May 12, 2022 Kevin 0
…

Tagged as: Critical Care, Nursing

Post navigation

< Previous Post
Your doctors don't keep track of what they're doing
Next Post >
Gender inequality is making burnout worse

ADVERTISEMENT

More by Debbie Moore-Black, RN

  • What money can’t fix: the scars left by a friend

    Debbie Moore-Black, RN
  • A retired ICU nurse’s brunch conversation sparks a life-changing moment

    Debbie Moore-Black, RN
  • Wisdom for new nurses: lessons from a 30-year ICU veteran

    Debbie Moore-Black, RN

Related Posts

  • What I learned after being hacked on social media [PODCAST]

    The Podcast by KevinMD
  • My grandfather’s death: What I’ve learned about life

    Munera Ahmed
  • The lessons learned from street medicine

    Nicholas Bascou
  • What this medical student learned from running a marathon

    Shoshana Weiner
  • A near-death experience taught this medical student a lesson

    Johnathan Yao, MD, MPH
  • What I learned from starting medical school in January

    Gaelle Antoine, MD

More in Conditions

  • How veteran health care is being transformed by tech and teamwork

    Deborah Lafer Scher
  • What Elon Musk and Diddy reveal about the price of power

    Osmund Agbo, MD
  • Understanding depression beyond biology: the power of therapy and meaning

    Maire Daugharty, MD
  • Why medicine must stop worshipping burnout and start valuing humanity

    Sarah White, APRN
  • Why perinatal mental health is the top cause of maternal death in the U.S.

    Sheila Noon
  • A world without vaccines: What history teaches us about public health

    Drew Remignanti, MD, MPH
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How veteran health care is being transformed by tech and teamwork

      Deborah Lafer Scher | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
  • Recent Posts

    • How veteran health care is being transformed by tech and teamwork

      Deborah Lafer Scher | Conditions
    • Why judgment is hurting doctors—and how mindfulness can heal

      Jessie Mahoney, MD | Physician
    • Why medical schools must ditch lectures and embrace active learning

      Arlen Meyers, MD, MBA | Education
    • Why helping people means more than getting an MD

      Vaishali Jha | Education
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • Why evidence-based management may be an effective strategy for stronger health care leadership and equity

      Olumuyiwa Bamgbade, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How veteran health care is being transformed by tech and teamwork

      Deborah Lafer Scher | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why flashy AI tools won’t fix health care without real infrastructure

      David Carmouche, MD | Tech
  • Recent Posts

    • How veteran health care is being transformed by tech and teamwork

      Deborah Lafer Scher | Conditions
    • Why judgment is hurting doctors—and how mindfulness can heal

      Jessie Mahoney, MD | Physician
    • Why medical schools must ditch lectures and embrace active learning

      Arlen Meyers, MD, MBA | Education
    • Why helping people means more than getting an MD

      Vaishali Jha | Education
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • Why evidence-based management may be an effective strategy for stronger health care leadership and equity

      Olumuyiwa Bamgbade, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Lesson learned: Pick your battles
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...