Scene 3: RCMC, Chief Nursing Officer’s Office

Scene 3: RCMC, Chief Nursing Officer’s Office

Expository Text: Several days after the derailment, Christine Sassman, nurse manager for the pediatric intensive care unit, has told Beatriz and Carl about the conversation Jill Lindner and Candace Hong reported to her. Beatriz calls Jessica in to hear her side and to explain RCMC’s policies on CAM.

Instructional Prompt: Click on highlighted characters to hear their thoughts on this topic.

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Dialogue 07: Beatriz explains to Jessica why she has been called into the CNO’s office.

Beatriz:

Jessica, I want to start this conversation by assuring you that this isn’t a witch hunt. You are entitled to your beliefs even when they are not popularly shared. What does concern me though is how we can integrate your beliefs with established hospital policy.

Carl:

I think what concerns me most is that you didn’t talk to me before you put in that call to Child Protective Services. So much could have been avoided with better communication.

Jessica:

I understand that, Carl. When it all was happening, it seemed really important to just make that call as soon as possible. But you know… I hadn’t even been planning to call them. I was told… and I don’t want to name names here… but I was told that I had to report it immediately. I thought I was doing the right thing.

Beatriz:

That makes sense. You understand, though, that in the future you should check with a more senior nurse and not act on your own like that?

Jessica:

I do.

Carl:

The other issue that we want to talk about is what appears to be an animosity on your part toward alternative medicine.

Christine:

Two of my nurses mentioned to me-independent of one another-that they were concerned that your attitudes toward alternative medicine created a barrier that could have negatively affected our ability to treat the Vang boy. That’s my concern. What we feel personally toward any particular practice… coining or chiropractic or even something as simple as taking lots of vitamins… shouldn’t get in the way of the relationships we need to build with our patients and their families.

This is important in pediatric nursing, and it’s also particularly important with people who come from certain cultures. For Hmong people, medical decisions are often made by the extended family. Some of the extended family members are going to be more traditional or even old-fashioned. If we can’t respect their beliefs even when we don’t agree with them, were going to have trouble working together for the best outcomes. Does that make sense to you?

Jessica:

Yeah… it does. This is really hard for me because I don’t want to be a racist or anything, but some of the practices I’ve heard about-particularly for the Hmong and Somali people… well the truth is that I don’t really respect those practices. I respect the people… I mean they’re my patients, but I don’t respect sacrificing chickens or believing that evil spirits cause mental illness.

Carl:

That’s fair enough but what you have to focus on is respecting the person and the culture even if you don’t accept particular beliefs.

Beatriz:

Jessica, Shannon Moe recently sent out a link to an online tutorial on this subject. I’d like you to be sure to do it and then make some time to talk with Carl about your results.

Dialogue 08: Carl offers Jessica some advice and encouragement.

Carl:

I think if you focus on the idea of understanding rather than agreeing with various practices, you’ll have an easier time with this. One of the big things for me is understanding why a patient might turn to alternative medicine and treatments. The more we understand motivations, the better we’ll be able to advise our patients.

Beatriz:

The other thing is that some complementary treatments can be very beneficial. Relaxation techniques have been use to help with pain management. Fish oil is one of our tools for fighting high cholesterol.

Jessica:

I understand that… but… and I’m not trying to beat a dead horse, but there’s science behind both those things you mentioned. All through my training, evidence-based practice has been the end all and be all… except when it comes to this topic.

Christine:

We’re getting back to the idea that you have to endorse alternative practices. That isn’t the case. You just need to know what they are and know which treatments your patients might be turning to.

Carl:

You’re right though… we don’t want to beat a dead horse. Do the tutorial and we’ll talk again. And relax… we’re not trying to make you into a Stepford nurse. We just want to help you do the best job possible for your patients