A Nurse and a Pharmacist Go On a Date That Resulted In Better Patient Care

“So, let me get this straight. If you have a cardiac event, or stop breathing, I can start CPR on you and potentially save your life, but if I go down, all you can do is call 911 and cry?”

Working in healthcare is difficult for many reasons, but one reason in particular occurs when the people providing direct patient care, often nurses, do not have strong representation when decisions affecting patient care are made. Even in hospitals utilizing nurse governance, meaningful change takes a long time. New ideas are often bogged down in committees, and then obtaining buy-in among all of the involved players. If the requested change is not budget-neutral, it can almost surely be kissed good-bye. This lack of empowerment over our work is daunting, if not demeaning.  

When a patient care policy is created rapidly it usually follows a sentinel event- an unacceptable, and preventable patient outcome.

But sometimes, a nurse gets lucky, and influences change, making patient care a little bit better.

I’ve been lucky to have had such an experience in my nursing career.

I don’t remember if I’ve written before that my husband David, who also recently retired from his career as a hospital pharmacist, and I were once coworkers at the same children’s hospital. We started dating after my recovery from breast cancer treatment. We have a cute “How we met” story. Maybe I’ll write a post about it someday.

Early in our relationship, David took me out for dinner. During the meal, I brought forward that my CPR card was nearing expiration, and I needed to renew it. Since we both worked at the same hospital, I assumed he had a CPR card too, and asked when did he need to renew?

“I’m a pharmacist. We’re not required to have a CPR card,” he informed me.

“Wait, what?”

“I don’t have a CPR card.”

I found this hard to believe. “But you work in the hospital. I just helped a housekeeper in the hospital register for a basic CPR class. You’re licensed. You attend our PICU codes. How can you not have a CPR card?”

“It’s not part of our job description.”

“So, let me get this straight. If you have a cardiac event, or stop breathing, I can start CPR on you and potentially save your life, but if I go down, all you can do is call 911 and cry?”

“Well, no, if we’re at the hospital I’d call for help, and flag down a housekeeper,” he humorously countered. 

 “This is a dealbreaker,” I thought to myself.

Except, it wasn’t. 

David registered for CPR training.

When I asked why, he explained it like this: 

“I voluntarily attend the pediatric codes that occur on my shift. From my perspective they appear chaotic because I’m not trained. Everyone has a job during the code, but I don’t. I want to become part of the team.”

To be fair, this was about twenty years ago. For the most part pharmacists were regulated to working in hospital basements, verifying orders and dispensing medications.

Having them attend codes at that time was novel, and their role was not clearly defined.

David’s willingness to consider my opinion, and grow as a professional because of it charmed me. Here was a coworker, a man I could be equals with. 

We continued to date.

David became certified in CPR. Then, going above and beyond, he studied for PALS, earning a card in Pediatric Advanced Life Support. Learning the algorithms, codes now made sense to him. He anticipated what drugs would be called for, and had them drawn up, decreasing the time it took to administer them to the patient, and freeing the nurses to attend to other functions required in a code.

The nurses welcomed his presence, but it was the doctors who noticed the significance of the process improvement.

“I want all of the pharmacists trained like David,” one of them insisted at a safety committee meeting.

Since money for pharmacist education existed, and no one could provide a rationale why the hospital pharmacists weren’t trained like David, CPR and PALS certification became policy at our children’s hospital. And once the adult hospital doctors and nurses learned about this, the adult pharmacists were required to have CPR and ACLS (Adult/Advanced Cardiac Life Support) certification too, system wide.

Not everyone appreciates having to certify for the courses, but everyone agrees that codes run more safely with pharmacists managing the medications directly at the bedside. 

Perhaps our hospital would have taken this bold step eventually, but in our case it started out as a simple conversation over a dinner date.