Reflections on Gonzo Living

 

Life is full of odd moments- you never know when you’re gonna get defiant.  Hunter S. Thompson

    A series of events occurring over the past few weeks have me reading about the life of Hunter S. Thompson. Mostly because I’ve been trying to understand someone I am close to, trying to understand his life choices. I don’t know if I can, but it’s part of my journey, and so I try.

   Also, I continue to ruminate on my last post, concerning torture (A Response to the Torture Memos, May 2, 2009). I’m troubled by the concept of “just following orders”, implied by the reference to “military grunts.”

   Following orders does not justify wrong actions in the profession of nursing. I’m not talking about making a mistake, regardless of the severity of the outcome. No one is immune from making a mistake.  I’m talking about the very few times in my nursing career I was given an order by a doctor to do something that I knew was wrong.  As a professional, as a human being, it is not okay to go ahead and perform the order because the doctor said so. It is my job, my accountability, to bring my concerns forth to the doctor and ask for different instructions. Usually, that works. Occasionally, it doesn’t and then I am placed in the position of gatekeeper for the patient’s safety. It is not comfortable to refuse a doctor’s order. On one memorable occasion, early in my career, I refused to give a medication to a child.  The doctor demanded my name, so he could “report” me to my manager, and I spelled it out to him over the phone “so that you get it right.”  A toxicity test on the patient confirmed my assessment and no report was sent to my manager.  Had I followed the order and the patient was harmed, “I was just following orders” would not have stood up in court as an excuse, nor would it have assuaged my damaged psyche.

   My friend’s choices, while difficult for me to understand, support his right to live life on his own terms, to make his own choices. Like Hunter S. Thompson, he didn’t have a high regard for authority.  I can learn from his example of self-empowerment.  While my own choices tend to be on the conservative side, I can learn from these two men the value of listening to my own conscience, my own inner voice. The path it leads me on might not be a safe one, but if I keep my integrity and self respect, then it’s the right one.

Moral Distress in Healthcare

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Detail from Goldsmith Artists collaborative project. Graphite/charcoal on wall. 2008

     There is a thoughful article in the NY Times on line regarding moral distress in nursing and medicine.  Go to

http://www.nytimes.com/2009/02/06/health/05chen.html?_r=1&partner=rss&emc=rss    to read the article.