What exactly do you do?

I get this question all the time. The conversation goes something like this:

What do you do?
I'm a nurse.
So you take care of patients?
No, not really I am a Quality Improvement Specialist
Well what do you do if you don't take care of patients???

I know it's a non-conventional thing for a nurse to do, but it is important and we need someone to do it. Someone out there looking for opportunities to provide better care to our patients. Not to get doctors, nurses and other medical care workers in trouble, just someone making sure that patients who go into the hospital come out better than when they got there and not worse. And, yes, I realize that sometimes that even means not coming out alive.

See it's personal for me. My brother was always sick. He had chronic renal failure requiring dialysis. He started dialysis and then miraculously got a kidney transplant a few months later. But, he was allergic to the anti-rejection medications so the new kidney took a hit right off the bat. Then it was back on dialysis. People live on dialysis for years. And they get tons of infections, have cardiac arrests and die suddenly because of erratic blood chemistry levels, blood clots, etc. It's a hard life, but people do live.

My brother was not the usual patient, he hadn't done anything wrong to "kill" his kidneys, he was just born that way. He didn't take the best care of himself and as a nurse I know he was probably one of the "difficult patients" we all encounter. We were scared and we wanted the best care that could be had. We watched the nurses like a hawk and questioned the doctors endlessly. We all had high expectations. I was in nursing school while my brother battled the brunt of his disease. I knew what kind of nurses patients needed and I was determined to be one of those nurses. I am one of those nurses. But I realized that not everyone is.

It was 2 days after Christmas, it was shift change and not "visiting hours" in the ICU. We asked to see my brother before his surgery, to say a prayer, to sit with him. He wasn't the usual comatose 80 year old patient in the unit. We were told no, we would have to wait, but they would get us before he went to surgery. My sisters and my dad waited in the hall as they wheeled my brother down the hall. My mom didn't have time to make it from the waiting room before they wisked him into the OR for this "minor pricedure".

My brother died alone in an operating room after a rushed decision to do a tracheotomy following a heart valve replacement because of MRSA growths on his mitral valve. My brother did not have heart disease, he had kidney disease... He was 28 years old. He died alone 2 days after Christmas and 2 days before his birthday, from complications of a health care acquired infection. My brother is in a better place, he suffered while he was sick. I am grateful for the nurses and doctors who did have patience with my family and I am angry that someone, somewhere along the lines made him sicker than he was by passing on that infection.

I have a passion for what I do, I don't want to tell doctors how to treat their patients. I want doctors to follow guidelines and develop protocols so that some of the individual accountability to remember every single mundane aspect of care is eliminated and doctors and nurses actually have time to take care of their patients.

Rest in peace Robbie ~