This story about any nurse, anywhere, reflects grace.
As a Christian nurse manager of three departments in a community hospital, God has enabled me to be fair, patient, empathetic and understanding. I tell my staff, "Just do your job, and we'll get along fine." I don't ask them to do anything I am unwilling to do. I expect work to be to the best of each one's ability. Generally this contributes to successful management. My departments maintain excellent patient satisfaction, within budgets.
Prior to accepting Christ as my Savior, I was a graduate nurse working nights on the only telemetry floor in a major medical center during the height of isolated AIDS patients. Patients received large amounts of intravenous antibiotics, and as new staff, I got isolation room assignments.
It was common to have fourteen patients, eight of them in isolation with multiple IV drips. We rarely had ancillary staff or a monitor technician. The night staff was responsible for checking the charts, ordering the medications for the next day, tabulating the daily intake and output and updating the nursing care plans. We also handled administration of medications, evening care, patient education, monitoring and signing the telemetry strips, transferring, moving and admitting patients, and the associated paperwork. Telemetry floors are high demand, with frequent admissions and discharges. The volume of work overwhelmed me as a new nurse. I learned bad habits.
It was impossible to complete everything that needed to be done. Something had to give, and it couldn't be patient care. I learned to chart ahead. If I waited until 3 a.m., odds were that anything that could go wrong would have already happened, so it was fairly safe to chart through to the end of the shift. I did not fill in times, in case the odds turned. This rarely happened. I justified that I was not "falsifying medical records" or lying, believing that if anything changed I would write an addendum. I saved time by lying to myself.
I used this shortcut throughout my career. Other nurses do similar things. Human nature, when pushed, tends to give in. I gave in time and time again, until it became second nature. I justified my actions, and the lies became consuming. James states, "You boast in your arrogance; all such boasting is evil. Anyone, then, who knows the right thing to do and fails to do it, commits sin"(Jas 4:16-17).
I became so good at justifying my actions that I failed to see them as wrong. I believed my lies.
Another challenge came when we received a designated cardiovascular lab. Patients were admitted and discharged from the lab, as many as six cases a day. Cardiovascular labs are hectic. Patients need to get in and out quickly. There may be multiple physicians who don't want to be delayed. Each patient requires a four- to six-hour recovery period that needs staff coverage. If the patient leaves at 6 p.m., so does the staff, even if they started work at 5 a.m.
I began to chart ahead. All patients got a 20-gauge angiocath in the left forearm. They had to; it was policy. The history was obtained from the physician history and physical. There was an education assessment and an IV conscious-sedation record with a post-procedure nursing assessment. Procedures, care plans and medications were the same for all patients. I started to chart items earlier and earlier. At first I charted at the end of the procedure. Then I charted at the beginning of the procedure. Soon I was charting days before the procedure.
I justified that if anything changed, the paper could be destroyed and new charts written. I thought, Everyone does it. I'm not lying; if something changes, I'll change the chart. I made excuse after excuse; all were lies that I believed.
Then I got caught. My colleague was appalled and distraught, but I blew it off. I had told myself the lies so many times that I believed them.
"Walk a mile in my shoes before you judge me," was my response. However, God in his infinite wisdom had greater plans for me, molding me into the person he yearned for me to be.
A few weeks later my supervisor, the vice president of operations, called me to his office for a meeting with him and the manager of human resources. I expected the meeting to be about restructuring and possible lay-offs. To my surprise the meeting was about some "disturbing news we had heard about your department and nurses' notes." For a half hour they asked me questions about what they had heard, and I told them the truth, as I saw it. Yes, I charted ahead, out of necessity. No, I wasn't falsifying records because if something changed I would discard that paper and start again. I assumed that I was right and charting ahead was not lying.
I knew how my actions would be interpreted. I was in serious trouble and expected to be fired. My actions would also bring down a nurse I supervised. I left, expecting the worst.
Later that day, the vice president again called me to his office. The administrative staff had met, deciding that the nurse who signed the chart should be suspended for three days without pay. As a manager, I would be held to a higher standard. Most concluded that my employment should be terminated.
Then came grace. The vice president continued speaking, "Although your errors were serious, I couldn't overlook your past record."
I listened in disbelief. I would be suspended for five days without pay, but I would not be terminated. He felt that I deserved a second chance.
Grace had stepped in. There was no earthly reason why I was pardoned. There was no earthly reason why such a grievous act should receive anything less than the fullest penalty.
It was God's grace, bestowed through the vice president of operations, that saved me that day. God's grace allowed me to see the error of my ways. As I drove home, my mind was consumed with all that had transpired. I couldn't believe that I didn't lose my job and was being given a second chance. I couldn't believe that I had been forgiven.
I realized how easy it would have been for the vice president to have terminated me; I saw the extent of his grace. As I began to see beyond my self-justification, my past life became clear, and my heart was opened. I was convicted of my sin.
Calling my supervisor, I thanked him for the grace he offered me. I acknowledged that what he had done must have been hard, but it was the best thing he could have done for me. I explained that if he had not shown mercy to me and had ultimately fired me, I would have become defensive and angry. I would have claimed injustice.
Instead, God stepped in, and grace took control. Without anger and defensiveness to carry me, I was forced to look at the situation honestly.
I'm sorry that I had to be "hit on the head with a hammer" to see the error of my ways, yet I continue to be awed by the wonder of our Savior's love. "While we still were sinners Christ died for us" (Rom 5:8), and while we continue to make mistakes, God's grace is sufficient and true.
This story is written for several reasons. First, in praise to my God and king, who time and time again bestows grace. Second, I owe my profession an apology. I am mortified by my actions and the lie that I justified for so long. Third, this story is for others who may be touched by this confession. May God use it to open the eyes of other nurses who have been blinded by similar sinful habits.
Finally, I share my experience to thank the vice president of operations, who looked at the bigger picture. It was his openness and fairness that enabled God to use him. It was his presence of character that brought forth God's glory. My life's verse is Romans 8:28, "We know that all things work together for good for those who love God, who are called according to his purpose."
Discussion Questions
See http://www.ncf-jcn.org/03fa_kep12.htm for discussion questions and a response from Patricia Emery.