As nurses, we have an interesting challenge: We need to make sure we are doing our jobs as quickly and efficiently as possible while still making sure to carefully pay attention to and make note of every detail in the care process. This can be especially tricky when it comes to conditions like stroke where every second makes a difference.
I sometimes pick on ER physicians for hesitating to give tPA for stroke despite data that supports administering, but the responsibility isn't 100% theirs. Our nursing skills play an important part in ensuring that a patient stays within the guidelines. As hospital systems, sometimes we push a little too hard to go straight to CT, for example. In general, I think pushing to go directly to CT is a good thing ... but problems arise when we get tunnel vision and forget the little things that can make a difference down the line. John Wooden, the legendary basketball coach of the UCLA Bruins, has a famous quote that I love: "Be quick, but don't hurry."
How does a basketball quote relate to healthcare? Imagine this scenario: After EMS's arrival, you take the patient straight to CT (acting quickly -- good thing). You're 20 minutes in and it looks like a little less than 30 minutes left to give tPA. Now, you're back in the ED, and when you take a blood pressure, it's 198/120. You are now officially behind the eight ball despite your good intentions. You had 25 minutes to obtain this blood pressure, but with all the rush and chaos, you didn't (because you were hurrying -- bad thing). You have the green light to treat, but now you can't because of the blasted blood pressure.
In a recent podcast, Stroke Program Consultant Debbie Roper encouraged Stroke Coordinators to allow their data to speak to them. One way to have your data to talk to you is to ask it questions. Ask your data why you have a sub-par treatment rate. If the answer is due to blood pressure, there may be room for improvement in your nursing education. If the answer is frequent little mistakes or missed pieces of information, you may have a hurrying problem on your hands. Slow down, work methodically, and check all of the boxes. Doing so may cost a few additional seconds or even minutes in the short-term, but can have major payoff in the long-term.
Remember: Be quick, but don't hurry.