I still find it interesting that many outside of healthcare don’t truly understand what a nurse does. Television, movies, and fiction all have varying takes on the subject– most of which don’t depict reality.

What is your definition of a nurse? When you’re in contact with the medical system, what do you want a nurse to do for you? I would love to know.

My ultimate role as a nurse is to serve as an advocate for my patients. In pediatrics, that means my clients range from a newly born infant to a young adult who is most often accompanied by a parent. How can this be a source of conflict? Let’s take a look at an example of how my advocating for a child can become a source of conflict between me and the parent.

A parent presents with her teen daughter and wants her tested for drugs. The mother has concerns that her child may be experimenting and wants confirmation. Can we run a drug test that covers common drugs of abuse? Yes. Will we in this situation? Depends.

How are we going to obtain the urine specimen if the teen is not a willing participant? We would have to hold her down, pull her legs apart, and insert a catheter into her bladder. Legally, this would likely be considered assault if the teen is not having a medical emergency. A medical emergency would be something dramatic– like no pulse and no breathing. Or, the patient is unconscious and we’re trying to determine why. In this situation, the teen is not experiencing a medical emergency. The teen is awake, alert, and communicating appropriately. As a nurse, I am not going to do that to her regardless of the parent’s demands.

What are the options?

First, the physician will have a conversation with the parent and child to discern the parent’s concern. The child will be interviewed alone and asked pointed questions about their drug use. The parent may also be interviewed alone as well. The first issue is to figure out if there is a legitimate concern. If there is, will the teen willingly submit to the drug test? If so, we’ll run the drug screen. If not, in a non-emergency situation, the approach will likely be to get the family into some counseling.

However, if we do drug test the teen, we may or may not disclose the results to the parent. Whether or not this information would be released depends on the state and the age of the child.

How has a nurse advocated for you?