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28 July 2013

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Kate

You know, you have a wonderful strength here in your ability to both empathize and analyse. I hope your friend benefits from this advice, I know it strikes me as something I could benefit from musing on a bit!

In particular, I find it interesting how you take something I've always considered a negative (I would state it, 'not choosing' is still choosing) and turn that on its head (you prioritize even when you don't have time to do so consciously).

Rebekka

I think I was about three paragraphs in when I thought "she needs to prioritize". This is a huge and acknowledged (though maybe not enough) part of nursing and, in my experience, a vastly under-acknowledged part of parenting.

You prioritize even when things are going great, but it requires greater consideration when demands are high and resources are low - illness among staff, especially ill or unstable patients, patients with high-needs family members, lots of multidisciplinary coordination...

Prioritizing is most necessary and most difficult when you have to choose between tasks that you consider basic care, or matters of course. Sometimes personal hygiene is going to be extremely perfunctory, or verging on nonexistent, because there are epic rounds, or a full day's battery of diagnostics. Or, what's harder for people to understand, because the patient next door, whom we can't tell you about because of confidentiality, keeps trying to die.

The ability to do prioritize becomes more intuitive with experience (think of a first-time parent of a newborn trying to pack a diaper bag).

Sometimes it just sucks. Then it's closer to triage. There are three M's in Danish: mad, mås, medicin. Food, bottom, medicine. The ultimate no-frills care.

Your friend should consider asking for a team conference, if she hasn't already. These are typically useful for complex cases where there are lots of different people caring for the same person(s). If some of the personnel is only peripherally aware of the other siblings, it may be possible to streamline some of the tasks. Are there exercises or training she can do with more than one child, for example?

bearing

Rebekka, I can't count the number of times you've commented with something insightful drawn from professional nursing.

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I think I read something somewhere about this

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