Posted by Lieutenant Kreed (Chief Medical Officer) in The Arrival of Leah Hart

Posted by Lieutenant Junior Grade Leah Hart (Nurse Practitioner/Counseling) in The Arrival of Leah Hart

Posted by Lieutenant Kreed (Chief Medical Officer) in The Arrival of Leah Hart
Posted by… suppressed (4) by the Post Ghost! 👻

(snip)

Kreed looked at her and said “I have no idea. That is your purview.” He took a breath and then said “I believe that one of us should be on duty at all times… or at least on call… but I would like to see some overlap in our daily routine so that we have a chance to confer or for any issues that may arise. I, of course, have the utmost confidence in your abilities as a nurse and a medical professional. The same cannot be said of the computer or of Star Fleet Medical. There will be some things that you will simply not be allowed to do by regulations. I will have to either approve or do the action myself. I do not want you to ever believe that is my doing. I would have no compunction to you treating me for any physical malady… and we know that you have the psychological side of health and wellness as your domain. I will strive to give you complete autonomy with regards to that; although I do want to be informed of the need for any kind of medications outside the normal anxiety, depression, et cetera. Just so I can be aware of where the crew is at. Is that reasonable?”

Kreed, CMO

“Absolutely,” Leah said with a firm nod. “I understand that there are limitations and I’ve never sought to go beyond those. Now, I might argue for a course of action I believe someone should take who has the authorization to do so, but at the end of the day, you have the medical degree. I appreciate that you want us to be partners here though. It makes my job easier, not just because we’re not automatically at odds, but because our works needs to dovetail neatly together in order to be effective. I like to talk things out with someone when I’m trying to make a diagnosis, and I have no issues going to you with medication requests above what you’ve outlined.”

“Can you tell me more about the organization of the department in a practical sense? I’m coming form a hospital background, so I know there will be a slight adjustment.”

~Leah Hart, NP

Kreed said “We are currently staffed with three Doctors, one Nurse Practitioner- yourself, of course-, seven nurses and four medics. I have assigned dedicated staff to each of three shifts, with an hour of overlap between shifts to allow for hand-downs of information. Sickbay is open at all times, and in the case of an alert all Medical staff report here for assignments. Most ships allow the highest ranking officer to be in charge if the CMO is out. I do not do that. When I am not here, it will be a doctor in charge. If there is no doctor, it is you. Regardless of that hierarchy, you as the Nurse Practitioner are in charge of the nursing staff. This has northing to do with doctors being superior to nurses; it has to do with the jobs being markedly different to those of us who do medicine. I would not know how to be a nurse. A nurse would not know how to be a doctor. What we do is complimentary, of course… but it is different. As such, a Nurse should be in charge of the Nurses. Is that reasonable to you as well?”

Kreed, CMO

“That’s fair,” Hart said before she brought her hand to her chin and tapped it with her index finger. “What is your stance on disagreements between nurses and physician? I will add the caveat that the issues isn’t one where someone is overstepping their bounds.”

~Leah Hart, NP

Kreed was silent a moment, thinking. “Disagreements between nurses, you. Doctors, me. Doctor and nurse? Both of us. But we do not take sides based on title. We do what is right for the patient, first and always. A nurse will get in more trouble with me for not doing something they know needs to be done and they know how to do because they were waiting for a doctor to sign a form. But that doesn’t mean they are free to make decisions outside of their medical purview. If they are not qualified, don’t do it. If it’s a matter of regulation or protocol getting in the way of proper patient care… that is an entirely different matter.”

Kane, CMO

“Good,” she said simply. “And my being around helps with that because I can authorize the basic things. I just wanted to be sure because I’ve dealt with more than my share of doctors who forget that nurses tend to spend a great deal more time with individual patients and might have information that doctor does not, or a better idea of what the patient needs holistically. I know you, but I don’t know the other doctors, so I just want everything to be clear up front.” He knew all to well that Leah wasn’t afraid to fight for a patient, even at the risk of conflict with those that thought they knew better. But that had been a different scenario altogether.

~Leah Hart, NP

“I have had no reservations with any of the staff thus far. But we haven’t really had much time for interpersonal interactions, either.” Kreed said. “Any other questions or concerns before address the other matter?”

Kreed

Leah shook her head and then sighed as she tipped her head towards the ceiling. Surely, that said a great deal to him?

“The other matter being our first officer,” she said, lowering her head to meet Kreed’s gaze. “As you know I allowed him to remain on duty while I was in transit with specific criteria he has to follow or that approval will be rescinded. There is some leeway, but very little and he knows that I won’t tolerate being lied to in order to get that leeway. Simply put, I needed more time with him in order to flesh out my report. I have a preliminary report that explicitly says that a follow up appointment is necessary in order to complete it, but at that time I would then have enough to come up with a treatment plan that can be discussed with his other care providers,” she said, gesturing to Kreed. “I almost didn’t clear him for duty though.”

~Leah Hart, NP