As a Nurse and a Patient

Nurses General Nursing

Published

As a nurse and a patient, who would you want taking care of you, let's be honest we all have Doctors, co-workers, AND Nurses who we would never want to touch us or our family.

Personally I would want the toughest, smartest, assertive, grumpy old army Nurse (sadly they are a dying breed) taking care of me and my loved ones. NOT the Nurse who gets all the patient satisfaction awards.

Sadly today it's all about patient satisfaction, not patient care or outcomes, most patients don't know what they are missing, but they love their nice NURSE.

Part of this is, I keep reading how mean some people can be, and how we need to be more accepting and supporting of each other.

What do you think?

I'd want my stern, but kind, mother. Or me (even though I'm not a nurse yet). I'll tell you what's what, but it won't be in a mean way.

Up Vote Up Vote ×
As a patient (not a nurse) I assume that if someone has graduated from an accreditated nursing school, passed his/her licensing tests, and been hired by a hospital, that they are qualified, capable, and competant. I also assume that if I am in a good hospital, that the nurse's supervisor will monitor their work and that the hospital will insure that the nurse receives continuing education. I also assume that the nurse is aware of what they can and cannot do well and will seek assistance when necessary.

Since I'm assuming that all the nurses in the hospital do a good job,.

Yes I believe most of the public believe that,

But in the real world, graduating from an accredited nursing school, passed his/her licensing tests, and been hired by a hospital, that they are qualified, capable, and competent, only demonstrates you can have the very basic basics and can pass a test.

Because we all know there is no difference in care from a seasoned competent and a new grad competent nurse, new grads know everything they need to know.

Up Vote Up Vote ×
Wouldn't you rate grumpy Nurse highly in a satisfaction survey?

Yes because I would be focused on patient outcome.

Up Vote Up Vote ×
Specializes in Geriatrics, Home Health.

Because we all know there is no difference in care from a seasoned competent and a new grad competent nurse, new grads know everything they need to know.

How do you expect a new grad nurse to become a seasoned nurse?
Up Vote Up Vote ×

Just like everyone else, by learning from yours and your peers mistakes, everyone is different. We all have strengths and weaknesses.

Build on your strengths and limit your weaknesses. Follow your passion and take pride in being a nurse.

Again I miss the rock solid nurses, I will never forget the things I learned from those who were the toughest on me. They were tough, called me out when I made mistakes and acknowledged when I did the right thing. I still want to make them proud. Today you would get written up.

Most new nurses are to thin skinned to benefit from that kind peer pressure. I never felt bullied, but there were expectations.

Up Vote Up Vote ×
Specializes in Pediatrics, Emergency, Trauma.
I've said basically this same thing over and over -- the "nice" nurse vs. the good nurse. The nice nurse the one that gets all those customer satisfaction awards, is the one who gives you all the water you want to drink even though you're on a fluid restriction. She doesn't make you cough and deep breathe post op because she knows how uncomfortable that is. If you don't feel like feeding yourself or washing yourself, she cheerfully does it for you because you know it's all about the patient satisfaction surveys and not so much about returning you to independence. Then there's the nurse that not only knows you're on a fluid restriction, she knows why. And when you ask for that big glass of water, she tells you about the fluid restriction and explains that she's getting you a small glass of ice chips. She insists that you cough and deep breathe, nevermind that it's uncomfortable for you. She doesn't want you to get pneumonia. And while she's happy to set up your tray and even cut your meat, you can feed yourself because it's all about getting you back to being independent. No matter how nice she is about saying no to the water and insisting upon coughing and deep breathing, she doesn't get the same amount of patient satisfaction awards, but her patients some how do better. Unfortunately, that isn't rewarded.[/quote']

:yes:

Although I've seen more good nurses than "nice" nurses,behave been mentored by the "good" nurses and have mentored them in the same fashion as I have experienced, I think there is hope for the future. :) I have seen more "good" nurses dismayed by their "nice" nurses when being precepted...so I believe in a tipping point may be in order (finally)....

Up Vote Up Vote ×
Yes I believe most of the public believe that,

But in the real world, graduating from an accredited nursing school, passed his/her licensing tests, and been hired by a hospital, that they are qualified, capable, and competent, only demonstrates you can have the very basic basics and can pass a test.

Because we all know there is no difference in care from a seasoned competent and a new grad competent nurse, new grads know everything they need to know.

Oh, I don't know. I think the public realizes that a new grad nurse probably isn't as capable or as knowledgeable as the battle-axe with 20-years under her belt. Even if both are technically "competent" there's no way a new grad compares to a seasoned pro.

But this is true of any profession. It's just common sense.

As a patient, I think I'd be most scared of the new nurse who's afraid to simply say: "I don't know, but I'll find out". The ones who try to bluff and fake their way through it are the scary ones.

On the other side of the coin, it should be pointed out that having decades of experience doesn't necessarily guarantee a top-notch nurse. I've worked with a few nurses (both LPN and RN) whose 20 years of experience only means that they've had 20 years to perfect their bad habbits.

Up Vote Up Vote ×
Specializes in Public Health, L&D, NICU.
Ideally yes, but in an imperfect world if I have to choose I want competent.

I was informed by an idiot nurse manager that "You could just about kill a patient, and as long as you were sweet while you were doing it, the family wouldn't care!" Um, I would care. I don't care how nice you are if you are stupid. Smart caring nurses are wonderful, but if I have to choose, I'll take smart.

A couple of years ago I was treated in the ER for intractable migraine with an iV of magnesium sulfate. Pharmacy delivered it as 2gm/250 ml of 0.9 NS x2 instead of 1 bag with 4gm of MgSO4. Bag 1 runs out. The nurse had not set the VTBI, so I got to listen to loud beeping for about 20 minutes, and the tubing all the way down to the pump was filled with air. When she finally came back in to hang the second bag, she stared at the air in the tubing, pulled the tubing out of the pump, looked at it again, bit her lip and said, "I think I'll just see if I can get the air to run through" with the tubing still attached to me. Now, I know it probably wasn't enough air to kill me, but it wasn't a chance I was willing to take. It wasn't just a few bubbles, but half of the tubing full. I politely told her that if she would get me a 20cc syringe and an alcohol swab, I would teach her a new trick. Thankfully she was willing, and I got all the air out of the tubing and then helped her set the VTBI. Her response said it all, "Wow! You learn something new every day!" She was very kind. Very, very kind. And young, and cute, and neatly attired. All the things that seem to mean so much to management and administration today. She was ignorant, though, and that ignorance could possibly kill someone. Give me the crusty old bat any day. If I want nice, I'll call my best friend.

Up Vote Up Vote ×
Specializes in Med/Surg, Academics.
Oh I agree! I was in the hospital for a few days last year and give me that old battle ax nurse! My newer girls were nice and sweet but they just pretty much came in and checked me out, gave meds and took off. I was having an odd pain at my incision site....just didn't feel right and these gals were like, we'll let me know how it is Ina few hours. The older gal had a feeling something was off and insisted the doc come and check it out, I heard her in the phone...this resident was getting an earful and she insisted the fellow come down. Sure enough my internal stitches were popping and needed repaired. Thank you to the mean gal( I heard the new nurses complaining about her) or I would have dehised.

I think this and Ruby Vee's descriptions are probably the most accurate of the differences between a good nurse and a nurse who is going through the motions but thinking she is a good nurse. The nurses who just put it off were assessing, but didn't know what to do with the information. There are nurses who put the IS at the bedside, but the patient doesn't know what to do with it or why it's important. Nurses who chart refusals, but don't take the time to educate the patient on the SCDs or the bowel maintenance meds and activities. Or who leave all the CHF teaching to the QI nurse. Or who treat the discharge papers as just another form to be signed, without pointing out the meds the patient still needs to take later in the day at home. Or come across a deconditioned patient who is ready to regain some strngth and think the PT/OT order is good enough. All of this stuff is still part of our job, but some nurses stop at just filling the doc's orders. It is quite an upsetting state of the profession.

Up Vote Up Vote ×
I was informed by an idiot nurse manager that "You could just about kill a patient and as long as you were sweet while you were doing it, the family wouldn't care!" Um, I would care. I don't care how nice you are if you are stupid. Smart caring nurses are wonderful, but if I have to choose, I'll take smart. A couple of years ago I was treated in the ER for intractable migraine with an iV of magnesium sulfate. Pharmacy delivered it as 2gm/250 ml of 0.9 NS x2 instead of 1 bag with 4gm of MgSO4. Bag 1 runs out. The nurse had not set the VTBI, so I got to listen to loud beeping for about 20 minutes, and the tubing all the way down to the pump was filled with air. When she finally came back in to hang the second bag, she stared at the air in the tubing, pulled the tubing out of the pump, looked at it again, bit her lip and said, "I think I'll just see if I can get the air to run through" with the tubing still attached to me. Now, I know it probably wasn't enough air to kill me, but it wasn't a chance I was willing to take. It wasn't just a few bubbles, but half of the tubing full. I politely told her that if she would get me a 20cc syringe and an alcohol swab, I would teach her a new trick. Thankfully she was willing, and I got all the air out of the tubing and then helped her set the VTBI. Her response said it all, "Wow! You learn something new every day!" She was very kind. Very, very kind. And young, and cute, and neatly attired. All the things that seem to mean so much to management and administration today. She was ignorant, though, and that ignorance could possibly kill someone. Give me the crusty old bat any day. If I want nice, I'll call my best friend.[/quote']

I'm new... What's the trick? I've tried pulling air out of tubing with a syringe and it didn't work.

Up Vote Up Vote ×
Specializes in Med/Surg, Academics.
I'm new... What's the trick? I've tried pulling air out of tubing with a syringe and it didn't work.

I've never done it, but I think it's this, in theory. Clamp the pt's J loop and engage roller clamp, remove tubing from pump, connect syringe to port distal to the air, open all clamps proximal to bag, pinch tubing distal to port where syringe is, pull/empty syringe/pull/empty syringe until air is removed, set up infusion.

I avoid this by using flush bags w/ primary VTBI @ 20 cc w/ rate set at same rate as piggyback. Using flush bags means pts will get everything from the secondary bag and primary lines will never go dry. Especially important with multiple abx infusions. I hate thinking pts may not get 20% of their meds from a 100 ml abx bag.

ETA: I get the smallest flush bag possible and label it "flush bag only" to make sure that if another nurse comes in to stop a beeping pump, she doesn't inadvertently set up an IVF thinking the patient has an order for it.

Up Vote Up Vote ×
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I was informed by an idiot nurse manager that "You could just about kill a patient, and as long as you were sweet while you were doing it, the family wouldn't care!" Um, I would care. I don't care how nice you are if you are stupid. Smart caring nurses are wonderful, but if I have to choose, I'll take smart.

.

Unfortunately, I think your idiot nurse manager was correct. As long as you're sweet, the family thinks you're smart and you know what you're doing.

Up Vote Up Vote ×
+ Add a Comment