Is it just me, or are nurses pushy? - page 3
Despite being a nursing student, I've don't have complete confidence in the medical establishment and always question any treatment I receive and, as someone in their right mind, would expect to be... Read More
Sep 28, '06As for your OB nurse, I would have handled that situation a little bit differently. I would have said that I wanted to put an IV lock into you now while it would be an easy procedure instead of later if something happened. I would explain to you that if, for some reason, we would have to get meds or fluids into you fast, I wouldn't want to be fumbling around trying to start an IV while the you-know-what was already starting to hit the fan. Especially if your labor had been long and you had little to drink. If your hydration is not up to snuff, starting an IV can be really difficult. If you were to hemmorhage or have a sudden drop in pressure and need a bolus, I don't want to be trying to hit your veins, missing them, and losing precious time.Last edit by NurseyBaby'05 on Sep 28, '06
Sep 28, '06I agree with the previous posts. We as RN's need to be assertive. I guess it could come off as being "pushy." But, like everyone has stressed, it is important to explain certain procedures and the reasons why we are doing them. Most pt's will comply if they are educated on the "why's." It could be that the origional poster was experiencing bad "bedside manner." But, you must keep in mind what is going on outside the box. Nurses today are recieving heavy patient loads and have little time to educate at the bedside. But, procedures should still be explained to the pt no matter what.
Sep 28, '06I'm wondering, firstyearstudent, if you should be in. Why would you want to become part of something that you don't believe in and distrust? You're going to have some trouble if you continue with this belief.
During clinicals in nursing school you seriously see about 20% of the situation - if that. You usually have one patient at at time, and you aren't even aware of a million things the nurse is doing behind the scenes - not just for that patient, but also the other patients she/he is in charge of.
When you're a student and have one patient, you have time to ask questions like these, so it would make sense to always do that. But as a practicing nurse with much, much more on your plate, it's just not realistic. ----Or, you could do that with every patient, but you wouldn't have any time left to implement your other more important interventions, like working with the pharmacy to make sure you get the right meds, calling doctors with errors you caught, making sure someone shows up to take your patients to xray so you can find out if they have pneumonia, etc. As a practicing nurse, you have to prioritize! If you start a debate with a patient, you'll be stuck there for a while and your other patients with more pressing issues will suffer.
Also, you will find that many patients are manipulative. No one enjoys getting poked or moving after surgery, but would you consider yourself a good nurse if you caved in and let your patients do whatever they wanted, however they went home with an illeus, got pneumonia, never healed, etc?
I always explain what I'm doing to a patient, and explain the rationale behind it, but it is first and foremost your job to get these people well and back home if possible. The hospital is not a hotel, and we are not a business trying to lure repeat customers by catering to their whims.
I understand what you mean, but as a student you are not seeing the entire picture here.Last edit by anne74 on Sep 28, '06
Sep 28, '06Quote from goats'r'usI couldn't agree more! Thank God some of us "push" our patients. I don't consider myself "pushy" but I like to think I know what's in the best interest of the patients. I also can become "pushy" to a Dr when I am advocating for my patients.yes, nurses are pushy.
if nurses weren't pushy, tonsillectomy patients would eat jelly and icecream for a fortnight, then return because they ate scratchy food, knocked off a huge clot and started bleeding, joint replacements would never get out of bed because it hurts too much, abdo surgery patients would all get pneumonia because deep breathing and coughing hurts, patients with limited mobility would get pressure sores because no-one wants to be woken every few hours to be turned, and no-one would shower because it's so much easier to just wash their face, hands and privates in bed.
think about it. we don't do it for OUR health!
Sep 28, '06Quote from firstyearstudentWhy do you even WANT to be a nurse?Despite being a nursing student, I've don't have complete confidence in the medical establishment
Sep 28, '06Try not to be critical or take what the OP said personally. That being said,the posters questioning why you're attempting to enter a field you "don't trust" bring up a valid point. A heart-to-heart with an instructor or someone who's opinion you respect who has been a nurse for a few years is probably a good idea. Some soul searching on your own would probably do you good too. I think you may be letting one bad experience with nurses as a patient combined with lack of "non-ideal world nursing" professional/student experience discolor your view of the medical profession. If you reflect on things and find this is not the case, nursing may not be the career for you. Or maybe the time for you to be a nurse is just not now. You may feel differently about the medical profession in a few years. If I were you, I would sit down and try to discern these things before proceding any further with your nursing degree. There's no sense in you spinning your wheels and being part of something you don't have faith in. Do I think you'll be an awful nurse? Probably not. Do I think you won't enjoy what you do and will feel uncomfortable practicing in a field you don't believe in? Yes. Not to start a flame war or pro-life/pro-choice debate, but feeling as you do now and continuing to practice in the nursing/medical field would be like a vehemently pro-life person assisting in elective abortions for a living. Good luck!:icon_hug: I know this can't be easy for you.Last edit by NurseyBaby'05 on Sep 28, '06
Sep 28, '06I have to make a confession, only 6 months ago I was a GN in a busy teaching hospital. And because I have a naturally polite personality, I was the nurse who always asked if it was okay if I did my assessment or this or that and was told so many times to come back later for reasons like The Price is Right was on and such that I had a horrible time with time management. Not so anymore. While I do not think of myself as "pushy" by any stretch of the imagination, I will tell you that once I got to understand that I wasn't inconveniencing my patients, rather I was treating them in a timely manner thus getting them better and back home faster, assertiveness has become a second nature. Patients for the most part understand that nurses aren't trying to do wicked things to them just because the doctor says so. The ultimate goal is to get the patient well and get them home. I explain the reason behind what I am doing and if the patient has any problem with it then they will tell you. I think it is commendable that you want to protect the patient's independence and decision making. However I challenge you to work as a nurse before judging. It is much easier to apply hollistic care and provide hours worth of patient education when you are a student than it is once you have a 6 patient load of your own and might I add, students of your own.
Sep 28, '06I am pushy, I am also calm, happy, quiet, assertive, loud, serious, funny. I am a different nurse for each patient, all the while trying to get everyone to their highest level of functioning.
Sep 28, '06This is why else nurses have to be "pushy":
Sep 28, '06Quote from firstyearstudentNot to sound calloused or flippant here, but bad things do happen. Sometimes they are nobody's fault."
I have some basic distrust of the medical system and, frankly, what I see doesn't make me feel more confident. I've seen people walk into the hospital for back surgery who are still there a year later with a drug-resistant infection. And guess what, the surgery didn't even fix their back!
I've seen people have bad allergic reactions to the penicillin they were given for their strep throat. You can avoid an allergic reaction by not treating the strep. Of course, I've also seen a young man on dialysis because of kidney failure from untreated strep throat.
Most of the "pushing" that nurses do are done to keep bad things from happening.
Sep 28, '06I have to be pushy sometimes, and not my personal favorite thing to do...but it has to be done in some cases.
Many times I find that questions that are asked of me are better answered by the MD! People don't generally know the difference between a nurse order or task from a MD order or task. SO I explain this and call the MD to come and answer a few questions for the patient (typically stuff the pt forgot to ask when the MD was there...it happens, happens to me too! LOL!).
If it is a question that I can answer I tend to give a nice apple/orange explaination, and sometimes I can get some print outs about it from our large data base computers/library! I also have to remind patients constantly that their an individual, and choices in treatments is an individual choice based on their history and condition and made by the MD! So I can't get too specific on things considering I am not a MD!
Other things like hanging an IV bag or what not...I typically use humor so people know what I am doing. "Hanging a bag of regular unleaded for you" or "gee look..another antibiotic for you! THis one is cherry flavored!" Or 'WOW...wonder why we call this the banana bag!?!?!?" LOL!!!! My patients (depending) seem more relaxed and cheerful when I do that!
Or when I go into do an assessment and I have to auscultate, I say "let me get my ears on and listen to your thumps, breaths and girgles!" or even "hey you have been here long enough to be a nurse...you know the drill..." LOL!
But at times you do just have to go in and do what you need to do and get out for the next patients...it happens! That is why I tell people from the start when explaining call lights..."hit this little red cross button here, and me or someone else will come as soon as possible, if it isn't me that means I am with another pt and will check on you when I am able!". That reminds them that I can become busy, but I still care!"
Sep 28, '06It's a tough balance to strike:
Being very respectful of every patient's complete autonomy and self-assertion and the push to manage your time (you have LOTS OF PATIENTS to do these things for) in an effective, safe and timely manner.
It's so hard to bring it ALL together in every case. But most of us do try, and very hard, I might add, to do just that.
Good luck in your studies and your future nursing career. Keep your mind open, as well as your heart, which already is. You have definately qualities I respect in a nurse. Don't lose sight of what is right. But be willling to see ALL sides and learn.
Sep 28, '06I don't look at it as being "pushy", I call it being persuasive. As a student, I had a patient on the med/surg floor who had mental health issues(paranoid schizophrenia) It came time for her to get washed up and trust me, she needed it! The floor had these wipes that had soap and lotion already in them. She was determined not to let me wash her up until I told her in a hushed whisper that these were brought in special, and that they were a "beauty treatment" Voila! She gladly let me wash her, because she thought she was sticking it to the hospital. Now, I'm sure someone new to nursing might be horrified by that, because I fibbed about the cloths. But ultimately, she was better off for having had that bath. I also agree with the person that said that they sign a consent to treatment. The patients that are in the hospital and then refuse to comply with treatment irk me. Nurses have enough to do without dealing with passive-aggressive mind games. I think once you are a practicing nurse, you'll understand more and probably will come up with some techniques for "persuading" a difficult patient that work for you. By the way, my instructor loved the "beauty treatment" idea. After that, I tended to get all the patients with mental health issues. Gee, thanks!Last edit by ortess1971 on Sep 28, '06