Is it just me, or are nurses pushy?

Nurses General Nursing

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Specializes in Education, Acute, Med/Surg, Tele, etc.

I 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!"

SmilingBluEyes

20,964 Posts

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

It'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.

ortess1971

528 Posts

Specializes in OR.

I 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!:rolleyes:

Altra, BSN, RN

6,255 Posts

Specializes in Emergency & Trauma/Adult ICU.

I agree with the other posters who have suggested that a heart-to-heart conversation with one or more of your instructors and/or other medical professionals you know personally is in order ... STAT. You would probably benefit greatly from exploring whatever is the source of your stated "distrust of the medical system" and your personal reasons for pursuing nursing as a career choice. We don't need to know those details here, but I agree that it's very important that you understand them.

Some relevant facts of life:

1. Bad things sometimes happen which are beyond our control. Post-op infections, disease complications, or the myraid permutations of a patient's lifestyle, personal values & family dynamics are simply reality -- not necessarily someone's fault.

2. Human beings are mortal.

3. Modern civilization has become sufficiently complex that responsibilities, knowledge bases and skills are specialized. None of us know everything about everything that we need/use in our daily lives. We maintain the basic variety of skills necessary to function well in society (including interpersonal skills), cultivate expertise in an area which suits us, and leave the rest to other "experts." To go back to the plumbing example ... my plumber will gladly explain why my bathtub is leaking into my basement and what he proposes to do about it. But he is the expert - that's why I pay him.

4. Psych 101: broadly applying a loaded pejorative term like "pushy" to describe a set of behaviors as varied as the the millions of professionals who practice nursing is not likely to be received well. You might still get your question answered, but you've opened yourself up to unnecessary bad karma in the process.

Altra, BSN, RN

6,255 Posts

Specializes in Emergency & Trauma/Adult ICU.

Clarification: many posts have described various educational/persuasive techniques used in patient care. After re-reading the entire thread twice, I personally read the OP to mean not so much that she objected to individual nurses' whose personal styles she may have perceived as being aggressive, but she is objecting to any patient care/procedure which is not completely explained and verbally agreed to by the patient, as in her foley catheter example.

I could be wrong.

rambisisking

145 Posts

Why do you even WANT to be a nurse?

Kev

I'm not sure this is fair. This poster is asking a question concerning the wellfair of people. That shows me that she has the patients welfare utmost in mind. No where did she say that we should not act in an emergency when needed. She only questioned why she has not seen an overall attitude regarding this issue for patients and even for herself as a patient.

To question her desire to be a nurse does not seem to be the issue here as she is already showing concern for patients rights. As nurses, you bet we have the responsibility to explain procedures to our patients, That attempt must be made, and then yes...for crying out loud...if you have an 89 year old confused patient flailing about you may have to just act and not continue to try to explain. That is a nursing judgement, and certinally in emergency situations this would hold a different priorety. But please do not let our ego's deny her stand which she is stating most respectively. What she is asking for is respect back and wanting to give this to her patients. I have been a nurse for 33 years, and yes, I would call out any nurse, doctor, or tech. for not explaining to me or to a loved one or to anyone what they are about to do and why. And I have! Because this is the profession that you choose does not mean that you have to agree with all that you see to be a part of it. I think it is very good to have new eyes to point out some things that we forget or overlook in our very busy schedules. This is how we continue our high standards and progress.

Thanks for more great responses. I am reading and thinking about everything that is posted.

Specializes in Acute Care Psych, DNP Student.

I can tell you that I have some *personal* issues of needing control for myself. When I am a patient in the hospital - I want to know what is being done before it is done. That is satisfied by a bried "hi there Multi, putting in a catheter for your surgery now. I'm going to do xyz and you might feel xyz." Wham bam done. That is fine. However, if my nurse asks me if I want to be catherized, if I want/ approve of having pre-op ab's, etc etc I would get exhausted from trying to decide what is really going on, etc. I would also question if she really thinks I ought to have these things or if she is trying to 'tell' me something. It is not my job as a patient to porifice thru so many details, and if I'm sick enough to be in the hospital I'm not exactly functioning highly on Maslow's well enough to think all this thru. We must surrender a certain amount of control when we are patients in the hospital. I hope that makes sense.

Now BIG things, like should I have xyz surgery...you bet I want full discussion. But for every single little thing it is overload. If I have a question or concern I'll ask. If I'm stymied or hesitant about something my nurse should pick up on that, pause and question me.

I am very tired so I know I'm not explaining myself well. I can tell you that I had an attorney once who called me daily during a routine lawsuit explaining detaaaaaaaaail by detaaaaaaail and asking me for permission to proceed. It was to the extent that it was overkill. It got me confused and zapped my energy. I needed him to be clear and brief about details and ASSUME leadership and get it done. He sucked me dry parsing details. I think the same can apply with patients in the hospital.

Now mind you I'm a control freak personally and this is my outlook.

Specializes in Paeds, Gen surg, Coronary Care, ED.

Before i was i nurse, i was never pushy, never stood up to anyone...

now i'm a bit of a power freak... and am pushy... in the nicest way possible.

as it has been said through-out this thread, as soon as i explain what i'm doing, there is co-operation. and lets face it. if a patient REALLY has a problem with in IDC or NGT being inserted... they'll arch up. which is fair. but its not in their best interest.

i also always tell my patients and family to continue to ask questions, so if the are unsure of what is happening, they are not afraid to ask...

but it also works both ways... i may be pushy with the Pt's, but i can also be pushy with the doctors... have you seen this patient yet? i'm not happy with how this patient is.. i dont think that x is appropriate...

it gets results

Nikki

Elisheva

200 Posts

I prefer the word assertive.

General E. Speaking, RN, RN

1 Article; 1,337 Posts

Specializes in floor to ICU.

I have told patient's that they have the right to refuse anything we want to do to them. It is their right. And I do explain it in a nice way. I have also told a few patient's that (if the situation calls for it) that they have the the right to leave AMA. They shouldn't be made to feel like a prisonor.

But it isn't always cut and dry what's the best medical or nursing decision in each individual circumstance. Don't doctors and nurses need to work with patients to figure out what the best course of action is and individualize care, taking into account the patient's needs and preferences? Isn't that why we need educated, experienced nurses who know how to work with people. Otherwise we could just get computer programs with protocols and flow charts to tell aides what to do.

And I know that takes more time than nurses have, and I know that nurses can't really get to know their patients because they're in the hospital for such a brief period of time now. But ideally, and doing what they can with the time they do have.

Maybe it's just me. People like to see confident doctors and nurses. They tell us this in school and I guess it's true. But I see a facade or worse (professionals who do really think they know it all!) and it's one I don't like. Medicine and nursing is at its very best when it's making its best guess about a course of action using scientific evidence, intiution and psychosocial knowledge about the patient. My favorite doctor was the one who when I asked "What's wrong with me?" said, "Heck if I know! Let's try X and see if it works."

I don't want to be a confident nurse: "This is best for my patient." I want to be a douting nurse: "Is this best for my patient?" And I would hope that my doubts grow, not lessen, as I become a practicing nurse.

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