Is it just me, or are nurses pushy? - page 9

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

  1. by   BSNin2007
    I graduate in May and during my first semester of clinicals I felt like the nurses would "eat their young" if allowed, BUT since being on the floor much more and also having been a patient several times and correlating these experiences I now get it. Being assertive is not being pushy. Hopefully your perception will change as you progress in your program as well.
  2. by   Millit
    I am in my final semester looking to graduate in Dec. and must admit that I also had the same issue. However, I will be the first to admit you must discuss this with your instructor, or find a tactful way to ask the nurses that you are working with about this issue because if left unresloved you will find yourself forever behind, and when you start acquiring more patients in your clinical day, you will see first hand how critical it is to get in there and get your assessment, your meds, and your vitals done, and then as you move through the day you have a little extra time to ask the patients if they have any questions or concerns that they would like to discuss since you have a little extra time. You will be able to judge for yourself the patients who need further explanations and those who are content to let the nurses and the doctors manage their healthcare concerns. Education is a large part of being a nurse, and I have found that if you assess the level of knowledge the patient has in reference to their healthcare, and to their current issues as you are doing your assessment, or your vitals, you will know immediately how to manage your patient throughout the day.
  3. by   BSNtobe2009
    Ok..I need for someone to educate me here.

    I thought DNR's were only requested by the family. Can a doctor legally write a DNR on a patient?

    I find that disturbing...especially with the case described.
  4. by   TazziRN
    DNRs can be requested by family but the order still has to be written by the doc. If you have an elderly pt at home with a chronic/catastrophic illness and the you/he want a DNR for the medics should you ever need to call them, it has to be signed by the doc. You cannot just tell the medic, "Don't do anything." Also, the family is not the first one that a DNR is discussed with, it is the PATIENT.
  5. by   Jraern
    You know I have been reading this thread from the beginning also. I am a fairly new nurse, but have tons of life experience--raised the family, worked other jobs, etc.
    the question I want to ask the original poster is what are you putting off doing to spend so much time debating on this site? When I was in school I had too much to do to misuse the time I did have. You have been given some excellent replies and advice from seasoned, practicing nurses, but you insist on debating. If nursing is something you continue in, you will come to the place where you understand that being a patient advocate does mean inserting, poking prodding, cajoling-- FOR THE PATIENT'S BENEFIT. We are critical thinking trained professionals. This is something else you will come to appreciate. You learn to not blindly follow orders. None of the other care providers no asmuch info on our patients as we do: labs, diagnostic tests, assessment, etc. That enables us to provide the care needed within the particular setting. You also seem to have overlooked the wide diversity of settings in the nursing field.
    Another question that has come to my mind after reading your posts, Do you have a family member or close friend whose treatment plan was perhaps unsuccessful?
    Nursing practice is learning, constantly learning. That's what makes it such an exciting career choice. The majority of practiciing nurses, if not all, want their patients to improve, heal, get better, go home.
    good luck to you.
  6. by   firstyearstudent
    Last week I helped hold a retarded woman down and stick an NG tube down her nose. It is the exact kind of thing I have issues with, but it appeared to be necessary. It actually wasn't as bad as I thought it was going to be. She was combative and upset but I spend time talking to her and trying to help her through it and she seemed okay afterward.

    I definitely see how you need to tailor how assertive you have to be depending on the patient. My classmate started out saying, "We're going to put this tube down your nose, okay?" and the patient started screaming. So I said, "We really need to put this tube in your nose and into your tummy so you can get the food you need. Look at me and my friend will do it really fast and get it over with." And that seemed to work better.

    But not everyone is mentally retarded...

    It was upsetting for me but I dealt with. Afterward my classmate said, "That was fun," without a trace of sarcasm. I guess she'll be the better nurse...
  7. by   firstyearstudent
    Quote from Jraern
    You know I have been reading this thread from the beginning also. I am a fairly new nurse, but have tons of life experience--raised the family, worked other jobs, etc.
    the question I want to ask the original poster is what are you putting off doing to spend so much time debating on this site? When I was in school I had too much to do to misuse the time I did have. You have been given some excellent replies and advice from seasoned, practicing nurses, but you insist on debating. If nursing is something you continue in, you will come to the place where you understand that being a patient advocate does mean inserting, poking prodding, cajoling-- FOR THE PATIENT'S BENEFIT. We are critical thinking trained professionals. This is something else you will come to appreciate. You learn to not blindly follow orders. None of the other care providers no asmuch info on our patients as we do: labs, diagnostic tests, assessment, etc. That enables us to provide the care needed within the particular setting. You also seem to have overlooked the wide diversity of settings in the nursing field.
    Another question that has come to my mind after reading your posts, Do you have a family member or close friend whose treatment plan was perhaps unsuccessful?
    Nursing practice is learning, constantly learning. That's what makes it such an exciting career choice. The majority of practiciing nurses, if not all, want their patients to improve, heal, get better, go home.
    good luck to you.
    I think debating is useful. It helps me to gathering information and opinions and form questions and think about things. I do not consider that a waste of time. I have two kids who are well looked after and a 4.0 average and a previous degree in philosophy. I'm smart enough so that this doesn't actually take up a lot of time for me (my brain can multi-task -- I'm also thinking about what to fix for dinner right now and wondering if it is okay to have an MRI immediately post-PCI). What I want to know is why are wasting your time reading or posting here if you think it's not worthwhile. (Tofu stir fry. The lastest studies say yes).
  8. by   Tweety
    Quote from firstyearstudent
    It was upsetting for me but I dealt with. Afterward my classmate said, "That was fun," without a trace of sarcasm. I guess she'll be the better nurse...

    If you think this is the type of nursing we are advocating on this thread, then you've really missed the point. But I hope you're being sarcastic.

    I hate, hate, hate, putting down NG's. It's probably the most hurtful distressing thing we do. Probably 25 or more percent refuse. To call if "fun" is a bit sick and twisted. Patients need a lot of education and TLC during NGT insertion. It's especially hard when the patient is confused, underage, or mentally challenged and doesn't understand, and you have to have restrain them afterwards.

    I have a problem with it too. I feel like I'm committing assault and battery every time I have to put one down.

    I have a problem with nurses like the student you describe. The kind that walks up to a patient "here...I have some pills for you to take", rather than go over them one-by-one so they understand and can refuse. Or "I'm going to put a tube down your nose.......".

    I think we have to find a balance between tough love for the patient, knowing when to back up and give them some leeway, and when (with family input) to put an NGT down while they are being combative.

    I was going to make tofu stir fry tonight, but am going out to eat instead.
    Last edit by Tweety on Oct 7, '06
  9. by   BSNin2007
    It is extremely refreshing that you have such enthusiam and innocence, however you need to grow a thicker skin if you don't drive yourself over the edge. Healing isn't always a pretty process, and some things we do may be construed as "mean" or cold but, as many others have said, the vast majority of us do it because we do care.
  10. by   ZASHAGALKA
    Quote from Tweety
    If you think this is the type of nursing we are advocating on this thread, then you've really missed the point. But I hope you're being sarcastic.

    I hate, hate, hate, putting down NG's. It's probably the most hurtful distressing thing we do. Probably 25 or more percent refuse. To call if "fun" is a bit sick and twisted. Patients need a lot of education and TLC during NGT insertion. It's especially hard when the patient is confused, underage, or mentally challenged and doesn't understand, and you have to have restrain them afterwards.

    I have a problem with it too. I feel like I'm committing assault and battery every time I have to put one down.

    I have a problem with nurses like the student you describe. The kind that walks up to a patient "here...I have some pills for you to take", rather than go over them one-by-one so they understand and can refuse. Or "I'm going to put a tube down your nose.......".
    But really, I can't ever quite resist whispering to myself, "up your nose with a rubber hose' everytime I put one in. . .

    ~faith,
    Timothy.
  11. by   TazziRN
    Quote from ZASHAGALKA
    But really, I can't ever quite resist whispering to myself, "up your nose with a rubber hose' everytime I put one in. . .

    ~faith,
    Timothy.

    *snort*


    *wiping root beer off monitor screen*


    Okay, I'm going back to my housework now......
  12. by   rambisisking
    Quote from firstyearstudent
    Last week I helped hold a retarded woman down and stick an NG tube down her nose. It is the exact kind of thing I have issues with, but it appeared to be necessary. It actually wasn't as bad as I thought it was going to be. She was combative and upset but I spend time talking to her and trying to help her through it and she seemed okay afterward.

    I definitely see how you need to tailor how assertive you have to be depending on the patient. My classmate started out saying, "We're going to put this tube down your nose, okay?" and the patient started screaming. So I said, "We really need to put this tube in your nose and into your tummy so you can get the food you need. Look at me and my friend will do it really fast and get it over with." And that seemed to work better.

    But not everyone is mentally retarded...

    It was upsetting for me but I dealt with. Afterward my classmate said, "That was fun," without a trace of sarcasm. I guess she'll be the better nurse...

    No Baby, You will be the better nurse at this point unless she developes some empathy. That is one of the battles that we must fight as nurses in our selves. I really think that you understand what is being promoted here. From what you say, You are seeing the fact that situations will arise when you have to just act for the patients welfare because in all situations you MUST keep your GOAL in mind. That is the patients welfare.
    You also consider their emotional well being part of their welfare and you should and so you at the time make the decision whether it is better for THEM (not you) that you spend those next minutes doing or explaining so that you can do with them in a good frame of mind.
    Does that sentence make any sense to you...I'm not sure If I explained well. It sounds jumbled to me, but You have to make nursing decisions and sometimes you have to make them very quickly. You will learn to do quicker evals. on what is needed at the time, I know YOU will because you question it all. You should...We all should!
    And for anyone of us to tell her that it is wrong for her to debate or question these things....Shame on you. Ego's need to go bye-bye!
    Question everything that gives you doubt, make sure you truly understand what you are doing and why and be sure that you agree with it or at least see the reason for it, This is how we become the strong intellegent nurses that we are expecting our patients to depend on. I don't ever want a nurse that does something that she feels is wrong or doubts just because she was told to do it. And if that takes a few extra minutes to do that it is because you are focusing on the patients welfare....now that being said, there are times that their welfare depends on you acting and not talking.
    I personally would want someone like you in charge of my care because I could depend on you to make the best decision at the time taking my whole being into consideration. I know that because I see you questioning in every one of your posts what is the best thing for your patient. The delima is to balance our empathy with our responsibility and we cannot even attempt to do this without questioning and debating. Don't stop this, even when you are considered a troublemaker, your patients depend on it.
  13. by   PANurseRN1
    Quote from ZASHAGALKA
    But really, I can't ever quite resist whispering to myself, "up your nose with a rubber hose' everytime I put one in. . .

    ~faith,
    Timothy.
    OMG. That was the best reply, ever!

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