"Send my girl down here now"...(Please.....)

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    I was writing a progress note today on a cardiac step-down unit when my concentration was shattered by a booming voice coming through the patient-call system. An 60 y/o gentleman (for lack of a better word)exclamied, "Send my girl down here nawh! (southern slang for "now"). The nurse at the nurses' station, who was working overtime to cover a shortage of nurses, looked puzzled. She replied, "Sir, I was not aware that you had a daughter. Anyway, she isn't here just now". He shouted back, "Don't be a dumbass! I ain't talkin' bout my daughter! Send me that damn nurse!" Now before I go any further, I should explain that this patient was alert and oriented, and could ambulate easily on his own. He could easily feed himself, (although he was NPO) and could walk to the bathroom without difficulty
    He was scheduled for a cardiac cath later that day. So what did he want so desperately? He wanted the nurse to hand him a damn magazine that was sitting in a chair five feet from his bed. I couldn't help but intervene, and I'm sure I'll catch criticism for this. I walked down to his room and without introducing myself, I said, "Lets get something straight! This person is a highly respected RN within this hospital, and she is not AND WILL not be addressed as your girl! It is clear that she is of no relation to you! Secondly, THIS IS NOT A FIVE STAR HOTEL! You can and will ambulate on your own!! That means that when you have to go to the bathroom, get a magazine, or scratch yourself, YOU WILL BE THE ONE WHO DOES IT AT THIS POINT IN THE GAME! These nurses are not your handmaiden, and they are NOT at your beck and call. Each nurse cares for 12 patients with very little assitance, and every patient on this floor is in far worse shape than you are! Am I absolutey clear?!
    Now before I catch hell for that, let me say this. I know that the concepts of "compassion", "going the extra mile" and "giving that patient an extra five minutes even though your feet are aching and your back is about to break" are all very sweet and are inherent traits of the "genuine" nurse. But lets be realistic. I worked as a critical care nurse in several states (as a traveler) before I pursued an advanced degree. Thus, while it may seem that patients like this are the exception, I know that they are rapidly becoming the rule. Although being a hospitalized patient is not fun, there is absolutely no excuse for patients or families to treat nurses with disrespect. The "turn the other cheek" rule is crap. Verbal abuse and condescending attitudes towards nurses have become worse every year for the past several years. Regardless of the nursing shortage or other factors, there is no excuse for this. In fact, the nursing shortage should generate more respect for these nurses. However, I feel that the general public perceives staff nurses (and particuarly floor nurses) as handmaidens and mindless recorders of blood pressures. This mentality is unfounded and very unfortunate. Maybe I'm crazy, (and if you read this far, let me know if I'm wrong), but I think that part of the problem is a image problem of nursing that stems from the media. Medical shows such as E.R. and Gideon's Crossing have become the rage over the years. Particuarly "E.R.". How many times has that show ever portrayed the nursing profession in a positive light? I honestly can't remember one show. I do remember shows that illustrate nurses as being jealous of physicians, and a show that illustrated nurses as "gossip queens". Numerous shows have shown the general public as being "authoritarian" and certainly condescending, but not one time have I seen one of these nurse actors make a stand. Does a movie such as "Meet the Parents" do much for the promotion of nursing? Please..The bottom line is this. The public, (in general) associates nursing with bed pans, bed baths, and "fetching some water". While these are all a part of nursing, other aspects include critical thinking and excellent skills. Yet, rarely, if ever, is this noticed. One more thing. I know that there are numerous patients (and families) that appreciate the care that you provide, as well they should. But this type of patient (and family) is a malignant tumor that continues to grow with time. If you read this far, thanks. If I'm way off base, don't be afraid to let me know.

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  2. 41 Comments...

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    OK, I fully agree with the emotions and anger you experienced. However, the question that comes to mind is this: Is this man always like this or just today, maybe there was an ulterior motive to getting the nurse to the bedside before you rightfully let him have it. Maybe this patient was not coping well with the thought of undergoing a cardiac catherization. Just a thought. I will admit though that I have been in similar situations by abusive and demanding patients before and it just makes you want to SCREAM!!!
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    Way to go Jason!!!!!

    I personally wish more people would stand up to patients and families like you did. At my hospital, Patients/families rule. What every they want, they get. I have said many times thay are letting the patient/family dictate care. For instance, I had a patient (intubated) who was on dipravan gtt for sedation. The patient was requiring a very high dose and was using almost a bottle/hr. (very expensive) I talked with the Doc and he changed it to Ativan gtt. Patient was youg (23) but Mom, Dad and grandmother were very "intune" with his care. When grandma found out what the new drug was, (6 hrs after the gtt was started.) she demanded it be changed, despite the fact that the patient was fine. Started crying stating it made two of her brothers CRAZY. The House Supervisor just happen to come around at that time and ask what was going on. I explained the situation. She said just to take the heat off of me, call the Doc and let him know. In my opinion, I should not have to justify using the drug the Doc ordered if it works and the patient is okay!!!! Well anyway, the Doc said "What do they want me to do? I'm not changing the drug." That's exactly what I wanted him to say, but Mom was insistant on speaking with him. After talking with the Doc (on the phone) Mom said "here, he needs to speak with you." The Doc then gave me an order to CHANGE THE GTT TO VERSED!!!!!!!! Can you believe that??? A lay person talked the Doc into changing the drug for no reason other than grandma did not like the drug. When we told her what the new drug was she stated"I don't know that drug!!!" in a panicked voice.
    I don't know what happened after that because I went home. Thank God it was the end of my shift!!!!!
    I am a real patient advovate but it just makes me angry when they act like they know more than I do despite the fact that they never even finished high school!!!! It is also very frustrating when they get mad because you didn't come right away when they called. Never mind the fact that your coding your other patient in the next room.
    your absolutely right, it does seem to be getting worse. Management doesn't seem to be backing us either. The only ones who I have found to stand up for us are Doc's,Pa's& Np's (like yourself) who were nurses and know what it's like to be in our shoes. I think that patient got what he deserved. Maybe next time he will be a little more curtious and get his lazy butt up and do something for himeself while he still can.

    Stories like this just infuriate me. I can't help but feel this is part of what is causing the nursing shortage.
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    well let me say that you are not far off. While I agree with your interpretations of E.R. etc. there is much more than the TV show issues. However, certainly, ER showing the nurse to use her best judgement in a critical situation to save a patients life would help. Certainly showing the extent of time needed for charting and documenting, would help (accurately). Unfortunately you are not the first too notice that the medical shows focus on physicians and/or medics. How many truely portray the "nurse". None that I have seen?
    On the other hand, e are living in the era of new technology and "fast food".

    "Fast food era" - definition - An era in which everybody is so consumed with their own life, that they expect everything to be drive up and/or wait on you, hand and foot at a speed just short of the speed of sound. If it does not happen that way, they loose it or blow up. I think society as a whole, has expected human employees to keep up with, and be treated like crap. Why? "Because it's your job". Not just nurses, any job.
    I had a lady the other day at Home Depote walk up, while I was standing in line with three sheets of plywood, and 12 2x4x8's, and some other stuff. She had two things with her. She walked in front of me, and pretended to be looking at something at the register stand. Then when the person in front of me was finished, she put her stuff on the counter, and pulled out her credit card, and never said a owrd too me. She didn't even look at me? I wanted to let loose on her and ask her if she was blind? Ask her what the hell she was doing? Maybe ask if she was just plain ignorant? Then I thought? Where does that put me? In the "fast food era". It doesn't make me any better than the rest. So I bit my tongue, let her ring out, and just smiled at the cashier, and said how are you today?

    enough said

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    Jason, there are people in this world who need to be told that they aren't the center of the Universe. Thankks for sticking up for the nurse on duty. I have told an arrogant S#* that he could call me by my name or by my title; but he was never to call any nurse "girl", "doll," or "babe" again. It angers me that people think that nurses are their maids or slaves; and although I don't think that we can change their attitudes towards the world at large; I do believe we can make them address us with some form of respect.
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    Jason, I wish you had been on our unit tonight to respond to the most outrageous request I've ever heard by a patient and their family. The nurse was called to the room to clean up the dump left on the floor by the patients' visiting pooch. The nurse refused of course, but can you beleive it? Of all the nerve...and I thought we'd seen it all.
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    Kudos. I think you did an excellent job. What was the patient's reaction?

    One of my pet peeves is patients who call you in to pull up their blanket (they came from home where they take of their houses), pour their water, etc. And the way they say it! "Pour my water!" "Get me tea; I hate coffee!" No please, No thank you.

    I recognize that there are rude people in all facets of life but something about having at nurse at the end of your callbell seems to bring out the worst in some people. It's a hospital, not a hotel; I'm a nurse, not a maid (not that maids should be treated like crap either!).

    [This message has been edited by Zee_RN (edited April 21, 2001).]
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    I wonder where the public gets the idea that we are handmaidens. Did anyone see Jay Leno last night? One of his "jokes" was that he had seen on CNN that there was a nursing shortage. And we can't do without nurses, because without nurses there would be no more porn movies.
  10. 0
    You know, I think this ole guy was havin' some control issues. When you are #12 on the priority list, you probably don't get to see your nurse very often and maybe he was starting to wonder what it would take to get to see him/her. Of course, he doesn't win the diplomacy award.

    To me, this post has some to do with nursing roles and perceptions by the public, but it has a lot more to do with nurses who are so overwhelmed (and I've been there myself) that an old man's crudely phrased plea for attention gets him a tirade that underlines that he really isn't important. The neediest patients have always ground on nurses. Did anyone ever see, "Mrs. Reynold's needs a nurse?" in nursing school. Do you have a patient that qualified as a Mrs. Reynolds? (For the young, Mrs. Reynold's was a lonely old lady with GBS or Polio on a vent [actually an iron lung in my version] who would clack her dentures at the nurse for attention.)

    I do not want you, Jason, to construe that I personally berate you. Alas, I have been there done that, too. However, I've never seen my patient relationship improve with an individual after I have informed them that they were low on my priority list. Once again, we are all casualties in this situation, but we are caregiver; they are patient. The nurses who I admire the most are the ones who walk in to these rooms with good humor and defuse the frustration. Wish I could tell you that I always manage to emulate them.

    Hang in there and go forward.
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    I did a search on Jay leno and found the website to NBC....It's easy to find...anyway I wrote a letter to Jayo leno about his joke.....you should all do the same...stand up and be heard....not that he will pay a whole lot of attention, but It made me feel better! And I have to say Kudos to Jason...I might have handled it a bit differently, but to the same end effect...as for the dog? Oh NO! I would have had to say something ***** about that one....

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