A Mile in Their Shoes

Part of patient care is the person's well being emotionally. So save the judgement. A facility should feel safe. If you have patients who are emotionally upset over their perception of care, this can add to an already diffcult patient assignment. Not to mention it is wrong and mean. A nurse is only as good as a patient's perception is a relatively new concept in nursing practice, but a concept that is not likely to change any time soon. With that in mind, a few words of wisdom... Nurses Announcements Archive Article

A Mile in Their Shoes

There's an old saying "don't judge unless you have walked a mile in their shoes". One of the more difficult aspects on becoming a nurse is seperating your private "you" from your nursing "you".

There has been more than one discussion on "hating" a certain patient group. That they are too difficult to care for, emotionally and/or physically challenging, that you are not one with their culture, their lifestyle, their choices. If you step back for a moment and think about how you as a nurse have the opportunity to keep your patient's dignity intact while providing excellent care, you can define your practice as a nurse.

Life is full of could've, would've, should'ves. As nurses, we are only educators. We don't own time machines to catapult someone back in time to change things for a patient. We can only go on from here. To remember that you can only educate a patient so much, empathize with their condition and the challenges that it presents, that you care about how they are cared for--this all goes a long way to ensure that a patient's condition doesn't worsen (causing more patient discomfort) than what they present with.

This is also a good opportunity to get creative. If you need to figure out how to care for a patient's challenges, brain storm. What can you do and how can you do it so that the patient is the winner? Use your brain and your resources. Ask seasoned nurses how they do what they do.

Part of patient care is the person's well being emotionally. So save the judgement. A facility should feel safe. If you have patients who are emotionally upset over their perception of care, this can add to an already diffcult patient assignment. Not to mention it is wrong and mean.

So really learn cultural competencies. Embrace the notion that patients have ideas different than your own, have customs or religions or definitions of family that may be the opposite of what you as a person feel is not "right". That's ok, but it is not ok to make a patient's perception as such that they feel less of a human because of it. So in your nursing practice, be sure that a patient's needs are put before your own personal thought processes.

Regardless how a patient presents, disease is not illnesses of moral failing, or poor self control, of poor choices. There are disease processes that have developed from choices or lack of, however, one can not assume that because someone is over-weight they eat too much, that they have chronic pain they are drug addicted and or "seekers", that they have COPD because they smoke, liver issues because they drink, psych issues because they are the generalized "crazy". Get those assumptions out of your head now, and it can only strengthen your practice as a nurse.

Patient's perception of care is becoming big business for facilities. With that being said, it should become a practice norm for you. When you are in your own life, in your own skin you can choose to act how you would like to. When you are responsible for the care and comfort of a patient, use your character and integrity as a nurse. It can make you well rounded, well respected, and an integral part of a nursing team.

jadelpn

About jadelpn, LPN, EMT-B

jadelpn, LPN, EMT-B

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There's an old saying "don't judge unless you have walked a mile in their shoes". One of the more difficult aspects on becoming a nurse is seperating your private "you" from your nursing "you".

There has been more than one discussion on "hating" a certain patient group. That they are too difficult to care for, emotionally and/or physically challenging, that you are not one with their culture, their lifestyle, their choices. If you step back for a moment and think about how you as a nurse have the opportunity to keep your patient's dignity intact while providing excellent care, you can define your practice as a nurse.

Life is full of could've, would've, should'ves. As nurses, we are only educators. We don't own time machines to catapult someone back in time to change things for a patient. We can only go on from here. To remember that you can only educate a patient so much, empathize with their condition and the challenges that it presents, that you care about how they are cared for--this all goes a long way to ensure that a patient's condition doesn't worsen (causing more patient discomfort) than what they present with.

This is also a good opportunity to get creative. If you need to figure out how to care for a patient's challenges, brain storm. What can you do and how can you do it so that the patient is the winner? Use your brain and your resources. Ask seasoned nurses how they do what they do.

Part of patient care is the person's well being emotionally. So save the judgement. A facility should feel safe. If you have patients who are emotionally upset over their perception of care, this can add to an already diffcult patient assignment. Not to mention it is wrong and mean.

So really learn cultural competencies. Embrace the notion that patients have ideas different than your own, have customs or religions or definitions of family that may be the opposite of what you as a person feel is not "right". That's ok, but it is not ok to make a patient's perception as such that they feel less of a human because of it. So in your nursing practice, be sure that a patient's needs are put before your own personal thought processes.

Regardless how a patient presents, disease is not illnesses of moral failing, or poor self control, of poor choices. There are disease processes that have developed from choices or lack of, however, one can not assume that because someone is over-weight they eat too much, that they have chronic pain they are drug addicted and or "seekers", that they have COPD because they smoke, liver issues because they drink, psych issues because they are the generalized "crazy". Get those assumptions out of your head now, and it can only strengthen your practice as a nurse.

Patient's perception of care is becoming big business for facilities. With that being said, it should become a practice norm for you. When you are in your own life, in your own skin you can choose to act how you would like to. When you are responsible for the care and comfort of a patient, use your character and integrity as a nurse. It can make you well rounded, well respected, and an integral part of a nursing team.

Nice post. I disagree 100% with this part. More often than not a patient's illness is a DIRECT result of poor choices. Why do you think patient teaching is so important ? If smoking, drinking, overeating, and being sedentary were irrelevant to health we wouldn't bother teaching our patients anything. Once a patient is in my care it doesn't matter to me how they got there they need my help right now. That goes for the person reaping their bad choices and the victim of breast cancer. Once you have to give CPR to a child killer everything else kinda pales in comparison (working corrections). Do your job with a smile and go home has served me well in my 20 years of nursing.

I came to understand that bad choices (like eating too much, smoking etc.) are a direct result of being sick. We just don't know how to pinpoint exactly what is making these people to have these sorts of unhealthy behavior. Unconscious desire of committing suicide?? Maybe?? I was about 10 pounds overweight, and I can say that is very difficult not to eat when you feel hungry all the time. I lost those extra 10 pounds 9 years ago, and I can understand why some patients are unable to make a change. I wish I could offer more than my sympathy for their suffering. That being said, I believe all patients should be helped and treated with respect.

Specializes in Psychiatry, Mental Health.

Very good post.

Even if a patient presents with problems that are a direct result of poor choices, life style or whatever - they are suffering now. As you so rightly say, we cannot take them back to before the bad decisions. If we reject the patient, if our words, behavior, facial expressions, or body language causes the patient to feel rejected the best teaching in the world will be useless. Being professional means summoning up empathy for the patient in our care without judging them and them giving them the best care--the best caring--that we can.

We can not assume that every patient with illness that CAN happen due to poor choices ARE from those choices. There are many reasons other than poor choices that can make a patient present with illness that we sometimes judge to be due to something a patient did or did not do. Things are not always as they appear.

Sometimes it is so hard to sit by and watch people make terrible choices. I feel so helpless. I have learned about myself that when I am being judgmental it is because of this helplessness. In my own profession, I want to help people make better choices, but when they just won't I feel powerless. That is when the judgment comes out. Now that I know that, it is easier for me to accept their choices and what comes from them and try to educate them. In the end, the choices are really theirs, but at least I know that for whatever amount of time I was involved, I did all that was within my own power. It makes it easier for me to accept things. It's not that I care less, I just don't judge as much and the relationship is better, which in the end makes it easier for me to give ppl the help they need.

I don't assume that my patients are emotionally healthy enough to want to make good choices in life. A lot of ppl leave the psycho/social aspect out of the equation, unfairly standing in judgement of these people. Bad behavior and practices might well have been ingrained into their way of being since childhood. And not everybody has the support system / correct information / inner strength /positive influences to make healthy changes for the better. Yeah, I shake my head at a lot, but I also realize that I only have a miniscule snapshot of them and their life so far

I meet all sorts in my department. I have made peace with the universe and accept that some people are going to go joyriding high in stolen cars. That is the way it is sometimes. I will care for them and advocate for them. Some people do manage to turn their life around if given a chance.

I do get irritated with the phrase "don't judge me". We are all judged, okay, and judging someone by their actions seems the fairest way to go. Some people want to be judged by their intentions and not their actions.

I don't agree with you about being overweight. I don't think it's always a result of bad choices. Some of us are descendants of populations that had to deal with recurrent famine. If periods of scarcity are a fact of life, storing fat during times of plenty is an evolutionary adaptation that favors survival. Chubbier people are more likely to survive. Flash forward to 2013 when there are more than enough calories to go around and many of us have jobs that don't require too much physical activity. Voila! Obesity epidemic. The agribusiness industry is not helping by deliberately using salt, sugar and fat as tools to manipulate us into buying their products.

No I am not overweight, justifying my excess pounds. I'm just someone who is paying attention, and has lots of compassion for those who can't keep their weight under control.

Everyone has to eat. Nobody has to smoke.[

QUOTE=Tatinha;7601455]I came to understand that bad choices (like eating too much, smoking etc.) are a direct result of being sick. We just don't know how to pinpoint exactly what is making these people to have these sorts of unhealthy behavior. Unconscious desire of committing suicide?? Maybe??

Specializes in Eventually Midwifery.

There has been more than one discussion on "hating" a certain patient group.

There is A LOT of hating that goes on here.

Specializes in ER.
I came to understand that bad choices (like eating too much, smoking etc.) are a direct result of being sick. We just don't know how to pinpoint exactly what is making these people to have these sorts of unhealthy behavior. Unconscious desire of committing suicide?? Maybe?? I was about 10 pounds overweight, and I can say that is very difficult not to eat when you feel hungry all the time. I lost those extra 10 pounds 9 years ago, and I can understand why some patients are unable to make a change. I wish I could offer more than my sympathy for their suffering. That being said, I believe all patients should be helped and treated with respect.

Some of it is lack of education. Some of it is that people don't believe bad things will happen to them. A lot of it is social (do my friends do this, Mom and Dad, characters, etc). For instance, I know diet cokes aren't the best things for me, but guzzle 'em by the truck full. Why? Mostly because my family and I have been drinking them since I was a small child, I crave them, they're available, I use them as a crutch when I get tired, like the way they make me feel at the moment, and I can afford to pay the dentist bills and haven't got a kidney stone or some other big bad thing that makes it feel worth quitting (...yet?).

I agree with you - no matter what got them there, treat them well. I always figure it isn't too late to make a positive change for your health unless you're already dead. Sometimes, that's what it takes to kick a bad habit - kind of extreme way to quit cigarettes LOL.

Specializes in Med/Surg, Academics.

We need to get rid of the word judgement, and use something in its place when talking about nursing care. Why? Because we must make judgements every day and with every patient to get to the root cause of their problems and provide the proper education. What we shouldn't do is write them off.

I completely disagree that some illnesses are not the result of poor choices. A nurse with half a brain will know what choices, if any, caused the conditions presented. That's part of our job in order to educate on the root cause--it's not a lack of compassion on the part of the nurse. What we do with that information defines us as nurses. Write them off or work with them to increase their well being?

I would also argue that part of a patient's emotional state is exhibited through anger, disrespect, and demanding behaviors. Just taking the verbal abuse like a good little nurse doesn't help anyone. Yes, I have said to a difficult patients, "my number one priority is your safety, comfort, and recovery. However, I will not tolerate being spoken to so disrespectfully. Lets talk about whats bothering you and fix it together." Nine times out of 10, the problem is fixable, and the patient's demeanor improves if the stated problems are addressed to the best of our ability. if they cant be fixed, the patient seeing that we are trying is often good enough. I also make sure that I am NOT rotated out of these assignments if I am working multiple days in a row to maintain trust and knowledge of preferences. I don't judge other nurses who want to be rotated out, but I personally feel it's not best for the patient.