Nurse sees worst, best of profession during daughter's ER visit

I agree that the issue here was not the nurses eating, laughing or chatting on the phone - it was that they were doing it in front of patients who were in pain and waiting for a very long time. It was the perception. Maybe there is nothing else they could have done to help at this point, but the PERCEPTION was that they were too distracted by these things to try. Show a little compassion! Be discreet. Be professional.

Again, no one disputes that perception counts alot when patients think they are not being cared for, however, her account of this experience did not take any other factors into account! She used her voice to bash nurses, what about everything else going on that night! A good journalist gets ALL THE FACTS, her view was so biased against her peers that I find it unbelievable her college and HcPRO allow her to write uncensored. It makes me sick that this biased account reached the general public.

As a supposed working nurse and nurse educator the system should be no secret.....her comments are expected of a novice, but not of a supposed "expert". I hope the organization that follows "nurse bashing" has her on the list as current enemy #1! She has done nothing to make us appear better. As a matter of fact, her follow up letter bugs me more. She had actually read our feedback and still doesn't get it!

Unless you are a working nurse in a critical care unit, balancing your load and assisting with others you cannot have a clue-you are ON for your shift. If anyone laughs, eats, or is on the phone....that may be their break. Perhaps a sign should've gone into the triage window-OUT TO LUNCH....and people wait like in other businesses. Honestly, unless you are a nurse that carries patient loads, or have had that experience....you don't have a clue.

Hmmm, nurse practioner---simple problems----one at a time. Hmmmm, labor and delivery----busy or not----depends. Her specialties. Not anywhere near the real world of floor/ER nursing!

What people don't know it it may be considered an emtala violation if you give the current wait times at the front door when a patient arrives, basically you are telling them dependent on their symptoms THEY WILL BE WAITING. Abdominal pain is lumped in with "all of the rest-but with slightly higher acuity due to symptomology/pain level.

Again, for students who have not assumed the responsiblity of a patient load. There is what we'd like and what is reality. There is no nursing utopia, it doesn't exist. You can do your best and some days it isn't good enough. Your performance depends on acuity, ancillary staff, and hospital beds. Any one of those can screw you up. Working as a CNA, or med tech will never give you an idea! I know, I did.

Maisy

Wow! I don't really think I can add anything new to this thread. Just wanted to say thanks to all who've responded. I've recently had the unfortunate experiences of losing a loved one then a week long hospitalization myself. I can say that the nurse's that took care of me were compassionate, caring and knowledgeable, but stressed by the sheer numbers of pts they had to care for. The state of healthcare in the US is frightening and if the "civilians" knew how sorry the state is, they would run as far away as possible. On the other hand, the misconception of the public regarding the role of nurse's is horrifying. I have to take care of the families who want me to retrieve the pt's slippers from under the bed (there were 5 healthy adults in the room) since that was my job, been delayed in getting pain meds to another pt since the husband was in the hallway snapping his fingers at me, calling me Hey, You, to get his wife some juice. I explained I would be right back after I delivered this pain medication to another pt, only to be told he didn't care, just get his wife some juice now and what kind of nurse was I..........Susan Gordon has it right hen she says that we are our own worst enemies by not educating the public regarding what we do. This though is a topic of great debate within our profession, because we should keep our mouths shut and suck it up. Ever the angel.

I haven't read the entire string here but I have to say that I am kind of horrified by the willingness to rip this nurse apart. Everyone seems so defensive!

What she said about triage was that they didn't smile or express concern.

Everyone is writing about how busy they are and it wasn't life threatening and so she had to wait, and so forth. How long does it take for you to smile and be kind? Is that too much to ask? She is the concerned family, scared, worried, maybe feeling guilty about not diagnosing her kid correctly herself at the git go and everyone in here is just ripping her up. (Yes I know that is a generalization, but you get the point).

When you deal with the public in this profession they are likely to be emotional because of the situation. We are supposed to be understanding. Passing udgment on her because she wasn't polite enough is just outrageous.

If I was in the hospital with my suffering child and I saw a bunch of nurses chatting and snacking instead of making sure the patients didn't need anything I would be offended too.

Those activities should be done out of view of patients. If you don't get your breaks or you can't nick someplace quickly to eat your burrito then that is a problem for you to take up with your management rather than being defensive and angry at a patient's family for the perception you give off; especially if you were not kind or informative at triage. These patients are not pieces of meat! They have feelings! They are scared and they have nothing better to do that watch you for a sign that someone is coming soon to help them!

If my family member is sitting in the hospital and not being bathed and waiting eons for call lights to be answered and the nurses were sitting around chatting and snacking I would be righteously furious and likely so would each one of you.

Deciding that a patient's condition is not important enough to be seen within several hours based upon nursing observations is not necessarily good nursing care. Since this patient had a ruptured appendix, this could very well have gone south very quickly.

Why are we so willing to rip one another up? why are we so willing to blame the patient or the patient's family for what seem to be reasonable things? Is simple human kindness and providing information such a high expectation that we cannot meet it? Is it because we are a primarily female profession?

Someone upthread commented that physicians do not do this. I wish we could be more understanding too. If we are unhappy with our working conditions then there are proactive things we can spend our energy on rather than kvetching about our patients and eachother.

Yes, we can, however, "kvetching" here is preferable to doing it within hearing range of the patients, wouldn't you say?

Physicians protect themselves and their fellows....I think we all need to be responsible for ourselves. I don't see kvetching here.....I see someone who had an opportunity, but blew it. Healthcare is a joke. Access to healthcarre, or lack thereof is jamming up the works. These are the issues that need to be addressed. Blaming a small portion of healthcare for a hospital experience is riculous and irresponsible!

Read her articles again, read her response...read some of the comments posted online and here. We can feel sorry for everyones illness....I do. I do my best as an ER nurse, truthfully, no one will ever take care of you like your family. No one will advocate for you like your family. I don't of one nurse who would leave a family member unattended at a hospital. If you do, their health may be seriously affected-especially if they are in a vulnerable population (elderly/children) or are very sick. There are not enough aides, no volunteers, or nurses.

Again, I will mention FIL who is still alive in hospice, but barely. The lack of assessment by his physician, kidney specialist, cna and nurses-after one shift ( I was working or would have been there) I came to find a man who had been sitting up, on a nasal cannula and eating the night before to 24 hours later-distended, tympanic, no bs, nauseous, in pain, hypoxic, vomiting with subsequent aspiration. ) NOT ONE OF THOSE MENTIONED PERFORMED AN ABDOMINAL ASSESSMENT...HIS CONDITION DID NOT OCCUR IN A FEW HOURS.....IT HAD BEEN WORSENING THROUGHOUT THE DAY! If you notice the list included all personnel who were responsible for his care and had seen him. I am angry at my peers, but more so at the physicians who said they examined him. If I was writing as Karen, only those terrible nurses would be at fault!

Maisy
PS OBVIOUSLY ANGELFIRE AND I HAD THE SAME IDEA-WE MUST HAVE BEEN WRITING AT THE SAME TIME-GREAT MINDS THINK ALIKE!

Originally Posted by Nurseynurseyme

I haven't read the entire string here but I have to say that I am kind of horrified by the willingness to rip this nurse apart. Everyone seems so defensive!


Well, no, you haven't read the whole thread, or you might understand our willingness to do so. We're defensive because she was completely out of line, and that kind of ignorance, placed in front of the general public, makes the job of nurses everywhere that much harder.

She was relating her experience and her feelings. That is not completely out of line. Some nurses (like other professions) are better/nicer/more compassionate/more skilled than others.

What she said about triage was that they didn't smile or express concern.

Have you ever worked triage? She did not mention what else was going on in that ER at the time. I have seen many a night when smiling was the last thing on my mind because I was concerned, only to be told that I needed to "look nicer". Then I would smile, only to have someone say, "What are you laughing at?" You can not win with some people.

Again, defensive. Sounds like you are assuming she is one of those "some people". I think of triage had been a little sympathetic and smiled it would have made a world of difference, and that is not too much to expect. The onus is on the professional rather than the patient.


Everyone is writing about how busy they are and it wasn't life threatening and so she had to wait, and so forth. How long does it take for you to smile and be kind? Is that too much to ask? She is the concerned family, scared, worried, maybe feeling guilty about not diagnosing her kid correctly herself at the git go and everyone in here is just ripping her up. (Yes I know that is a generalization, but you get the point).

You also have no idea how she treated those triage nurses. If she was so darned proud of the way she threw her hissy fit son the floor, I'd be willing to assume she wasn't exactly all sweetness and light herself in the ER. Sick kid aside, niceness goes 2 ways.

Sounds to me like you are overstating her behavior. When she expressed concern about the patient you couch it in pejorative terms="hissy fit". Are you saying that she somehow deserved less care because you don't like her? So then the patients need to be concerned about making their nurse like them in order for the nurse to act kindly and with compassion? Does that seem right to you?

When you deal with the public in this profession they are likely to be emotional because of the situation. We are supposed to be understanding. Passing udgment on her because she wasn't polite enough is just outrageous.

So is judging us for feeling slighted about her putting this nonsense out on a national forum.

Again, her experience is not nonsense. This is her experience and her opinion. Just because you don't agree, and you were not there, doesn't make her experience somehow not valid. If you think that my opinion that kindness and information should be delivered to patients irrespective of our personal feelings and their behavior and perceive that as judgment then so be it.

If I was in the hospital with my suffering child and I saw a bunch of nurses chatting and snacking instead of making sure the patients didn't need anything I would be offended too.

Did you stop to think that that might be the only break they had had all night? How do you know that they are not chatting about why Mr. James in 242 can't seem to get well?

So then the patient should be concerned about the nurses' breaks? They were laughing at off color jokes. I read her follow up article. This is just not appropriate in front of the public.

Those activities should be done out of view of patients. If you don't get your breaks or you can't nick someplace quickly to eat your burrito then that is a problem for you to take up with your management rather than being defensive and angry at a patient's family for the perception you give off; especially if you were not kind or informative at triage. These patients are not pieces of meat! They have feelings! They are scared and they have nothing better to do that watch you for a sign that someone is coming soon to help them!

This would be great if management gave a rats rip about it. And they don't, as just about anyone here can tell you. People come to the hospital LOOKING for things to complain about. I am so sorry you feel that way about your patients. My patients do not do that. There are a very few that are problems but not a large percentage and certainly not all of them. Do you work in a hospital, and if so, do you work on the floor or in the ER? If you can not answer yes to either question, don't preach to us about what we should do, you don't know of what you speak. If you do, shame on you, you should know that "taking it up with management" is about as useless as a milk bucket under a bull. And so then it's the patients' job to worry about their nurses getting breaks and eating?



If my family member is sitting in the hospital and not being bathed and waiting eons for call lights to be answered and the nurses were sitting around chatting and snacking I would be righteously furious and likely so would each one of you.

Deciding that a patient's condition is not important enough to be seen within several hours based upon nursing observations is not necessarily good nursing care. Since this patient had a ruptured appendix, this could very well have gone south very quickly.

They did not know it was a ruptured appy. That is my point. They didn't know how serious it was. This is clearly stated, had you read further. The little Star Trek gadget that you run over a body that diagnoses them has not been invented for triage yet. Neither have X-ray eyes. This type of sarcastic attitude is nonresponsive. She had abdominal pain, VS were obviously stable, or they would have sent her back sooner. MI, stroke, trauma, all take precedence over a not-otherwise-impressive belly. And with no labs or scans, and no order for the same, they had no way of knowing that the belly was acute. Work triage for a while. You can only do so much.

Why are we so willing to rip one another up? why are we so willing to blame the patient or the patient's family for what seem to be reasonable things? Is simple human kindness and providing information such a high expectation that we cannot meet it? Is it because we are a primarily female profession?

I'm going to pretend I did not read that last sentence. That won't make it go away. That was a question. I don't know the answer. But women tend to be hypercritical of eachother sometimes I think.

Someone upthread commented that physicians do not do this. I wish we could be more understanding too. If we are unhappy with our working conditions then there are proactive things we can spend our energy on rather than kvetching about our patients and eachother.

Yes, we can, however, "kvetching" here is preferable to doing it within hearing range of the patients, wouldn't you say? Yes, and eating and telling off color jokes are also best done out of range of the public.

Originally Posted by Nurseynurseyme

I haven't read the entire string here but I have to say that I am kind of horrified by the willingness to rip this nurse apart. Everyone seems so defensive!

Sorry you feel that way, her article started the trend. If all isn't right in the hospital....obviously it is the nurses fault. Where was her equal reporting when she wrote her article for a national publication? It seems to me that she didn't bash all of the nurses, she said some were excellent and some were not. Better yet, how dare she pick and choose nurses, guilty until innocent or they graduated nurses from her program which are inadequate. Which is better? I went to nursing school with other people and I know that I would not want some of them to be my nurse. One of them had sex with a patient. We are not all equal and if I could choose nurses whom I knew to be compassionate, than I would. As a family member, if I saw a nurse force a student to administer pills that had fallen on the floor because she didn't want to go get another set from the pyxis (and this has happened) then I would demand that nurse stay away from my family. I don't see a huge problem here.

What she said about triage was that they didn't smile or express concern.

I try to smile....some days it's harder than others....when I can't go the bathroom, it may be appear as a grimace. Clearly you must be one of the ones that cares if you are trying at least to smile! I think that the first contact with the patient might set the tone for the entire visit.

Everyone is writing about how busy they are and it wasn't life threatening and so she had to wait, and so forth. How long does it take for you to smile and be kind? Is that too much to ask? She is the concerned family, scared, worried, maybe feeling guilty about not diagnosing her kid correctly herself at the git go and everyone in here is just ripping her up. (Yes I know that is a generalization, but you get the point).

Everyone is scared when they go the hospital. Again, she knows the process....as a parent and a professional, if she felt her child was in danger or if her acuity was at a higher level. It needs to be communicated. Escalate, you do own the responsibility for your own health, or your childs. Suffering in silence, then blasting others is ridiculous. If you haven't been critical care then you really DON'T KNOW! I read her follow up article. She says she DID go to the desk several times and was essentially blown off. I have seen this happen and I have had patients tell me other nurses have done this. I think she was functioning more as a parent at this point. It's hard to be "clinical" when it's your child.

When you deal with the public in this profession they are likely to be emotional because of the situation. We are supposed to be understanding. Passing udgment on her because she wasn't polite enough is just outrageous.

Again, we are all understanding of a sick child....not understanding of throwing us as a group under the bus! She claims to know the system, then respond to the system.....don't blame the nurses who have to work with possible poor staffing, full beds or anything else. We'll never know what the other challenges were. To her it was just us. I think everyone is taking this personally, when it seems to me that she is just relating her experience. It seems like everyone is jumping on her for her negative experience with SOME of her nurses but she spent some time talking about good nurses too.
If I was in the hospital with my suffering child and I saw a bunch of nurses chatting and snacking instead of making sure the patients didn't need anything I would be offended too.

Need anything such as? Pain medication?-can't give without doctor. Stretcher? -need to have a space. Food?-everyone should be NPO. Maybe a blanket? Maybe an update as to how many critical patients are still left to be seen ahead of her? Maybe offering Mom some coffee or something? It didn't necessarily have to be an RN checking on them; just making them feel less "forgot" would probably do wonders.

Get the drift? What mom wanted was the ticket in....obviously a no can do. Higher acuities, dying people, traumas, MI....who knows, it wasn't reported. Just sucky, eating, laughing nurses who would give her the "golden ticket". I don't know if I agree with your "ticket in". I think she just was worried about her kid, stressed and guilty that she'd missed it, and looking for a resolution. Again, I think that a few kind words and an update might have done wonders. And maybe feeling a little less dismissed by the people at the desk.

Those activities should be done out of view of patients. If you don't get your breaks or you can't nick someplace quickly to eat your burrito then that is a problem for you to take up with your management rather than being defensive and angry at a patient's family for the perception you give off; especially if you were not kind or informative at triage. These patients are not pieces of meat! They have feelings! They are scared and they have nothing better to do that watch you for a sign that someone is coming soon to help them!

You are right-back to the civil servant-OUT TO LUNCH sign in the window. I don't know what the answer is. But I think that just accepting things doesn't really help either.

If my family member is sitting in the hospital and not being bathed and waiting eons for call lights to be answered and the nurses were sitting around chatting and snacking I would be righteously furious and likely so would each one of you.

That's not what was said-read the article. I don't know of any nurses that sit on their butts. It doesn't happen. Is this your experience, if so I'd like to work there. I read her response, she went to the desk several times with her concerns and they were not responsive. They were eating and laughing at off color jokes.

Deciding that a patient's condition is not important enough to be seen within several hours based upon nursing observations is not necessarily good nursing care. Since this patient had a ruptured appendix, this could very well have gone south very quickly.

Triage nurses provide an initial screening, they also reassess. There was no reassessment. They did not retake vital signs. She went several times to the desk and she didn't feel heard. If the mother "nurse" did not update her nurses....that is her fault. I don't do nursing by ESP. For those who don't know....the triage nurse is in constant contact with the charge nurse....if there are no beds, there are no beds. If her mother couldn't assess her symptoms, what makes you think a triage nurse is going to assess them any differently. Mother has admittedly held off due to her daughter's drama queen status....maybe they should have accessed medical care sooner. I do not think that access to medical care is the problem, in this scenario I think the system did not make the patient/family feel heard and they, at least at the outset, did not feel that the staff were responsive.

Why are we so willing to rip one another up? why are we so willing to blame the patient or the patient's family for what seem to be reasonable things? Is simple human kindness and providing information such a high expectation that we cannot meet it? Is it because we are a primarily female profession?

Tag we are it! She started it...no seriously, get a grip. READ OTHER COMMENTS. I did read more of the other comments, but honestly everyone just seems so negative and mean spirited, generally.



Someone upthread commented that physicians do not do this. I wish we could be more understanding too. If we are unhappy with our working conditions then there are proactive things we can spend our energy on rather than kvetching about our patients and eachother.

Physicians protect themselves and their fellows....I think we all need to be responsible for ourselves. Agreed. I don't see kvetching here.....I see someone who had an opportunity, but blew it. Healthcare is a joke. Agreed, in many cases. Access to healthcarre, or lack thereof is jamming up the works. Again, agreed. These are the issues that need to be addressed. Blaming a small portion of healthcare for a hospital experience is riculous and irresponsible! I didn't read her article as a general indictment of nursing; there were several favorable comments about her nurses.

I guess I read her article as a report of her own experiences good and bad. We all know that there are good nurses and rather scary ones out there. I honestly believe that a little more kindness at the outset and a little more information and maybe an actual retaking of vital signs once while they were waiting would have gone a long way towards making this patient/family happier.

I honestly don't think that is too much to ask. And I still don't think that we need to be shredding her for her relating of her experience.

Read her articles again, read her response...read some of the comments posted online and here. We can feel sorry for everyones illness....I do. I do my best as an ER nurse, I believe that based upon your words here truthfully, no one will ever take care of you like your family. Agreed No one will advocate for you like your family. Agreed I don't of one nurse who would leave a family member unattended at a hospital. If you do, their health may be seriously affected-especially if they are in a vulnerable population (elderly/children) or are very sick. There are not enough aides, no volunteers, or nurses.

Again, I will mention FIL who is still alive in hospice, but barely. The lack of assessment by his physician, kidney specialist, cna and nurses-after one shift ( I was working or would have been there) I came to find a man who had been sitting up, on a nasal cannula and eating the night before to 24 hours later-distended, tympanic, no bs, nauseous, in pain, hypoxic, vomiting with subsequent aspiration. ) NOT ONE OF THOSE MENTIONED PERFORMED AN ABDOMINAL ASSESSMENT...HIS CONDITION DID NOT OCCUR IN A FEW HOURS.....IT HAD BEEN WORSENING THROUGHOUT THE DAY! If you notice the list included all personnel who were responsible for his care and had seen him. I am angry at my peers, but more so at the physicians who said they examined him. If I was writing as Karen, only those terrible nurses would be at fault! I don't know that I agree with you with this last statement but I agree that if someone had performed an assessment then something could have been done sooner to help your FIL. I think the same problems are likely at fault with him: overworked and understaffed and physicians breezing in and out without actually looking at the patient. In long term care, there are local to me up to 34 patients per nurse and often 2 aides. If the patient is not communicative, it's possible that things might not be noticed for a while because it's a challenge to get the meds out. If the aides or the patient or the family don't report a problem, nobody will know.

Maisy
PS OBVIOUSLY ANGELFIRE AND I HAD THE SAME IDEA-WE MUST HAVE BEEN WRITING AT THE SAME TIME-GREAT MINDS THINK ALIKE!

I am not sure her account would've been seen so harshly, had it appeared here as a vent.

The issue at hand is that her comments went unchecked and without a full picture to the general public. If a nurse states we made her wait, and she doesn't get it....how in the world will the general public get it? Our systems aren't perfect, but they are driven by staffing and patient population. This was an important statement that could've been placed at the forefront. Again, I must state she didn't follow the rules of journalism, and allowed a national magazine to publish a "tiny" piece of the healthcare problem-creating sensationalism....let's face it, bad nurses are juicier subjects than....say perhaps, big business in hospitals. It's sort of like saying "illegals" are the reason we have problems in the hospital.

If you noticed all posters wished her daughter well.....but to other nurses, she just proves what an isolated view academics have of the current problems affecting America's nurses.

Maisy

I am not sure, but it may be that this was an editorial type of article in which it's essentially an opinion, and so under that umbrella it's not necessarily a given that all points of view are represented. But I see your point. I do think though that we as a group have been too harsh with her.

I think the experience will make her a better educator, and I think some of the issues discussed herein will make people think about perceptions of the public a little bit and it might change some behaviors that we all do, and that's a good thing.

I have copied her article and one of the reponses to the Director of my local nursing program and several of the instructors to perhaps start a dialogue with the students. Maybe that will do some good.

I still think that many times nurses are way too harsh with each other and I don't understand why that is. I am very fortunate to work in a collegial environment where we try to help each other and I feel very blessed in that respect.

Our healthcare system needs work and I don't know what the answer is, I'm only one person. But I still think that kindness and communication will go a long way, and I work at that. I don't always succeed but I work at it!

Thanks for your response. I enjoyed the dialogue.