A few questions about bedside manner.

[0.adamantite]

I am a nurse of about a year on a medical-surgical ward. Many of my co-workers are also new nurses. They are great nurses and often get many compliments from our patients. Our manager will print the compliments and had them in the break room.

I never get compliments or remembered by my patients. I have not heard anything bad about my clinical practice, which my manager says is at or above her expectations. My manager says I'm a calming presence for my patients. I think what I'm lacking though is a good bedside manner. I believe that I may be on the autism or Aspergers spectrum, as I have always had difficulty with social skills and have been described as awkward or "weird" more times then I can count. My speech patterns are often weird, too.

I am friendly, introduce myself to patients and families, make sure they are comfortable, fill their water pitcher, round on them, and update them with any changes to their care. I manage pain and nausea. I am wondering what you as nurses do to go the extra mile for your patients and make them feel truly cared for?

For example, I had a patient who got tearful while we were discussing his plan of care. I sit in the chair next to him and ask him if he's having a hard time now right. He tells me he's afraid of what his test results will show. I tell him that he's in the right place, I'm glad he's here, and the doctors will do their best to figure out what is going on with him. I offer him a warm blanket or to go for a walk with me. I also offer our chaplain service. He declines, and remains tearful. I sit for a few more minutes and then my phone rings and I have to excuse myself. When I return, he is not so tearful, and says he doesn't need anything more.

I am left feeling that I didn't do enough to comfort him. I have trouble finding the right things to say, as well as I don't feel comfortable touching people or offering hugs. What else can I do?

[CrunchRN, ADN, RN]

You sound like a wonderful nurse to me. I am sorry it isn't acknowledged more.

[That Guy, BSN, RN, EMT-B]

Sometimes flying under the radar is not a bad thing. Just saying.

[BrandonLPN, LPN]

Well, contrary to what Brandon says, holding someone's hand during a difficult time is NOT a stupid thing to do. Also, you do NOT have to be bubbly to make a difference.

Case and point: I recently had a miscarriage at 11 weeks. I stayed home for most of it, but on day 3 I had lost so much blood that I could barely stand up without passing out. I went to the ER and was seen by a weird-o OB with did not care at all how traumatic the experience was for me. I ended up spending the night. When the charge nurse came in to get some information and check on me, the FIRST thing that she did was hug me and tell me that she was sorry for my loss. She was the only person who acted like she cared about my situation at all. I would not describe her as bubbly, but she was COMPASSIONATE.

Now, if you are not a bubbly person, that is OK. But to be a good nurse, you must have compassion. Of course, you should not fake any emotion or try to be someone you are not. But letting your patients know that you care can make a real difference to them in their time of need. If you have trouble expressing compassion, you could consider checking out the following book for help on developing the skill of expression: 101 Simple Suggestions and Quotations to Express Compassion and Empathy: (An aid in healing ourselves and the world): Linda Furiate: 9780595324132: Amazon.com: Books

Oh, don't be so sensitive. I never said it was a stupid thing to do, just that it's not something I'd do.

I worked at a hospital where their latest bright idea to increase satisfaction surveys was to have all the nurses make it a point to sit on the side of the patients bed, make physical contact (like holding their hand or touching their shoulder) and have a "caring conversation" (as they put it). Supposedly, "research" showed that sitting next to the bed and making physical contact was what patients wanted.

Not all of us have personalities where that sort of intimacy comes naturally. Nor do all patients, for that matter. If I were a patient, I'd be incredibly uncomfortable if a nurse came in and did that with me. I don't care if I just found out I have cancer, it would be weird.

Trying to tell nurses how to be compassionate is pointless. Different people show compassion in different ways.

And I bet part of the reason the OP doesn't get many compliments posted on the wall is because they type of patients who appreciate her style of nursing aren't the type of patients who'd make a big fuss about giving such compliments.

[thelema13]

Make them laugh, always works for me.

[TheGooch]

Oh, don't be so sensitive. I never said it was a stupid thing to do, just that it's not something I'd do.

I worked at a hospital where their latest bright idea to increase satisfaction surveys was to have all the nurses make it a point to sit on the side of the patients bed, make physical contact (like holding their hand or touching their shoulder) and have a "caring conversation" (as they put it). Supposedly, "research" showed that sitting next to the bed and making physical contact was what patients wanted.

I find that to be intrusive. The last thing I want when I am feeling like crap is having someone sitting on the bed next to me making idle chit chat disquised as a "caring conversation".

[cardiacfreak, ADN]

I'm not "bubbly" either. Most people describe me as very straight forward. One thing I have learned over the years is that I don't need someone to pat me on the back and tell me I am a good nurse (although it is nice when it happens), I know I am a good nurse and I don't mean it in an arrogant self-conceited manner. Recently a family member came to the hospital to visit her father when I walked into the patient's room the daughter told me she was so relieved that I was his nurse because about a year prior her mother had been a patient and was not doing well. The mother's nurse had asked me to look at the patient and assess what was wrong, according to the family member I had saved her mother's life. Now I don't remember this patient or the daughter but the daughter had remembered me and my name. After a year had gone by and this person remembered me and my name, was a better compliment than a piece of paper saying I did a good job.

So to all of my non-bubbly comrades in the nursing business we don't have to be something we are not to be a good nurse. Bubbly does not always mean better.

[movingforwardRN]

@theCommuter, @BrandonLPN

took the words right out of me

I am introverted, very reserved and focused, and I don't believe hallmarking or pretending to care more than I do is necessary, because I do care about you getting better and that reflects me being here and doing my job to make sure you get better. I won't sit on the bed with you and hold your hand.

When I let go trying to be like other nurses who "Listen" and "Feel", I began seeing results, and seeing my patients get better. I am a kind person, but more serious about you getting better and getting the heck out of here. We can't do that, talking over tea.

Just be yourself, but always be kind. Don't over do anything.

[VivaLasViejas, ASN, RN]

I think I fall somewhere in the middle of all this. I've had many, many compliments from patients and families over the years, but seldom received cards/letters or commendations to management. At least I can say in all truthfulness that I've never received a complaint, or been told that I don't convey enough caring.

[nowim clean]

I treat all my patients the way I would MOM. Yes that includes touching holding hands and spending time in the room with them. That's me and I never see it changing

[jadelpn, LPN, EMT-B]

OP, one of the most difficult aspects of being on the spectrum is that it is often difficult to "sense" what a patient is feeling/wanting by attempting to interpret tone.

Sounds to me like you have adapted well to an appropriateness in your practice. Another way of perhaps dealing with a patient who is tearful, scared and the like is to use your resources. I know you had said the patient declined a chaplain, however, to say "I am concerned that you are scared, I am concerned you are tearful, and I would love to include in your plan of care ways to deal with that for you". Acknowlege, validate, and incorporate into plan of care. Then that puts the control back onto the patient to be able to then decline should they decide not to take advantage of the resource.

There are so many names, so many faces, so many "things" that a patient doesn't always remember all of them. And there are those patients who only remember the bad, and not the good. It is disappointing when others are receiving "kudos" and you are not. However, that your manager pointed out that you are a calming presence is wonderful. That your talent and love is for developmentally delayed and elderly dementia an asset. Have you thought about certifications is either (or both) of these things? Not that it will necessarily get you kudos, but it may be just what you need to validate these strengths.

http://www.nursecredentialing.org/GerontologicalNursing

http://www.ddna.org/pages/certification

And as a pp stated, sometimes flying under the radar is not a bad thing. Know at the end of the day you did what you could for who you could.

[anotherone, BSN, RN]

If I ever cry in front if someone, the worst thing , Ii think,, would be for it to be acknowledged. Patting my shoulder or trying to hold my hand will increase my anxiety or have me thinking you are an inappropriate weirdo. some who say to treat others like you would want to be treated don't realize some of us want to be treated differenly!

[mamagui]

@Brandon

I'm not gonna sit on the side of the bed and hold a patient's hand and have a "caring conversation" or whatever stupid fluff management is telling us to do that week.

In fact, it seems you did say that it was "stupid fluff."

Furthermore, some people are sensitive. Compassion IS part of the job- no, not everyone shows it in the same way. But for someone on the spectrum, learning the skills to convey compassion to a patient is as important as learning the clues people give as to what they are feeling.