A Spoonful of Sugar

Does it help the medicine go down? Can one be a nurse and view it as just another day, a job, a paycheck, a means to an alternate end? Can we care for patients without really caring about them? Is it necessary to fluff and buff while clinically following treatment plans? Nurses Announcements Archive Article

This is an interesting debate. One that can have multiple pros and cons. In essence, can one be a nurse and view it as just another day, a job, a paycheck, a means to an alternate end? Can we care for patients without really caring about them?

There are more than a couple of trains of thought on this subject. Most people do not "automatically" think of nursing when planning a career that doesn't encompass a level of interaction with people that one is not likely to find in a number of occupations. One has to deal with people who are at the most vulnerable states of mind. Who have lost a great deal of control. That their function depends on what a nurse does or does not do. But can a nurse just do what they need to, cut bait, and move on? Do facilities care about the numbers, or do they care about the patients? Do facilities want a nurse to take on greater and greater assignments of higher and higher acuity and do it all with a smile and kind words?

With that being said, does one have to be compassionate, caring and "this is my calling" attitude to accomplish the goal of the facility? If you ever look at or read a facility mission statement, it would be interesting to see if nurses have the time or energy with ever changing staff patterns and responsibility to do what any given facility claims that they should be doing.

With the introduction of HCAPs and the questions that it entails, there is a strong argument that yes, in fact, unless one is a really, really good actor, you need to have some essence of caring. HCAP has a number of questions at least one of which is usually along the lines of "did the staff care for you as a person". I am not a gigantic fan of such subjective questioning, however, it has come to a point where re-imbursement is dependent on it. Caring looks and acts differently for every single person, every single interaction. It is not easy to be able to complete tasks, and have a heart to heart at the same time, all whilst a nurse's 7 other patients are all waiting for their turn. (Which another line of questioning on HCAP is about waiting). Essentially, one could say that with staffing, a nurse could be set up to fail.

But the focus is not on nursing, it is on the patient "experience". Some refer to it as our "customers". Customer denotes to me that one chooses to have a service or buy a good. Unfortunetely, at least a fair number of patients are not in a facility because they choose to be. Not many patients are into the fact that they can not live at the level they are accustomed. That they have functional decline. That they need to have a bunch of stuff done to them and for them. So many nurses are finding themselves walking a fine line.

Some facilities have scripting. I believe I have been pretty vocal in my general distaste for this type of communication. I don't think this is the be all and end all of patient satisfaction. Most adults can really tell, especially after the 4th nurse comes in a says the exact same thing as the prior 3, day in and day out, that nurses can not stray from a set script. On the other hand, this can assist a nurse who is not in it for anything other than a means to an alternate end to touch key points to have patients satisfied, and not get too involved in the fluff.

With this in mind, one could say that schools of nursing can teach in an alternate way. Stay focused on the science of nursing as opposed to the art. Which is an interesting theory, however, what would that do to critical thinking skills, which can be thought of as the most important nursing skill? But can one think critically, while following a script, not stray too far off course, and still clock out on time?

Nursing is dependent on assessment. Assessment is partially dependent on asking questions. Scritping is asking open ended questions. If a nurse can not react to the answers to the questions--critically think--then a nurse is set up to fail. And there's a whole lot of patients that a nurse has to repeat this scenario with. All while being mindful of customer satisfaction.

So to provide the act of caring we at least in part need to act as if we care. And most nurses do care--to a certain point. It is worth noting, and a point of interest, that most acute care facilities are going away from LPN/ADN/Diploma nurses. These areas of study can be considered more of the art of nursing at the bedside type education initiatives. One could argue that higher degreed nurses at bedside are more in tune with the science of nursing, therefore, are more in tune with the actual goals of a facility, regardless of what any mission statement may say.

To be a nurse who is not committed is a complicated scenario--as it is an occupation that one has to think about if they can accomplish to the satisfaction of the patients they take care of.

In my opinion nursing is the hardest job there is. It requires knowledge,skill, patience,and always having to deal with the unexpected. How you choose to do your job depends on how you perceive the job Everyone is different in that respect.

That nursing is the most respected profession goes to the public perception of what nurses are asked to do mentally and physically every day. Patients often have to share their most intimate secrets and have you witness them while in pain,fear,and disability.

Let us not forget we are there to serve, but not be servants either to patients,families or physicians.

Specializes in Pediatrics, Emergency, Trauma.

Let us not forget we are there to serve, but not be servants either to patients,families or physicians.


THIS needs to be a reminder for ALL NURSES, as well as newbies and students. :yes:

In my opinion nursing is one of the hardest and lowest appreciated job in the world. But we care our beloved patients like a family member and at the end we get happiness that we have done something for somebody in need. this is the only happiness we usually get

Specializes in Pediatrics, Emergency, Trauma.
In my opinion nursing is one of the hardest and lowest appreciated job in the world. But we care our beloved patients like a family member and at the end we get happiness that we have done something for somebody in need. this is the only happiness we usually get

I respectfully disagree about it being lowest appreciated; In the years that go by, I find more people appreciate the work that I do; most of their attitude and frustration is born out of external and/or internal factoring of loss of control, and other issues; most of it is about the individual or familial dynamic; it just happens they direct it to the person at the bedside the most-nurses.

Specializes in Hospice, Nursing Education.

I have worked with many professionals and the ones that did the job best are the ones that cred about their patients. How to do a good nursing job is beyond my understanding because it is the caring that helps to decide who to work with first to be able to give the best care. Prioritization can be done from report but when you see and talk to your patients the order changes based on the patient's needs. The nurses that work like automatons get the job done usually faster then me by the patients usually do not pike the care and the little things get missed because caring brings out information and observations that spending time with the patient provides.

A spoonful of sugar really does make the medicine go down, in the most delightful way.

I could not be a nurse if I didn't care about my patients. My heart is in it, and that is what keeps me going. I'm a proud RN.

Specializes in Oncology, Ortho/trauma,.

I thinks it should also be clarified the difference between "caring for someone" and "caring about someone"

Caring for someone as care (noun) "the provision of what is necessary for the health, welfare, maintenance, and protection of someone or something"

I think most if not all of nursing is about this.

Caring about someone

as in care (verb) "feel concern or interest; attach importance to something." You can choose to do this as well as a nurse but it is not necessary to be a good nurse. In fact I would warn nurses to be careful of placing attachments on your patients as this could lead to Compassion Fatigue.

If this were the case,how would you be able to take care of the convict? Someone you morally object to or lifestyle choices. You can care for someone with kindness without having to care about them.

You care deeply about your patients while you are at work, but when the whistle blows you leave everything at work. I have my work life as a nurse, which I am totally committed to, and I have my totally seperate personal life. And I don't mix the two.

I was an RN for 41 years , my goal was to treat each of my patients like I would want my daughters treated. I loved being there for my patients and loved even more that they knew that I was there for them. They were my focus even if it meant going without lunch or breaks, I was willing to do that for them and more. It wasn't their fault that the hospital was hung up on numbers and profit margins instead of the patients and the staffs well being. I worked with nurses who sat at the desk on the phones, playing games on the computer, reading , going out to smoke every hour, taking extended breaks and lunches etc while their patients suffered from neglect the entire shift. I liked having a clear conscience at the end of the shift that I had done the best that I could for my patients to keep them safe.

I remember one time that a nurse like the ones I mentioned above kept saying during report "I have hardly had to move all night, you have a great section, even Elizabeth has behaved all night with an O2 sat of 98%". I immediately got up and asked that nurse to record the rest of her report because I was going to go check on Elizabeth (our frequent flyer) because I have never known of her to have a sat that high. When I walked into Elizabeths room she started reaching for me, she did indeed have an O2 sat of 98%, however, her respiatory rate was 60 and she was diaphoretic. ABG's were done stat , her pH was 7, co2 60, she was immediately intubated and placed on a vent. Yes indeed, she had behaved the entire shift and hadn't caused that nurse any problems at all.

I wanted to be a caring nurse who gave optimal patient care, I hope to at least be remembered for that.

Nursing is very difficult but can be rewarding as well.