As a Nurse and a Patient

DoeRN · Dec 18, 2013

I have to go in for major surgery which I keep putting off well because I'm a nurse. I'm one of those crunchy, approaching middle age, firm and direct nurses. But I also care what happens to my patients and though they may not like what I have to tell them they understand that I'm looking out for their best interest.

So I would love to have nurses who think the same way I do. I don't need all the hand holding and behind kissing to get good satisfaction scores. Give me someone who knows what they are doing and looking out for my best interest.

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Not_A_Hat_Person, RN · Dec 18, 2013

It's not an either/or situation. A nurse can be firm, competent, assertive, and friendly. What worked in the military doesn't necessarily work in civilian life.

KenH · Dec 18, 2013

I have to agree that it is not a all or nothing thing, and I don't think it is only a military thing, maybe I should have started the post with "you know your old when". My wife who has been a nurse for 30 years CNA-LVN-RN-BSN RN-FNP always hated being given the difficult PTs, because she was good with them, she is the smartest RN and nicest person, and she misses those charge nurses when she makes rounds and takes calls from the floor nurses, but I am biased.

I guess I miss the mature charge nurse who was the rock that held everything together, who made sure everyone had a bath before noon trays, knew when and why to call the MD, knew the labs and made rounds with the MD. Its probably just where Im at but the medserg charge nurses are 2 years out of school, they are all very nice, good organization and communication skills, but have the attitude that they are not the doctor and don't worry about such things to much. Patients tend to get worse before they get better.

You know your old when you miss that firm, tough, rock solid Nurse, that had certain expectations on How, When and what should be done.

BSNbeauty, BSN, RN · Dec 19, 2013

I would want someone who is a both. Competent and Caring. It really isn't that hard people.

nurseprnRN, BSN, RN · Dec 19, 2013

I'm generally in decent shape, but my sweet husband is getting along, and he has gotten to the point where he wants me to go with him for all his appointments. Not that there are that many of those, either, but it's not just an annual physical either. And there are times when I just go nuts .... seeing the medical assistant take his BP through his sweater with the automatic cuff put on crooked, loose, and the mic nowhere near the brachial artery. I mean, he's on BP meds that have been adjusted quite a bit lately, and I'm starting to wonder what data that's based on. I don't give a sweet damn whether the MA is a nice person. I just want an accurate BP. Is that so hard? I truly do dread the day either of us has to be hospitalized.

Susie2310 · Dec 19, 2013

I'm generally in decent shape, but my sweet husband is getting along, and he has gotten to the point where he wants me to go with him for all his appointments. Not that there are that many of those, either, but it's not just an annual physical either. And there are times when I just go nuts .... seeing the medical assistant take his BP through his sweater with the automatic cuff put on crooked, loose, and the mic nowhere near the brachial artery. I mean, he's on BP meds that have been adjusted quite a bit lately, and I'm starting to wonder what data that's based on. I don't give a sweet damn whether the MA is a nice person. I just want an accurate BP. Is that so hard? I truly do dread the day either of us has to be hospitalized.

Grn Tea, I just wanted to share with you that I have been in a similar situation with a family member regarding my family member's BP and the medical assistant, and since our experience has been that our doctors' do make some medical decisions utilizing the BP the medical assistant takes, what I have found very helpful is to monitor my family member's BP at home and keep a record and take it in when we go to my family member's medical appointments. This way if the medical assistant's BP is out of our trend we can choose to address the situation with the doctor by referencing our data, and if necessary we state our observations of the medical assistant's technique respectfully and factually. We can also discuss BP trends and changes in trends with the doctor. If changes to medications are proposed, we can refer to our data and ask questions we believe are necessary. Our actions have proved very helpful for my family member.

In the beginning we actually did tell my family member's new doctor about the medical assistant's technique, and the doctor received our information courteously and non-commitally, but the situation continued, and we found it was necessary to advocate for ourselves. We have observed that it is quite common for some of the medical assistants to not use proper technique when taking our BP's. I now take my family member's BP log with us to all significant medical appointments.

Best wishes to you.

Columnist · Dec 19, 2013

I wrote an article about this topic a few months ago called Be the Nurse You Would Want as a Patient.

In this article I said, "Nurses do not have the ability to change your reason for being in the hospital, but they do have the capacity to make your hospital experience a more pleasant one. I am not talking about customer care, so to speak. I am talking about nursing.........including the little things. What might seem little to us may mean the world to the patient."

"Sometimes we forget that bedside nursing involves being at the bedside for more than procedures, medications, assessments. Yes, all of these things are definitely important to the care of our patient. But we must also remember that it is at the bedside where we can let the true compassion of our profession shine through some of the darkest hours that our patients and their families face."

CrunchRN, ADN, RN · Dec 19, 2013

I would want someone who is a both. Competent and Caring. It really isn't that hard people.

Ideally yes, but in an imperfect world if I have to choose I want competent.

Ruby Vee, BSN · Dec 19, 2013

As a nurse and a patient, who would you want taking care of you, let's be honest we all have Doctors, co-workers, AND Nurses who we would never want to touch us or our family.
Personally I would want the toughest, smartest, assertive, grumpy old army Nurse (sadly they are a dying breed) taking care of me and my loved ones. NOT the Nurse who gets all the patient satisfaction awards.
Sadly today it's all about patient satisfaction, not patient care or outcomes, most patients don't know what they are missing, but they love their nice NURSE.
Part of this is, I keep reading how mean some people can be, and how we need to be more accepting and supporting of each other.
What do you think?

I've said basically this same thing over and over -- the "nice" nurse vs. the good nurse. The nice nurse, the one that gets all those customer satisfaction awards, is the one who gives you all the water you want to drink even though you're on a fluid restriction. She doesn't make you cough and deep breathe post op because she knows how uncomfortable that is. If you don't feel like feeding yourself or washing yourself, she cheerfully does it for you because you know it's all about the patient satisfaction surveys and not so much about returning you to independence.

Then there's the nurse that not only knows you're on a fluid restriction, she knows why. And when you ask for that big glass of water, she tells you about the fluid restriction and explains that she's getting you a small glass of ice chips. She insists that you cough and deep breathe, nevermind that it's uncomfortable for you. She doesn't want you to get pneumonia. And while she's happy to set up your tray and even cut your meat, you can feed yourself because it's all about getting you back to being independent. No matter how nice she is about saying no to the water and insisting upon coughing and deep breathing, she doesn't get the same amount of patient satisfaction awards, but her patients some how do better. Unfortunately, that isn't rewarded.

Ruby Vee, BSN · Dec 19, 2013

Well, we're not all dead. I suppose I'll count my blessings.
And we're not all grumpy, either. :)

I'm not dead yet, although I AM pretty grumpy right now -- probably because I'm more of a patient than a nurse lately.

Ruby Vee, BSN · Dec 19, 2013

I'm not dead yet either and I am not usually grumpy either. But I have to admit as a frequent patient these days I am concerned for my care more often than I am not....there is so much missing and so much lack of responsibility...I don't know something is definitely missing.
The stress on that staff is palpable. However, I see a lot of "Whatever..." attitude. There are days if i see one more gum smacking, eye rolling nurse.... it makes me want to scream.
I had one recently tell me it was no big deal the med he/she hung on me didn't have my name on it...and I quote in between the gum snapping and rolled eyes..."What difference does THAT make..... it's the right med isn't it?" I was ready to spit nails! Really? At 10 am you can't find another label or the right med with my name on it when pharmacy is in the house on a non stat med???? I was stunned.
Did I complain? Yes. Will they talk about that "female dog" in outpatient IV? Yes. Do I care? ABSOLUTELY NOT!

Gum smacking, eye rolling nurse who is sure she is meant for bigger and better things than the bedside. I've met a few lately. It seems that too many nurses are chasing the patient satisfaction scores and not enough are doing good patient care. I guess I can't blame the newbies -- it's being drilled into them that patient satisfaction is king, and their preceptors, most of whom are convinced that they are shortly going to be doing something loftier away from the bedside, aren't drilling the basics into them.

I'd like my nurse to be competent, responsible and well-versed on the basics of nursing care such as accurate assessments and knowing, understanding and following the plan of care. I don't care so much about attractive or sunny of disposition.

Ruby Vee, BSN · Dec 19, 2013

WE used to have a critical mass of those that CARED and now we have just the opposite, nothing is a big deal. There used to be a positive peer pressure to be on top of your game, now they call it bullying, most just don't care, they don't get "NOT on MY Shift", But our hospital mostly only hires new grads. But there are some that take off running and rise to the top.

You're right. We used to have a critical mass of nurses that cared and now we don't. Nothing is a big deal, and many of these new nurses don't expect to be at the bedside any longer than it takes to be admitted to anesthesia school. They don't really care about their patients doing well long term, they just want to get through the shift as easily as possible. Why risk an argument with a patient about a fluid restriction; just give him the water he asks for. Why have an uncomfortable moment about teaching the patient to cough and deep breathe -- just give him more pain meds and hope for the best.

There used to be peer pressure to be on top of your game -- and now they call it bullying. You are absolutely right there. And so the newer, more malleable preceptors don't insist on their orientees being on top of their game lest they be accused of bullying. They let things slide, especially if the orientee gives them any pushback.

I'm glad I'm nearing retirement age so I don't have to work like this much longer. I'm despairing of the kind of care I'll get the next time I'm hospitalized, though.