Excerpts from the book "The Nurses..." By Alexandra Robbins. Hospital life exposed? Or a m

[beckster_01, BSN, RN]

I have been troubled for quite some time about the excerpts that I have read from this book, as well as the long comment threads that follow. I truly regret not posting about this earlier this year, as many comment threads to the excerpts that I have seen are now closed, but I am still seeing it floating around on Facebook and I just HAVE to speak my mind! I have been reading responses from both nurses and non-medical laypeople. The general nurse's response is "thank you for being our voice! This is so accurate!" Meanwhile, the layperson is shocked and appalled by the nursing behavior that is described.

Let me pause to explain that I have NOT read this book in entirety. This isn't meant to be a book review, I understand that Ms. Robbins is attempting to improve the public's perspective of nursing. However I feel that many of the experiences she observed are taken out of context and the publicity of these articles is only serving to undermine the trust that readers have in not only nursing, but the medical team as a whole. This got long as I was typing so I am only going to talk about one article that I read recently, an opinion article found in the Washington Post titled "Nurses make fun of their dying patients. That's okay." Nurses make fun of their dying patients. That’s okay. - The Washington Post The second is posted in Politico, an online magazine "Don't get sick in July, and other tips, tricks, and advice from American nurses." For brevity's sake I am just going to post the link and not talk about it yet, but I am interested I other's opinions. Nurse Confessions: Don't Get Sick in July - POLITICO Magazine

Let's start with the first article. The title alone is appalling. It is meant to grab the reader's attention, but if my mom just died in a hospital and I saw that title I would be offended before I even started. End of Life issues are already difficult enough in the ICU. It is easy for a family to interpret a Palliative Care consult as a push by the medical team to "quit wasting our time and let mom go already." Of course that is not how we mean it, but it shows how important it is for the medical team to let families know that we truly are putting their loved one's needs first. To spread the rumor that we turn around and laugh about the corn found in mom's airway simply does not build the trust that we need to address these issues.

The "acronyms" referenced are terms that we might use in online forums or breakroom talk. The furthest I would go is if someone asked me "what happened to bed 2?" it feels more sensitive to say she went to the 9th floor (our hospital has 8,) than to discuss her death in hospital halls. I would NOT say that bed 2 is "approaching room temperature."

The next paragraph goes on to quote a nurse saying "Laypeople would think I'm the most awful human being in the world if they could hear my mouth during a Code Blue." Really? Because I find I feel better about a code and our efforts if a family is able to be present without obstructing the healthcare team. I WANT them to see our professionalism during an emergency. When my team codes we are cooperative, professional, and furtive in our efforts, and it truly does not matter how hopeless we think the outcome is. We might laugh to release the pressure if something funny happens, for example if I pop the cap off a med syringe and it hits someone in the nose. That is 3 stooges funny and it is totally appropriate to giggle.

Moving on. About halfway through the article Ms. Robbins goes into the nurse's need to decompress during this stressful job. She argues that because we care so deeply about our patients, it is ok to make jokes about them. I agree only to the extent that it isn't completely disrespectful to the patient and their family. There is a line. I joked today about a patient who has bilateral AKAs who was trying to kick me. I told her something along the lines of "cool your jets!" But I didn't make fun of her for not having legs. One is making light of a situation, and the other is making fun. It is ok to do the first thing, not so much the second.

If I were to go by comment threads alone then I seem to be the only healthcare professional that is concerned. Am I being oversensitive? Is this really how other nurses feel and I don't see it or the culture on my unit is unique to others? Is she addressing issues that are more focused in the ED versus other clinical areas? Do people even care? Anyways, I have much more to say (I found the second article even more disturbing), but I really am interested in hearing what other's have to say first.

**Disclaimer** I typed this whole thing on my iphone, in the middle of the night because of shift rotation insomnia. Please pardon any typos, or poorly formulated sentences. Or misused vocabulary- I'm sure it's in there somewhere

[HouTx, BSN, MSN, EdD]

I had to stop myself from repeatedly 'liking' your post.... I need a "Love Love Love" button for your post.

To me, you're a beacon of hope to this COB with 30+ years in the trenches. When we (oldies) say the same things, people just shake their heads with that "is she senile already?" look on their faces. As we shuffle toward decrepitude, it's wonderful to know that the legacy is secure. You get it. It's not about us and how much fun we can have at work. It's only another code to us. For our patients and their families, it's a profound experience - an indelible event that will affect memories of their loved one for the rest of their lives.

Great iPhone typing skills also!