The Nurse on the Other Side

[sheilagood52]

Me...the Patient

You thought I didn't notice the fake, tight smile you gave me, but I did. I heard the edge of irritation in your voice and saw the roll of your eyes as you turned away. And, for future reference, your mouth does funny things when you're biting your tongue.

I didn't hear the things you said to your co-workers as soon as you cleared the room, but I heard them in my mind as if standing next to you.

"God, the patient in 505 is intolerable." The others teetered as you described me.

"Bet she's a nurse; is she?"

I imagine you couldn't pull my patient record and demographics up fast enough in search of my occupation. You groan echoed loudly, "She's an MSN."

The others laughed at your misfortune and walked away.

You wrote your name on the whiteboard in my room with a flourish and told me to call if I needed anything. But, you didn't mean it. I saw the hurried and dismissive way you wrote resenting the nuisance board.

You checked the orders for the day, scanned the most recent labs for obvious outliers, made a note of the meds to dole out, and moved on. You didn't delve into my history, or the reason I ended up in the emergency room; you didn't have time. Yet, discovering I was a nurse, made you cringe.

Am I Your Worst Nightmare?

I'm your worst nightmare or so you say; right next to the physician-patient, you had last week. I'm your patient and I hold a master's degree in nursing. I know things, lots of things about medicine, the role and responsibility of nurses, and more about the disease ravaging my body than most physicians. Knowledge is a powerful thing, and, yes, sometimes too much is a dangerous thing. Physicians see me occasionally and this is my first encounter with you, but I live with the complications of my illness every day. If I had to choose, I'd take more knowledge over less any day.

But, why does finding out I'm a nurse, bring out the worst in you? Why the snippy attitude or rolling eyes? Why should I hide the fact I'm a nurse? We're supposed to be kindred spirits.

I'm not here to grade your performance or make you feel, whatever you're feeling. I'm here to get well. A little compassion from one nurse to another will go a long way in making that happen.

I no longer practice nursing, not in an official capacity, but I remember what inspired me. I wanted to be like Florence Nightingale, help the sick, cure cancer, or the next big disease threatening to wipe out humanity. I had big plans. I'd advocate for my patients, unique in their illness and they would remember me with fondness. Although my career was cut short, I still maintain my license and keep up with medical practices. Nursing is a way of life for me. It's who I am.

The Healthcare System

The whole health care system is unrecognizable to me these days. Nurses are still overworked and underpaid. Electronic charting and medical records have nurses spending more time in front of the computer than at the bedside, and patient care has become check-offs on a computer screen.

Remember the lab values I asked about?

"They were normal," you said. Did you bother to review the pattern of my previous labs? No, you evaded my questions and became annoyed. If you had, you would've realized they weren't normal, not for me. One size does not fit all.

To you, I'm the pain in the *** nurse-patient in room 505, but this is my life, my body, and my pain. I should have a say; I've earned it.

One day you will be me, the nurse on the other side, receiving instead of giving care. Tired, sick, and afraid, the truth of who you are will slip out as your own knowledge compels you to ask questions and push for answers. Clinging to the last bit of control you have, you'll pay attention to the care you receive as never before. Once a nurse, you're always a nurse.

That time will come faster than you can imagine. When it does, you'll want a compassionate nurse. One, who listens, answers questions, takes your concerns seriously, and treats you with the respect every nurse deserves no matter her age or circumstances, not one who rolls her eyes in impatient mockery.

[Jewelsforme]

No, we do not go in "ready to be angry," at least most of us who are chronically ill, unless we are called names like "psych patient" when in fact we are a GI bleed or other REAL physical ailment that needs help. I get mad when I am smiling, quiet, suffering and minding my own business, then someone comes up and says I need a psychiatrist. Then watch the little Portuguese lady come out of me. I try to keep her hidden whenever humanly possible, but some people insist on seeing her. In those rare instances, I introduce them to a part of me that even I don't want to show. Otherwise, I am calm, quiet, or crying quietly when the pain goes over 7 or 8, never demanding attention or help. After several hours of waiting in ERs with no one checking on me, watching far less ill or injured people come in and discharge out, my husband will help me dress, then help me hobble out of there to suffer quietly at home. Believe me, because it's true.

[Jewelsforme]

In a word, yes. But we value each and every single one of you who do not pass judgment on us, because we are in a very weakened and vulnerable position now and adore those of you who truly care about us. But the ones who show they care, even for the 30 seconds they have to spend with us, are rare indeed. Big hugs.

[Jewelsforme]

I forgot to thank you Anna - for treating each patient as a human, regardless of what we did for a living. I never had the time, nor desire, to dig up any personal info of any patient unless it may help me to care for them. I knew some day I could be any one of them. I just didn't know how soon it would be ♥

[girlvet]

You have no idea what is going on in the emergency department you are in. I work as an ER nurse and I am sorry but someone with chronic pain is not a priority. Priorities are chest pain, CVAs, cardiac arrests, trauma. Chronic pain should be handled by your own doctor or a pain clinic, not an ER.

[Jewelsforme]

Well, let the attacks against us roll. I was not in the ER for chronic pain. I was having chest pain and needed a cortisol infusion since the home I'm injection did not stop the arrythmias. I limp because yes, I also have chronic pain. A truck hit me, going down the wrong way and slammed into the front of my little car. Not that the reason will matter much to others. But I live with severe pain, which causes a limp. I could be wrong if you were not responding to me. Then I apologize. But if your response is directed to me, then there you have it.

The hospital is 3 miles from me, we have a rather small ER, one I used to go to quite often as a nurse for patient transports up to our floor. When I was a patient there, other than for chest pain, the cardiac bays were empty. Just one example (of many) - A bicyclist came in, walking fine, from England, who was visiting our island for vacation. He said he fell off his bike and just wanted to make sure his wrist was not broken. He was bending it back and forth - I could see because the curtain was not pulled all the way. And his wrist turned out not to be broken. However, I watched as he walked to radiology, walked back to ER, and walked out d/c'd with pain meds and script (yay for him) with his SO to their hotel. But the staff was in with him constantly, offering pain meds, etc. Me? Hot abdomen with bloating and pain with active GI bleed. Hours later, yes, my husband did help me dress and had to go to another hospital, which is hours away, but I rec'd the care and follow up I needed. I could go on, with eye-opening negative care from several hospitals in different states. However I will not because the knee jerk defensive/agitated presumptions are just one of the smaller reasons why I no longer desire to ask for medical care.

Chronically very ill people get this kind of attitude and anger directed at them a lot. So on top of feeling ill to the very core of our existence, most of us will avoid seeking medical help at all cost. The indignity is extremely difficult to tolerate while trying to survive numerous system dysfunctions for the rest of one's life. Pain is a whole other different animal. I do wish you well. With much aloha.

girlvet said:

You have no idea what is going on in the emergency department you are in. I work as an ER nurse and I am sorry but someone with chronic pain is not a priority. Priorities are chest pain, CVAs, cardiac arrests, trauma. Chronic pain should be handled by your own doctor or a pain clinic, not an ER.

[emtb2rn, BSN, RN, EMT-B]

Jewels, what arrhythmia is treated by a cortisol infusion? I've worked up many arrhythmias, from dead to svt, but have never seen cortisol used.

[elkpark]

I'm sure that many people (nurses) have had, as clients, the kind of experience the OP describes (although the description does sound pretty subjective and maybe over-dramatic). But all of us have also had the experience of having clients who aren't satisfied no matter how much we do or appear to care for them. I would ask, what do we actually owe our clients in terms of our emotions and attitude? We're there to provide nursing care. It's bad enough that the general public expects us to all be sweet, loving, caring, selfless angels of mercy 24/7, without other nurses expecting it, too. I would question whether the nurses posting here and complaining about how they've been treated as clients have ever had a bad day or been less than perfect at work. Unless you can honestly say that you've never sighed, or rolled your eyes, or tightened your lips at something a client said or did, I'm not really seeing the point.

I also agree with the point made by another poster that I don't see why nurses (or other healthcare providers) are necessarily entitled to "better," more caring, more compassionate care than I provide to anyone else.

[Jewelsforme]

I understand. It is not known because it is rare. With extremely low cortisol, mine was 1.7 at the time, the heart cannot function correctly. I had to do quite a bit of research myself because even physicians would have the deer in the headlight look as I handed them a brief print out from PubMed of other science based sites to show the correlation between cortisol and the heart. But for me, I was having runs of SVT and periods of asystole, documented on the monitor printouts. Perhaps for another patient with very low cortisol, they would have other types of irregular heart rates. I can only relate what happened to me. Treatment was hydrocortisone PO 3 x daily for five years until the adrenal glands began to work again. The steroid replacement therapy was no fun piece of cake. It had its own terrible side effects. But thanks so much for asking. I had no idea until I experienced it. With all my best.

[sheilagood52, ADN, BSN, MSN, RN]

Thank you for taking the time to comment. However, the irony of your comment, "...it seems that you are being judgmental," was not lost on me. Why should a nurse be intimidated because of my knowledge and experience? And, I have "brought it out on the table," before and with similar reactions. I'm not suggesting every nurse responds this way, but it only takes one to make you wary. I didn't imagine the tone of voice or the rolled eyes, they happen. And, I get it, nurses are overwhelmed and overworked. Perhaps she had other things on their mind, but having been a nurse at the bedside, just like all of you, patients who happened to be nurses or physicians never intimidated me. We often had very enlightening conversations.

I wrote this article to bring out in the open, something that happens. Pretending it doesn't is the same as pretending, "nurses don't eat the young," is a fallacy.

[sheilagood52, ADN, BSN, MSN, RN]

LadysSolo

I do not consider myself a difficult patient, but an informed patient. When I'm sick, I prefer, as you to be left alone. I don't call the nurses unnecessarily, but if I have a question or concern, don't brush me off. My physicians and I have an excellent rapport. Thanks for reading and commenting.

[sheilagood52, ADN, BSN, MSN, RN]

Of course, every patient deserves respect. The point of my article is my experience and other medical professionals who've shared theirs with me, don't always get it. And no, I don't have a chip on my shoulder, as you suggest. Why is it when a nurse brings to light behavior contrary to the image of the all compassionate nurses offend you?

I love my profession. I believe nurses are the glue that hold our health care system together, but to deny these things happen is sticking your head in the sand and, certainly does nothing to improve nursing.

[sheilagood52, ADN, BSN, MSN, RN]

You're absolutely correct. Any nurse who has been in on the shift reports know how these things go down. A patient who's on the call button non-stop? You bet eyes are rolling and a few remarks made. After all, nurses are human too and sometimes, making jokes between each other (even about patients) is a stress reliever. However, it doesn't make the patient and their concerns any less real. All I'm trying to convey by writing this article is nurses are patients too.