What NOT to do when your patient works in healthcare too...
Ever felt a palpable change in bedside manner once your healthcare team learned you are a nurse? Have you ever noticed a difference in your own attitude towards a patient once you learned that they work in health care, & have you ever thought about it? I have.
You have been there before or at least I have, where I enter the room begin gathering patient history and reason for admission when there it is... it's obvious from the patient responses -they are not your layperson patient and eventually reveal that they too work in healthcare; Usually I feel like I can handle it and nothing changes in my bedside manner, -or does it?
Until a recent experience of being on the other side, (the patient -not the provider) I always thought my communications with fellow health care workers were fine...but were they? I have compiled a list of all the things that struck me as odd and unsettling in my experiences as a patient. These experiences served to remind me that not only am I a healthcare provider but a patient (and a customer) and therefore just as worthy of the courtesy and professionalism that is afforded any other patient. That being said I'm going to take this into account whenever I come across a fellow healthcare worker as a patient in my practice.
So without further ado... What NOT to do when your patient works in healthcare too...
Discuss the finer points of ICD10 coding. Yes -they are bothersome and tricky but please don't waste my time (the patient) complaining about them.
Assume that I know everything about your practice. Healthcare is huge and can be very specialized so my knowledge base may differ from yours.
Revert to technical jargon. Granted, -as a healthcare provider I may understand what you are saying but I'm not on the job and frankly don't want to be while I'm the patient. So explain it like I'm 5. Please, if I'm really sick I won't be offended, honestly. (Understandably this is going to vary and someone might get offended so in that case -jargon it up. Remember the mantra in school about "Always be flexible!" =P
Complain about time constraints. Nothing makes a patient feel uncomfortable like telling them that you didn't even have time to review their chart before seeing them. Really.
Badmouth other practitioners. We all work with them; please don't bring them to my appointment. Comparisons and scoffing at their mistakes don't make me (the patient) feel more confident in your practice.
Interrupt after posing a question. Why ask if you have no interest in hearing the answer? I realize there are time restrictions, yet I have also discovered some very important information that has directly affected patient outcomes by allowing for 'the long answer'; Remember that when someone is sick they can't necessarily be concise.
Partake in professional one-upmanship. What is it about the medical profession that attracts this kind of behavior?
Treat the computer. Eye contact it so important! Just because I'm in the business doesn't give you the provider permission to effectively use our appointment to catch up on paperwork.
And last but not least...
Don't hand a family member of the patient (whom you've just learned is a nurse) a shoulder immobilizer and say "You should probably know how to work this." then walk away.
Remember that stress and fear reduces a person's IQ significantly and take that into account during patient education. Please KISS (Keep It Short & Simple). Where Did My IQ points Go? | Psychology Today
Treat me like a patient (not a colleague) with the same fears and concerns that anyone else might have.
It's discouraging or perhaps encouraging how the 'Don't' list outnumbers the 'Do' list. Obviously, the 'Do' list will take more time and patients (pun intended). I'm sure that all of us at one point or another have guarded against telling our providers what we do for a living to ensure an unbiased approach to our care. On the same note when visiting family members in the hospital I have warned them against revealing my profession for the same reasons.
For me I will endeavor to remember: with all my patients' health care professional or not -ultimately we are all just people and want to feel safe and taken care of in the healthcare setting. What are some of your experiences? What would you add to the 'Do' and 'Don't' list?Last edit by Joe V on Jun 14
Practicing RN since 2009 in MedOnc, Radiation Oncology, Med/Surge and Geriatric nursing.
Joined: Jul '09; Posts: 1; Likes: 19Jun 11Joined: Jan '14; Posts: 806; Likes: 2,882"Remember that stress and fear reduces a person's IQ significantly and take that into account during patient education. Please KISS (Keep It Short & Simple). Where Did My IQ points Go? | Psychology Today. Where Did My IQ points Go? | Psychology Today"
You make some excellent points. I love this Psychology Today article (thanks for the link), which explains why stress & anxiety slow our thinking. The fact that the patient is sick and/or physically compromised only adds to the stress. As you said, "when someone is sick they can't necessarily be concise."
Please do explain things to me as you would to a layman. Don't expect me to be an expert in all areas of nursing.Jun 11Occupation: RN and blogger extraordinaire Specialty: 20 year(s) of experience in LTC, assisted living, med-surg, psych ; From: OR, US ; Joined: Sep '02; Posts: 26,993; Likes: 44,862It's funny how I always seem to go stupid when some medical calamity happens to me. When I was diagnosed with diabetes in 2011, everything I knew about the disease basically went out the window, and I had to have my PCP explain things to me as though I hadn't taken care of hundreds of diabetics in my career. Same thing happened when I was diagnosed bipolar a year after that---it was like I'd never even heard of the condition before. So yes, I like to have my healthcare providers pretend they don't know I'm a nurse and talk to me just like they would any other patient. I may know the basics but there's a disconnect between that and applying them to MY situation.Jun 11Occupation: Registered Nurse (ADN) From: US ; Joined: Jun '11; Posts: 149; Likes: 151Please remember that I feel like crap. I had meningitis a couple of years ago. There were sooo many things I couldn't comprehend due to pain and narcotics for pain.... like the nurse saying "you are really red. We are turning this iv off now"... I had Redman syndrome from Vanco, but I just felt horrible from the pain. I didn't really understand if I was having a serious reaction or or what. And I didn't care. Just fix it.
Also, doc. Please don't come talk with me when. I'm on the bedpan. Thanks!Jun 12From: TX, US ; Joined: Oct '06; Posts: 1,188; Likes: 2,359I was admitted a couple of years ago and my doctor told the nurses that I was a nurse. My nurse comes in the room and identifies herself and says so you are the nurse. I looked at her and said "NOPE, I AM THE PATIENT." I generally do not try to identify myself as a nurse when I am admitted. I just want to be treated like any other patient.Jun 12Joined: Aug '01; Posts: 1,681; Likes: 2,675I make it a point not to mention that I am an RN when I am in for any kind of medical treatment, be it in the hospital, in urgent care or in a provider's office. Sometimes they guess, because I might use terms that most laypeople wouldn't use in discussing my treatment, but I don't want people to feel like I am scrutinizing everything that they are doing.Jun 13Joined: May '16; Posts: 774; Likes: 1,161I went in for a procedure awhile back. I asked my wife NOT to tell anyone I was a nurse, but she spilled the beans! All of a sudden, the nurse caring for me asked me where I worked, so I told her. She then went in about how she used to work there and did I know so and so and does so and so still work there. She proceeded to tell me all this dirt on some of my coworkers. I really didn't want to know all this and it made me uncomfortable when I went back to work. She was a great nurse to me in every other way, but I didn't need to hear all that!!!
When I have cared for other nurses, I did feel self conscious at times. I was afraid I'd forget to do something important like wash my hands correctly or some other dumb thing and they would notice. In hindsight, I realize how silly that was. As a patient you are either in pain, miserable in your illness, or frightened/stressed as others have mentioned. You aren't looking for mistakes or behaving as a Nursing instructor.Jun 13Joined: Jun '17; Posts: 66; Likes: 100I am on the other side of the coin. I DO tell people that I am a med-surg nurse who have worked for 30+ years. I have even told my dog's vet. I want them to know so that they know my use of medical terms come from my knowledge base, and not from the internet and google searches. About 6 months ago, a dog-literally-bowled me over from behind at the local dog park. My left knee was screaming and I asked to have the ambulance called. I was in and out of the ER in one hour's time. This included taking a portable X-ray and having it read. I had the best service and feel it was because they knew I was a nurse. This time, one of the ER nurses had worked with me on the floor several years ago and so knew. I was very pleased that the MD ordered a portable XR so I wouldn't be moved to/from the cart to the machine. Whether I always tell someone that I'm a nurse, depends on the situation and if I'm in my small hometown or out-of-state.Jun 13Specialty: 1 year(s) of experience ; Joined: Mar '18; Posts: 24; Likes: 18I, too, am on the other end of that spectrum. So many times I have gone in and not told them my background in medicine and I end up getting ignored, dismissed, or told "I shouldn't worry about that" when really it's just been that the healthcare provider did not want to take the time to deal with it. FYI not all people are like this but the area I used to live in did not have very good health care and it was only after they learned I was in the medical field that they would listen to me.
I'll give you an example: my dad was admitted to the hospital for heart problems. He was there for a week. Prior to this he was scheduled to have his gallbladder removed. I drove 5 hours to come help him because nobody in the family could tell me what was happening, only that he had stomach pain and "no one was doing anything". So I thought I would talk to the doctor. I hadn't seen my dad in about 6 months and when I got there his abdomen looked like he was 9 months pregnant. I mentioned this to the doctor even he made his rounds and his response was " well we did an ultrasound on his gallbladder and didn't see anything wrong with it" (understandable since prior to this he was supposed to have it removed). So I asked what else they were doing because this wasn't normal for him. The doctor legit waved his hand in the air and told me "they couldn't find an obvious reason for why it was happening. Didn't want to do further testing and that he could just follow up with a gastro doctor when he gets released". I was furious. They weren't even willing to try to run more tests and thank goodness I put my foot down because it turned out he had an aneurysm that was causing his abdomen to fill with blood! Smh. If I hadn't of told them my background, they would have kept pushing it off and have started him on new blood thinners without any kind of monitoring for that specific condition.
Another time, I was the patient and had a real bad infection that resulted in a 5 day stay with 3 different antibiotics around the clock. I had it before but never this bad, this quick. Day before I wait for my appointment with my gp. He gives me oral antibiotics which was 100% okay! 3 hours later though, I'm in so much pain that I know I need to go to the ER and get some pain meds so I do. They give me some no problem and some nausea medicine with a shot of antibiotics to have in addition to my oral ones. I get home and about two hours later after both tylenol and ibuprofen I'm running a temp of 101. I can't get it to come down and even with the nausea medicine I'm getting sick to my stomach. All of these things are highly unusual for me. I would get pneumonia, strep, and the flu and NEVER run a fever. My immune system just doesn't respond right so when i do get a fever I know I'm in trouble. I can't walk or drive so my husband had to carry me to the car, pulling over every few minutes for me to get sick. I get back at the ER. My husband explains we were just here. I'm sent to the triage nurse where I explain all this to them and she looks at me and says "you didn't want to give the antibiotics time to work?" Legit rolls her eyes. I re-tell her about fever, not being able to walk etc and how unusual this is for me and I've never had an infection this bad before. She says "well, 101 isn't that high. We don't even count it until 102". By this point I was fuming because my tempo was 101 on tylenol AND ibuprofen and had risen to 101.59 just in the short car ride. At this point I'm too sick to argue or explain. I was very unresponsive and just couldn't do it so I decided to just wait for the treating doctor. My husband asked for a wheelchair or where one was at since he had to carry me in because they didn't have any out front. The admin nurse told him to just go find one. So my husband had to go back into the er rooms asking patients if they had a wheel chair they didn't need and any other staff. He finally found one a corner, unsure if it belonged to anyone and just took because he was so fed up with the attitudes of the admin nurses and staff from earlier. He asked fora bag in case I got sick since i had been doing so very frequently and they never brought us one. 20 minutes later, i know I'm going to be sick. I can't stand to go to the bathroom and my husband was like "do you want me to ask again?" ( it would have been his 3rd time asking) and i said no. They don't believe I'm sick then i can just puke right here in the floor and they can see it for themselves so i did. Oooo they were mad but only had themselves to blame since I had asked nicely, multiple times. I get back into the ER and the doctor comes in, takes one look at me and has me admitted, given dilaudid and put on three different antibiotics (vancomycin, imepenem, and i don't remember the 3rd) but they would eat through my veins every 5 hours and I would need a new line put in. Thank God the nurses and staff I had once admitted were actually caring and took it seriously. Honestly, i would have left to to another hospital if I had felt good enough to do so but I was so lethargic and unresponsive that I couldn't even tell that to my husband. That was not the time to be made to feel like I was being a "hypochondriac" or "drug seeker" or "didn't know what I was talking about" when it came to my own body and it honestly only changed when i finally felt good enough to tell them I worked in medicine and even had a close working relationship with the head of their pathology department. I felt bad because if I was a lay person, I may have felt so discouraged that i would have just gone home and the doctor told me straight up he didn't think I would have made it another day. Needless to say I did report them because regardless of your initial assessment or even previous assessment a condition can change rapidly and especially when dealing with infection that's spreading (in my case it was hard to get rid of cellulitis) you should never treat them like they shouldn't be there. They are there, spending their money on something no one really wants to spend money on, because they need your help. Kindness goes a long way. And when someone's extemely sick, the last thing they need is an attitude. If the person isn't arguing back, generally unresponsive, that's a good sign they're pretty bad off because healthy me would have jumped her butt over those comments.
Anyways, sorry for the long post but I just wanted to share my other end of that spectrum storyJun 13Joined: Jun '18; Posts: 5; Likes: 5I'll spoil any of you when it will be my opportunity to do so. As a CNA, I took care a few retired nurses. They were amazing to work for.Jun 13Joined: Oct '08; Posts: 2,312; Likes: 11,311Treat the computer. Eye contact it so important! Just because I'm in the business doesn't give you the provider permission to effectively use our appointment to catch up on paperwork.
As far as appropriate , yes, please. Those words mean specific things to me as opposed to lay terms. I most definitely don't want to be talked to like a 5 year old.Jun 13Joined: Oct '03; Posts: 17,405; Likes: 42,962It wasn't an emergency, and I wasn't hospitalized, but, a number of years ago, the lab work from my routine physical came back with elevated cholesterol. The LPN who worked for my PCP for many years called me at home, and the notification and sum total of the "education" I received about this health condition was, literally: "Your cholesterol came back high. Dr. X wants to start you on a statin. What pharmacy should I call the prescription in to? Oh, and you know about the diet, right?"
I kid you not (I particularly liked the "you know about the diet, right?").
(I explained to her that I would need a whole lot more than that before I was willing to start taking a new medication; I would either need Dr. X to call me himself so we could review the full results of my lipid panel together, which statin he wanted me to take, and the risks/benefits/alternatives/etc., or, if he preferred, I'd be happy to make an appointment to come into the office to discuss that with him, could she please let him know that, and I'd wait to hear back from someone. I never heard back from anyone at the office. I never started the statin. I did make some serious dietary changes and started exercising. He never mentioned it at any subsequent visits. I'm still fine.)Jun 13Joined: Jul '12; Posts: 725; Likes: 1,304I try not to share I'm a nurse when I'm a patient. It inevitably comes out there. Usually when I give too accurate and succinct information, or use the correct terms, and/or when someone recognizes me.
Some time ago, I was a patient in our ED at work. My being a nurse kind of came in handy - I was able to discuss my care with the resident and attending treating me - and advocate against an expensive and unnessecary round of imaging. They asked where I work, I explained I worked in that facility, they asked what I did, I admitted I was a nurse. They asked where, I told them my department. They asked which "part" and I told them. Which is when they finally decided to believe me - my "issue" and present or absent symptoms were very similar to issues patients I care for have.
I hate, more than anything, when family members are hospitalized and it comes out that I'm a nurse. Several family members have had surgery where I work, I've been ID'd by coworkers, and by friends who work on the inpatient units my family member(s) were placed on. But overall, in general, it's so annoying - like the floor nurses expect me to translate or reinforce everything because I'm a nurse.
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