what I wish I could say to my AAOX3 patients!

[Lola77]

I would like to print out a little pamphlet called "How to Be a Good Patient" and hand it to every alert and oriented patient who arrives on my floor. This does not, of course, apply to confused patients, demented little old ladies or drug addicts going through acute withdrawal. I expect those patients to act like circus animals. However, if you are an adult who has voluntarily sought help for a medical problem, and are now lucky enough to even be in a hospital bed, there are some things you should know.

#1. YOU WILL NOT SLEEP. This may sound cruel, I mean, how can you get better if you don't sleep? However, if you come to a hospital expecting a nice, quiet spa environment with cute nurses fluffing your pillows before you drift away into a healthful sleep, you are delusional. Time is short - your insurance will likely only cover a couple of days in that expensive bed. You will be woken up throughout the night to have blood drawn, blood pressure taken, IV meds administered, quick neuro assessments to ensure that your brain is not oozing blood. You will also likely hear people screaming and crying, cursing and laughing all night long. If you are lucky, it is not your own confused roommate who is constantly climbing out of bed only to set off his bed alarm. If you think you may need something to help you sleep, 3:00 AM is NOT the time to ask your nurse for an Ambien. Ask ahead of time when she has time to call the doctor for an order. Which brings me to my next topic. . .

#2. YOUR NURSE DOES NOT HAVE ACCESS TO ANY DRUG THAT MEETS YOUR FANCY. If you suddenly feel gassy or your left knee itches, your nurse cannot reach into her magic scrubs pockets and procure a Tums or Benadryl for you. Doctors are the one who must order any and all medications, EVEN IF IT'S "JUST A TYLENOL." Do not get mad at the mean nurse who won't bring you extra morphine because your back hurts. That mean nurse must put out a call to a doctor, wait for him/her to call back, pray that he/she is in a good mood and will give you the requested drug, write an order in the chart, scan that order to the pharmacy, wait a zillion years for the pharmacist to profile the medication, wait another zillion years for the pharmacy tech to bring the medication, then the nurse can bring you your Tums. This can take a while. Do not think the nurse is secretly hiding your Tums and enjoying your gassy discomfort. Which leads nicely into my next heading. . .

#3. THE NURSE IS NOT YOUR ENEMY. Yes, the nurse must do things that sometimes causes discomfort - we must start IV lines, insert catheters, change dressings on painful wounds, give you shots - but we do these things to help you get better. We take no joy in them. You know that doctor that just left your room? The one to whom you were very nice and polite? The one to whom you listened quietly, asked no questions, and didn't bother to tell that you are bleeding profusely out of your rectum or experiencing chest pains? Yeah, well HE is the one who orders these tests and blood draws and procedures. Speaking of that. . .

#4. TELL YOUR DOCTOR ABOUT YOUR SYMPTOMS. I cannot believe how many patients lie there quietly, smiling away when the doctor is in the room asking how they are feeling. "Oh, fine, Dr. Bighead! I feel great!" then. . .5 minutes later when the doctor has left the floor, this same patient is suddenly in excruciating pain, has numbness in her right foot and blurry vision. When asked why the HELL they didn't tell the doctor who just left, they shrug "oh, I don't know. . .I didn't want to bother him. . .he is so busy." Then the nurse must call the doctor and tell him that the nice, smiling patient they just saw is now a quivering mass of pain and can't feel her own face. This leads doctors to think that nurses are nutcases. Which takes me to my next point. . .

#5. DO NOT TAKE YOUR ANGER, FRUSTRATION, ANNOYANCE OR SCHIZOPHRENIC HALLUCINATIONS OUT ON YOUR NURSE. In general, doctors are treated like gods and nurses are treated like ****. Plain and simple. We as nurses try to proclaim that we are professionals and that we make a difference - in actuality we are treated very poorly by most people in the health care world. We are in the very difficult position of being the "coordinator of care" for patients, yet we lack any power to actually make decisions. We have all the responsibility but none of the power. I spend so much of my day making phone calls, trying to make things happen. Trying to get test results, find out what is going on, talk to the doctor, get medications ordered, figure out why the patient has not yet had that MRI of the brain or echocardiogram. Nurses are viewed as nagging wives. . .and tend to be treated as such. Doctors, in general, do not talk to nurses, they do not tell us what is going on with patients nor do they tell us the future plan of care. For me to figure out what is going on, I often have to try to read the doctor's handwritten progress notes, which is pretty much like trying to decipher ancient Egyptian hieroglyphics on a pyramid wall. There is very little direct communication between doctors and nurses. If you want to know if you have cancer, for the love of god, ASK YOUR DOCTOR.

#6. YOUR NURSE HAS 5-6 OTHER PATIENTS, SOME OF WHOM ARE A HELL OF A LOT SICKER THAN YOU. If you ask your nurse for some coffee and a newspaper, and she tells you that it will be a few minutes, do not get huffy and demand to see her nursing supervisor. For all you know, that nurse has a patient in the next room who is not breathing or is in desperate need of some pain medication. As nurses, we must prioritize, and yes, my "least sick" patient will get less of my time. This is not to say you are not important and I am ignoring you, but no, I don't have time to listen to you whine about your chronic neck pain when I have another patient who is having a seizure.

#7. "H" DOES NOT STAND FOR "HILTON." Don't complain to me about the food, the lack of TV channels, the view from your window, the "smell" of the hospital, of not being able to take a shower or go downstairs for a cigarette. You are in the hospital. Get that through your head. It is NOT like being at home or on vacation. We now call "patients" our "clients" or worst yet, "guests." Our administrators are much more concerned about if our patients are happy than if they are getting better. My boss is always telling me how much my patients "like me" but I never hear anything about my actual care. It would be better for the hospital's rating if I let that overweight diabetic eat her ice cream rather than tell her NO - at least she would be "happy."

#8. SOMETIMES IT IS GOING TO HURT. Yes, getting out of bed and walking after abdominal surgery hurts. Pancreatitis? Oh yeah, you are going to hurt and you are not going to be eating anything for days. #18 IV in the AC? Yup - it is going to hurt and likely be uncomfortable as hell for as long as you have it. DEAL WITH IT. You are in the hospital. Yes, it sucks and No, I don't expect you to be happy about it, but don't constantly whine and complain and demand that I "do something about it." You are not going to be magically cured just because you are in the hospital, and sometimes there is pain that even high levels of narcotics does not completely eliminate. Walking the day after surgery hurts, but it is the only way to heal, avoid pneumonia, and get out of the hospital.

What would you like to add to my pamphlet?

[gentlegiver, ASN, LPN, RN]

I think you covered it all. I might add, if you are on State Insurance (like Medicaid) don't tell me I have to get you everything your heart desires (even if it's against all Dr's orders) because you "pay for my paycheck". You don't pay for anything, I'm paying for you to be a here.

[Cat_RN, ASN, BSN, RN]

I can't think of anything to add but just want to reiterate the one about how the Hospital is NOT the Hilton! Don't ***** to me in the middle of the night about how the bathroom water is not hot enough, the food is crap, the water in your cup isn't cold enough, the bed is uncomfortable, the sheets too rough, the shampoo makes your hair dry, and the doctor not getting back to you about your left great toe!

This is not a SPA!

[Cat_RN, ASN, BSN, RN]

I think you covered it all. I might add, if you are on State Insurance (like Medicaid) don't tell me I have to get you everything your heart desires (even if it's against all Dr's orders) because you "pay for my paycheck". You don't pay for anything, I'm paying for you to be a here.

THIS.

[Lola77]

ha ha ha! I haven't had a patient say that to me. . .yet! (about "paying my paycheck")

[highlandlass1592, BSN, RN]

I want to know why your left great toe pain, which according to you has been going on ALL day, suddenly becomes an emergency at 2 am and why you expect me to call someone and wake them up about it? Nope, not gonna do it. Rounds start at 6 am, I'll do vascular checks but otherwise SHUT UP and go to sleep.

Ok, it's off my chest now. I guess you can tell I work nights.

[highlandlass1592, BSN, RN]

ha ha ha! I haven't had a patient say that to me. . .yet! (about "paying my paycheck")

Good grief, if I had a nickel for everytime I heard that one, I could take early retirement!!!

[Cat_RN, ASN, BSN, RN]

Good grief, if I had a nickel for everytime I heard that one, I could take early retirement!!!

ME TOO. And I always think the same thing... you're on STATE FUNDED insurance.. which MY taxes pay! I'm actually working for YOU to be able to be here! Be nice to me!

[mamamerlee, LPN]

No, we don't have a hospitality suite where all of your family can get free soda and snacks. The items I have on hand are for the patients who missed meals.

And I cannot roll 3 cots into the room for your family to stay overnight.

[Zaphod, BSN, RN]

NO, best one. DO NOT have your family call me in the room, to ask me to TURN ON THE FAN ??? Do you people not see the huge ON/OFF switch. Geeez

Or to brush your teeth if you have 2 perfectly working hands.

[fungez]

9)Shut up and show a little gratitude. For me, for your doctor, for this hospital, and for your health care, which is the most advanced in the world. If you don't like it, move to the sub-Sahara, where there's less than 3 docs per 10,000 people. Or Sierra Leone, where the average life expectancy is 41. Or Haiti, where they spend an average of $83/year/person for health care. You may not like the way your dinner tastes, but at least you're getting a dinner. Eat it and quit pestering me about it. I've got work to do.

[cardiacmadeline, RN]

Your nurse is not a TV guide.