Having a good attitude is key. In this article, the author explores two different approaches to nursing and encourages us to continue to be our very best.
Nurse A enters the emergency department bay where a critical patient, in the process of stroke protocol lies semi-comatose on a gurney, surrounded by anxious family members and friends. She says, “There aren’t any rooms over in ICU. You all will have to spend the night here. I will watch over him, but I have 3 other patients I am taking care of. I think you all should complain to the administration. If you don’t, nothing will change. I know I’m outta here as soon as my husband gets a transfer.” As she leaves the room, her negativity fills the space just as surely as if she trailed toilet paper on her shoe.
Nurse B
Nurse B enters the same area to start an IV and hang plasma. She does her duties in a professional manner and asks the family if they need anything. “Well, the other nurse told us there aren’t any rooms upstairs. What are we going to do?” She replies, “We will continue to take excellent care of your loved one while he is in our department. We will be just outside the door if you need us. Please don’t hesitate to call. We will also be working diligently to get the patient to the ICU as soon as is possible. Is there anything I can do to help you all be more comfortable while you are here with us?” As she leaves the room, the family sighs but feels re-assured that matters are under control and that they don’t need to be as worried.
As a Faith Community Nurse who often visits a variety of Emergency Departments to be with families who are in a time of crisis, I see all kinds of nurses in action and am able to observe their interactions with patients. Unfortunately, I have witnessed some Nurse A’s and a number of Nurse B’s. While many Nurse A’s may feel perfectly justified in their complaints and what they say may be true, it is disheartening to see and hear nurses complain to patients, especially in their moments of true crisis.
What would Nurse B’s say to Nurse A’s?
She would be polite and not condescending but she would say in no uncertain terms:
Don’t vent in any way to patients and their families.
Don’t tell them about your life, about how tired you are, about how many shifts you are working, about how low your pay is or about how your car is in the shop. They do not care. They are sick. They need your help. They do not need to be in a position where they feel they need to take care of you.
Being a professional means working through the bad times as well as the good times.
Work is not always fun. It is work. It can be rewarding but it isn’t always rewarding or fulfilling. There are times when it’s just plain old hard. Get over it. Work anyway. Show up early. Dress professionally. Do a great job. Make your team proud. In the end you will, most likely, experience some sense of satisfaction for doing your best.
You are in complete control.
You can’t change your circumstances and you can’t change what happens to you but you can always be in charge of how your respond. Your reactions are totally yours. Maintaining control of your attitude is what makes you stand out from other nurses. As Zig Ziglar said, “Your attitude not your aptitude, will determine your altitude.”
The Big Picture
Every part of your life experience matters and fits together to make a bigger picture. While a “dream job” may never come your way, every job teaches us something. When we are new grads and have to “settle” for something less than we expected, we learn to do our best, to be humble and to persevere, gathering whatever we can and growing through it. As we go through our professional lives, many of us are able to look back and acknowledge with great humility, that yes, that job that we hated so much during that season of life, was critical to helping us get to where we are today, doing what we always dreamed of.
Remember, it is always about the patient. It is not about the nurse. Being self-less, not self-absorbed leads us along the path that brings light and life to our spirits. Contrary to our natural inclinations, when we serve others with a joyful heart, we find the true rewards that we were seeking all along.
Are You an A or a B?
Probably most of us are some combination of a Nurse A and a Nurse B, hoping that we are much more of a Nurse B most of the time. We can help one another along by not feeding the frenzy of complaints and instead by calmly and steadily working together to pursue true professionalism as nurses, setting great examples for one another to follow.
Having been the bearer of bad news for years now to many patients/family members its all in how you approach it: I always ask what they've been told about the situation or what is your understanding of this situation? What kind of questions do you have?
After I understand what they understand (whether right or wrong), then I steer the conversation to the meat of what I want to discuss.
There is no reason for me to get emotionally involved because in order to do my job, I have to remain an objective observer.
Thank goodness I work in a SNF where that inane scripting hasn't been a thing, at least not yet. While most of us don't go out of our way to complain about staffing issues, we also tend to not lie about it. When a resident or family member comments about an obviously short staffed shift I will let them know that yes, we are challenged today. No point in lying about it when a shift is bad enough that they ask.
Hospitals love to hang banners in visible places: "Voted Safest Hospital in the Valley" "#1 in Cardiac cCare" and my all-time favourite: "Magnet Facility".
I'm still waiting to see a hospital post their staffing ratios on a banner.
Wonderful comment!!!
I am a combination of A and B.
I have had patients with unrealistic expectations due to the fact that I must assess 12 patients before I can do their dressing change.
Since I do not want these patients to think I am ignoring them, I tell them exactly what is sitting on my plate, but that I will take great care of them.
I find this approach resets expectations, while keeping the patient happy.
I am assuming that the spirit with which this was written is commendable. The over-simplification and stereotypical portrayal of of A and B are a very unfortunate approach, though.
People do not change their behaviors by seeing them portrayed in an exaggerated manner. Stressed people trying to navigate a difficult situation especially do not change their behaviors by being vilified. They simply become more downtrodden.
Second, the approach of not seeking an honest rapport with patients or in any way saying things with the intent of dishonesty, particularly with regard to scenarios where their care is compromised (in ways either big or small), is a violation of our very Code of Ethics; Provisions 2, 3, 4, 5, and 6 to be specific (there are only 9). Clearly it is wonderful if a situation can be portrayed in a "not dishonest" manner while providing the best care possible and maintaining professional decorum and demeanor - - but that, of course, wouldn't include profuse exclamations about the excellent care and the idea that someone will be right outside the door.
Third, part of what actually enables the situation of poor allocation of resources for nursing care is a long history of nurses being expected to cover for others' decision-making.
Fourth, it is but a delusion to believe that patients can be fooled about these difficult situations. Any nurse who has always maintained decorum and been careful not to disparage the employer knows this and has fielded questions from patients that get right to the heart of the matter; they can and do make their own observations. They might choose to respect (and therefore trust) a nurse who appears to make the best of things by not spouting off, or they may simply recognize that they are being lied to, and that the person lying to them can't be trusted any more than any other agent of the business.
Lastly, yes, Nurse A's comments were not professional. But it's a grievous offense to imply that the main thing wrong with the situation is "her negativity."
??
As others have stated, there is a middle ground here, and I highly suggest using it in order to protect the patient rapport and one's own dignity and integrity (which is addressed in Provision 5).
Specializes in Mental Health, Gerontology, Palliative.
There needs to be a balance between 'bitter and twisted' and 'little Miss happy'
While I dont discuss staffing with families, i have been known to encourage families to take their concerns re staffing directly to management when they have expressed concerns about obscenely high patient to staffing ratios
There needs to be a balance between 'bitter and twisted' and 'little Miss happy'
While I dont discuss staffing with families, i have been known to encourage families to take their concerns re staffing directly to management when they have expressed concerns about obscenely high patient to staffing ratios
Yes.
Management seems to think that all patients are blind.
They are not.
I have had multiple patients tell me that my facility is understaffed.
I encourage them to comment honestly on Press Ganey survey.
traumaRUs, MSN, APRN
87 Articles; 21,288 Posts
Having been the bearer of bad news for years now to many patients/family members its all in how you approach it: I always ask what they've been told about the situation or what is your understanding of this situation? What kind of questions do you have?
After I understand what they understand (whether right or wrong), then I steer the conversation to the meat of what I want to discuss.
There is no reason for me to get emotionally involved because in order to do my job, I have to remain an objective observer.