Nursing Judgement Does Not Equate: A Nurse's Judgement

jadelpn, LPN, EMT-B

Nurses are human. We all have our own thoughts on our patients, each other, our units, our systems. Some can be positive, enlightening, and even help us to build a better practice. Others, become character contests that in my opinion have no part in nursing practice.

I am not for a moment suggesting that a nurse ever be unethical in the care they provide. Never cross the boundaries of practice that would ever put your license in danger, your life in danger, knowingly or unknowingly do stuff that you know is unlawful.

But what is worth exploring is the thought of practicing good nursing as opposed to practicing moral judgements.

The big elephant in the room is abortions. And you may come across this in your practice. There are lots of ways now that a woman can obtain an abortion, and not all of them come with no risk of complications. I would ask you to remember that no one lives anyone's else's life. We do not know from whence someone came, what circumstances brought them to us, only that there were complications, the patient is here, and is going through both physical and emotional stress. It is not a nurse's place to be judge, jury and moral police. It is the nurse's duty to care for the patient as you would any other. To do less would be just wrong. On a number of levels. Never let a patient feel worse about themselves then perhaps they do. It is a dis-service.

Another frequent topic is patient's with issues regarding weight, habits, and other things that patients do that makes them unwell. Again, the running theme of we, as nurses, have not a clue in the world what drives someone to overeat, smoke, not eat, partake in drugs and alcohol. We can only take the information presented to us, educate in a way as to not scold, devastate, or character assassinate, but present options. It is up to the patient whether they are ready to make the changes. It is not up to us.

Ah, and the "drug seekers" which quite frankly is just such a degrading term. Unmanaged chronic pain (and I would dare say physical or emotional) is just a never ending cycle. However, with that being said, it must be horrible to be in unrelentless pain 24 hours a day, 7 days a week. To have health care professionals, who are bound to ask if you are in pain or to rate your pain and treat your pain to roll eyes, whisper about "seeking" or other comments no matter how thinly veiled is just not good practice to say the least.

And patients whose lifestyles are an alternate to your own. People have the right to love who they would like to, in some areas marry who they would like to, be who they would like to be. Always be mindful to the fact that respect given is respect earned. You may not personally agree with same sex partners, transgender men or women, however, they are patients. With needs that have to be addressed. So quoting the Bible, showing distaste, and/or (as at least one thread for discussion on here suggests) giving less than stellar care based on someone's core being is not correct.

No one can be 100% open to 100% of patients. However, to check your judgement at the door on your way in can perhaps open your eyes to human suffering in a way that you have never seen before. And that is the bottom line. Human suffering. In the end it matters not how someone got to you, but they are there. And each patient deserves a nurse that is using good nursing judgement, not judgemental nursing.

solneeshka, BSN, RN · May 8, 2013

I wish I had the luxury of time to be so judgmental. Really, all I can deal with is the multitude of tasks I have to take care of for the patient and the hundred other things I have to do at the same time. Not long after the bombings in Boston, I read an article about the health care providers who treated the victims, and one nurse said something about how she didn't think she could have cared for the bomber who was caught. I remember my very distinct reaction was, "It wouldn't even enter my mind." I'd be like, finish giving me report already, I got $@&! to do! To a very small degree, I can back this up as I work for a large urban facility and have perpetrators of crime as patients with enough regularity to know that I just don't have the room in my brain to get moral in regard to my patients. A patient is a patient; if they need their BP Meds, an Accucheck, a dressing change, and are complaining of pain with an active pain med order, then they are going to get their BP Meds, Accucheck, dressing change, and dilaudid, whether or not they raped someone last night, because I have got $@$! to do for sweet old granny next door, and I can't take care of Granny without taking care of Con. And I'm not necessarily taking care of Granny before I take care of Con, because I do not necessarily have that luxury. If it will get my $@$! done faster or more efficiently, then okay, but if taking care of Con first accomplishes that, then I take care of Con first. All of the nursing care that needs to get done already fills my brain. If it didn't, then I might be judgmental, I don't know. It's a non-issue. Too much $@&! to do to think about it.

BSNbeauty, BSN, RN · May 8, 2013

Well said OP. I 100 percent agree. There are many things I don't agree with but who am I to judge. My job, my call is to provide the best quality care and to be compassionate.

NurseDirtyBird · May 8, 2013

My hubby (a cop) told me a story about a car chase with a DUI/hit and run suspect who was also suspected of vehicular homicide. Both the cop and the suspect crashed with injuries. Both were taken to the ER. Of course the uniform was off in the hospital, all the nurses knew was this guy was there because of a DUI MVA that killed somebody. The treated the cop like crap. They delayed answering call bells, delayed pain meds, made snide remarks within his hearing...until a whole bunch of uniforms showed up to visit him and see how he was doing. As soon as the nurses figured out who he was, he got the royal treatment.

I was appalled at this. Nurses have a responsibility to give equal treatment to EVERY patient, no matter what they think of them. You don't give substandard care because someone may have done something awful, and you don't treat them like kings because they did something good. I've cared for leaders of charitable organizations, and I've cared for child molesters. All received the same treatment to the best of my ability.

You cannot expect zero bias, as nurses are human after all, but you were correct in saying we need to do our best to check our judgment at the door. Thank you for sharing this.

RNSavingHearts · May 9, 2013

Could not agree more!! (P.S. I loved solneeshka's response! TOTALLY can relate!!)

Susie2310 · May 9, 2013

Thank you for a very important article. I strongly agree.

lovingtheunloved, ASN, RN · May 10, 2013

Amen. Every human being deserves compassion and competant care, simply because they're human.

Everline · May 10, 2013

Love this and agree!

she244 · May 10, 2013

Working in an ER is hard due to the fact that your have to take care of the child and the child molester sometimes at the same time. We had a 5 month old baby who was drugged and died due to aspiration due the caregiver propping a bottle up and leaving the child unatteneded. The caregiver delayed calling EMS when she found the child unresponsive. Later that day the child giver came in with chest pain. That was a very hard time for all of us, but the nurse who was assigned to the lady did a great job, although reserved while assessing her and doing the protocol for chest pain, we all with held our temper and comments until later and met to discuss what happened and how to and how not to respond in that situation. Nursing is hard at time because we are human. But I love Nursing and am glad even on my worse days that I am a nurse able to help people.

amygarside · May 13, 2013

nice article. thanks for the post..

macawake, MSN · May 13, 2013

Just wanted to say, this is a great article! :up:

LadyFree28, BSN, LPN, RN · May 13, 2013

Spot ON!

Nursing Judgement Does Not Equate: A Nurse's Judgement

About jadelpn, LPN, EMT-B

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