Nursing Misconceptions

nelcoy4 · May 28, 2008

i know this is from a old thread, but i wish i could print this and show some of my patients

i don't think the public has an understanding of what the scope of practice is regarding nurses. definately most have serious misunderstandings about nurses.
for instance:
1. med administration. alot of people think it is just providing the medication. it is soooo much more than that. assessment and evaluation of the effectiveness of medication. knowing the correct dosages and questioning orders when appropriate, neither doctors or nurses are infalible. also the reason the nurse took a few minutes to provide your medication is because of the 5 rights of medications administration and triple checks she was taught in order to ensure your safety.
2. that we only do what the doctor tells us to do, without question. or we are subservient to the doctor. not true, as patient advocates we have a responsibilty to ensure the safety and well-being and that can include questioning a doctors order. there are so many independent fuctions a nurse does. the nurses plan of care is implemented based on what the physicians orders are and the patient's diagnosis. we also need to evaluate and assess the effectiveness of any care we provide. we are the ones who alert the doctors when the patient's condition changes. we are accountable for every action we perform as a nurse. funny how often we will be blamed when the crap hits the fan.
3. anyone can be a nurse. unfortunately there are issues with others who are not qualified either as an lpn or rn out there that are being referred to or referring to themselves as nurses. sorry, but if you don't meet the educational and licensing requirements, you cannot be a nurse. patient's do not understand the different roles involved in providing their care and how each role varies, cna, lpn, rn, rt,etc. nor do they understand that not all who are providing their care are not nurses.
4. they do not understand that the nurse has to prioritize her care in regards to patients. they are usually not aware of how many patients a nurse may be responsible for. we do not sit at the desk with our feet up drinking coffee while we decide to see to your needs at our convenience. the priority the nurse has to address first may not be yours!!
5. everything is the nurses' job. some aren't aware that the cna can empty their urinal or assist them to the br. if the room is not cleaned, that it is actually a houskeeping issue. if the phone, tv, a/c, heat, etc are not working it is an engineering issue. if breakfast is not to your liking it is a dietary issue. frankly i wish the extensions for these different departments was listed in the room. having to deal with things that are not the nurse's job adds to the stress. we are the first to hear any and every patient complaint.
6. nursing isn't stressful. there are alot of people who don't believe it is that stressful of a job. media plays a big part in this one. notice how not busy the nurses are on soaps/prime time tv. people are under the impression that we have sooo much time on our hands.
7.they also don't realize that nurses are often not accorded the same rights as other employees are entitiled to according to labour laws. this is perpetuated by administrators. many nurses are working 8-12hr shifts without any breaks. how many times have nurses left late for their shift, they're not even entitled to leave on time and usually are not even paid ot for leaving late or not having breaks/lunches.
8. patients don't understand the policies & procedures or legal framework we have to work under. hippa, jcaho, sbons, health practice acts, standards of practice, etc all have a say in how we do our job. for instance, in compliance with hippa we are now suppose to blacken out any name/label on ivfs or ivpbs we discard after use. as i said to my manager, "what don't you want me to do in order to this?" i wasn't kidding.
9. customer service. this is a biggie. few threads here on this issue alone. management that won't back up their staff when they are dealing with an unreasonable person. this also impedes the nurse from prioritizing care. press-ganey, another form of harassment as far as i'm concerned.
10. tolerating abuse is part of the job. verbal, physical, sexual, etc what ever type of abuse, most of us have been subjected to one form or another. for some reason, people think we should have to tolerate this despite the fact that in other professions it would not be put up with. also in many instances there is lack of support from management when abuse occurs. often the nurse is made to feel at fault, blame the victim.
i wish more education was provided to the public about the realities of the nursing profession.

loriangel14, RN · May 28, 2008

I have been sitting at my computer charting and had pts visitors ask me if I was winning or if I was playing solitaire.

RNperdiem, RN · May 28, 2008

A lot of people do not realize how little they will see their doctor in hospital. Once rounds are over and the docs have made their plans for the patients, written their orders, they are in surgery or doing procedures. The nurse is who you will deal with most of the day.

The nurse does not know when the docs will be here.

The nurse probably does not know the results of your MRI, CT or XRay unless the doctor has chosen to inform her. This rarely happens.

SoundofMusic · May 28, 2008

Not to sound ageist, but I find a lot of these attitudes from the older pt. crowd. I guess they get their misconceptions from the "old days" of nursing when things used to be a certain way. I don't think some of them realize how hard you study, how hard it is to get into school, that we're not just a servant class.

Many of them will still call your their "girl" or something -- comment on how pretty of a nurse they have for the night or something -- as if that is all important vs. coordinating and making sure they receive the care they're supposed to - drives me nuts.

qt2168 · May 28, 2008

Or how all you do as a nurse is clean bed pans! UGH. Thats right 2 years of school and thats all they could teach me.

NursKris82 · Jun 19, 2008

They think we are miracle workers or a "hospital in a box". I was at church and two girls on the dance team bumped heads. One of the girl was sitting in the chair, barely able to keep her eyes open or talk. They came to get me because I was a nurse. The leader points to her and says "assess her! Do your nursing thing!" (exclamation mark for worried tone, not rude) Well... there isn't much to assess. She can't open her eyes and is barely able to talk. Survey says... CALL 911 and don't let her fall asleep (that I did know). I see why they called me, but I just wondered what they expected me to do. Gotta love the uninformed lay person!!

quincy24 · Jun 19, 2008

people think that we have great hours and work when we feel like it. its different than the business world but we do all shifts but switching from day to night and working weekends and holidays is no picnic.

Morettia2, BSN, RN · Jun 22, 2008

what got to me lasy night...errrrr....was a non-compliant pt. who was literally driving me crazy. Around 6am the pt. was screaming "get me my MYLANTA" like a 5 y.o. child not getting a popsicle. I was trying to explain that I called the house MD and the tele resident a fwe times and I have not had call back from either MD. The pt. says, "How come it takes you, bad word, forever go get my MYLANTA, when I can go to the store down the street and buy it myself?" I said, "Mrs.XYZ, every medication I give you, that I don't have in your chart, I need a doctor's order for, and I know MYLANTA is something you can buy at your local pharmacy, but in the hospital I need the doctor to approve the order."

The pt. looked at me, screamed something in jibirish, and proceeded to take off the Nasal Cannulea and blew a snot rocket right on my glasses. and said ,"get my MYYLLLAANNNTTAAA!!!" OH GROSS..I almost vomited

But what gets me is that pt's don't seem to understand that when they are in the hosp. any OTC drug we have to have an order for. My name says RN not MD after it, and since I am your night shift nurse I have to jump through hoops to get you said OTC med. And I will do it just give me 5 min. to find out if you are susposed to be getting said med. or if there is a reason why you are not getting said med.

Needless to say the pt. was sucking down so much mylanta at home that the MG++ was elevated that's why the MD's were laying off the mylanta, the pt. did not want to understand that drinking a bottle of Mylanta a day can affect their heart.

By the way pt. has NO hx of GRED or anyother stomach related problems, just drank Mylanta b/c her daughter would buy it for her and tell her to take it, the daughter is not a nurse or a doctor.

The pt. then went on to do this right in front of me and the nursing assistant, "Well since I am not getting my MYLANTA, I am going to drink gingerale." I asked if the pt. has heart burn or a upset stomach. Pt. said NO just wanted the daily chug of Mylanta she takes at home. I said, "hold off on the gingerale, I will get you some water."

I stepped out of the room for approx. 2 min. To get some fresh water.

Meanwhile, the pt. proceeded to CHUG 2 cans of ginger ale and literally stuff 1 pack of graham crackers in her mouth. As soon as I saw her I said, "Mrs.XYZ, why are you drinking the gingerale so quickly? Are you thirsty, would you like some water insted b/c drinking the gingerale so fast is going to give you gas and possibly make you vomit along with the pack of grams you just ate so quickly."

I didn;t even get the vomit part of my sentence out when the pt. projectile vomited all over me and the Nursing assistant. OH GROSS, not only did I have snotrockets blown on my face but the pt. used ME as an emesis basin thank god i put a blue plastic gown on before entering the room call it a sixth sense. I almost lost it!!!!

Like a 5 y.o. who chugs soda too quick, and vomits b/c of all the carbonation..yea..but I was dealing with a 50 y.o. insted. I didn;t even know where the pt. had gotten the gingerale, I saw that she was stock piling it in her bedside table. I also found out that the pt. had done the same thing to the day shift nurse so the pt. could get mylanta after vomiting.

I called the primary at 6:30am, the MD was not too happy but I had just been abused by a pt.'s bodily functions. I explained what happened. The MD said, "the pt. has a hx of doing said actions."

All I wanted to say was PSYCH CONSULT? but I bit my tongue the MD further explained that a few weeks ago in her office the pt. didn;t feel like getting up from her chair in the waiting room to use the bathroom and urinated all over the place. Pt. is ambulatory. The MD apologized to me and said just give a one time only dose of MYLANTA.

So I go into the pt's room, I almost vomited b/c the pt. was driving me nuts and had me runnning all night, I confiscated all the gingerale from the room which was 15 cans where the heck did it all come from????, now the pt. was chugging water insted of gingerale. And SCREAMING about nothing.

I just smiled, said "I have your MYLANTA" the pt. automatically shutup. I gave her the Mylanta.

At shift change about 45 min. later at 7:00am, I am endorsing the pt. to the day shift nurse when we hear, "NEW NURSE I WANT MY MYYYLLLAAAANNNTTTAAAA" I literallly rolled my eyes, get through report and said, "I woke the primary MD up about 30. min ago at 6:30AM about this situation. YOU HAVE to keep your eye on the pt. b/c the pt. will CHUG liquid untill she vomits, if she dosen;t get her way" Can you say aspiration pneumonia?

Needless to say I think that the pt. will end up with a pt. watch for the rest of the day. And since she has no HX of GRED or GI problems, she willl have some soon if she keeps up this nonsense or she will just end up with a NGT per MD's orders which if she pulls it out then she will really end up with a pt. watch..

This is what people don't think about, the Nurse is there for you, but don't abuse your nurse. Don't make the nurses play off eachother.

We read why you are not getting Meds for a reason and ACTUALLY UNDERSTAND WHY YOU ARE NOT GETTING THE MEDS. And when we tell you who you are not susposed to have the medication don't scream at us and blow snotrockets and chug gingerale to make yourself vomit on us. That will just get you a psych consult, a 1:1 pt. watch and a possible NGT. and a possible order to be NPO Then you won't have anything thing to eat or drink with a god awful tube shoved up your nose that we have to crush your meds and give through that godawful tube and then you might really have heartburn b/c those meds have been crushed.

I swear this pt. had Munchausen's in a way.

I am not a cold hearted nurse AT ALL, in fact I am the sweetest nurse in the world, but when you abuse me with your bodily functions, I am not a sweet nurse. How can I be when you make your self vomit on purpose and snort snot on me. I realize you are sick but doing such actions will not get things done faster.

It was a long night and yes, I did throw out my uniform when I walked in the door this morning and took a hour long shower. Let's just hope I don;t get sick from all this garbage.

Thanks for listening

Imafloat, BSN, RN · Jun 23, 2008

I run into a lot of people who think that because I am a nurse I can write my ticket to work anywhere I want, any hours I want and that I am rich off of nursing. I am always like HEELLLOOO, there is a nursing shortage for a reason, the hours suck, the pay is ok, but not for the amount of responsibility.

Medic2RN, BSN, RN, EMT-P · Jun 23, 2008

I had an elderly male patient tell me: "You're a very smart girl! Do you want me to write you a letter of recommendation so you can be promoted to doctor?"

Huh. I thought becoming a doctor was more difficult than that.

I've come across many people believing that if you didn't cut it at med school, then you would change to nursing.

gt4everpn, BSN, RN · Jun 23, 2008

i work midnights to. i used to have a neighbour who would constantly ask me how much sleep i got on my shift, and then wouldn't believe me when i told him that i didn't sleep at work. he was a retired factory worker and apparently when he worked, they used to relieve each other for "naps." i'm sure he also got his breaks and left on time to. he was also a brain-pickled idiot to boot anyway.

believe me i've got friends and family who don't understand that as nurses we can't always leave right when our shift is offically over. sorry mr. jones, but would mind not hemorraging until after i leave. :uhoh3:

they also don't understand how we can be denied ot when we leave late. alot of facilities have a policy that we are to inform them an hour ahead of time if we are going to be ot. mrs. smith it's really inconsiderate of you to stop breathing 5 minutes before my shift ends. :uhoh3:

they also don't understand why we don't get breaks or lunches. we are not provided relief to start with. if our patient's need our attention they get it, irregardless of what time it is. if our co-worker is overwhelmed, not only can they not relieve us, we usually wind up helping them (that's a good thing). sorry mr. jones, i'm going to lunch so we're just going to wait to start those chest compression on you. :uhoh3:

as allainina ponted out, people don't understand the legal responsiblity we have. i've had patients who don't understand that what they are given for pain and how often they are given it is not up to my discretion. also that we need orders to even give otcs such as maalox. i had one patient who couldn't understand why i had a problem with her having her own vicodan at the bedside. she was screaming, "you ****** ******* (4 give me back my stuff!!!" sorry honey, but i'm not in the mood to code an od tonight and i'm also not in the mood to knowingly jeopardize my license by allowing you access to a narcotic at your bedside so you can "top up" the narcotics that i'm already providing you and that you are demanding exactly when they are due. :uhoh3:

also people aren't aware of all the laws that govern our practice that we have to follow.

oh believe me they get to knowing those laws real quick when they wanna sue!!:angryfire:angryfire:angryfire

gt4everpn, BSN, RN · Jun 23, 2008

i'm not knocking any other truly believe people that work such jobs as in offices really dont know what work is, sitting at a computer typing all day long or answering phones pales in comparison to not being able to pee for 4 hours or being on your feet for 3 hours!! straight banging out meds!! (ltc) i dont know any other profession where people (patients/pt families) get away with abusing staff!! i work in ltc and i'm fairly young so people think i'm a cna and they also think i wipe butt. discovery health had a show entitled ''nurses" chronicalling what nurses go through day to day! but they dont show it anymore! they show alot of what doc go through though (whatever!) i'm tired of people thinking nursing is a female proff if anyone lay person did nursing for a day theyd see how agressive and demanding it is, absolutely nothing feminine about it! i had a friend who didnt even know what an rn was let alone an lpn! i had to explain everything to her! im just tired of ignorant people! i'm an lpn and people tend to think we're not real nurses! no offense to my fellow lpns but thats a minor part of why i'm going for my rn! lpns just arent respected even by their own manangers sometimes! it kills me how the manangers where i work get so much praise, while us poor lpns sweat it out all shift long working so hard watching them kick back! lets not forget its not only lay people who dont respect nurses, its management as well, even some nurse manangers!!!