Nursing Misconceptions

Published

What do you think are the biggest misconceptions that the public has regarding nursing and the stressful job we must perform every day?

I am supposed to be doing homework . . . studying Ida Jean Orlando-Pelletier's nursing theory. Her focus was on the patient's needs.

"Patient behavior, nurse reaction, nurse action".

I've been watching video of an interview with her too. Her theory is considered fundamental to nursing practice.

The term "customer service" bothers me too . . but the focus has to be on the patient and as good an outcome as possible.

I also hate the term "client".

:coollook:

Carry on . . .. I'll try to get back to my homework.

steph

Up Vote Up Vote ×

Katherine Kolcaba . . . "Comfort Care". The experience of receiving effective care that meets comfort needs.

Three types of comfort: Relief - the state of a patient who has had a specific need met.

Ease - a state of overall calm and contentment

Transcendence - a state in which a person rises above problems and pain.

Etc. . . . ;)

(steph):clown:

Up Vote Up Vote ×
Katherine Kolcaba . . . "Comfort Care". The experience of receiving effective care that meets comfort needs.

Three types of comfort: Relief - the state of a patient who has had a specific need met.

Ease - a state of overall calm and contentment

Transcendence - a state in which a person rises above problems and pain.

Etc. . . . ;)

(steph):clown:

excuse me?:chuckle

and this has to do with...:confused:

you're out there, steph.:chuckle

i don't know why, but this post cracked me up.

leslie

Up Vote Up Vote ×
excuse me?:chuckle

and this has to do with...:confused:

you're out there, steph.:chuckle

i don't know why, but this post cracked me up.

leslie

it has to do with the ongoing discussion above about people not liking or liking the term:

customer service:d

"i think customer service is the backbone of nursing". . . .

"did you just come out of your hospital's orientation in a fugue state? "clown.gif

the nursing theorists i'm studying today do focus on the patient. caring for the patient. comfort care. focusing on the patient behavior. etc.

Up Vote Up Vote ×
it has to do with the ongoing discussion above about people not liking or liking the term:

customer service:d

"i think customer service is the backbone of nursing". . . .

"did you just come out of your hospital's orientation in a fugue state? "clown.gif

the nursing theorists i'm studying today do focus on the patient. caring for the patient. comfort care. focusing on the patient behavior. etc.

ok....?

actually all nsg theorists focus on the pt, yes?

but thanks for the feedback.

just playin' w/ya.

leslie

Up Vote Up Vote ×
ok....?

actually all nsg theorists focus on the pt, yes?

leslie

Actually . . . no. :D

Kolcaba is about comfort.

Watson is about caring.

Comfort is a patient outcome.

Caring is about how nurses do their work.

steph

Up Vote Up Vote ×

Caring is about how nurses do their work.

steph

...which inevitably affects pt outcomes?

whether direct or indirect, it's still all about the pt...i would think.

anyways, sounds interesting.

thanks.

leslie

Up Vote Up Vote ×
Specializes in Medical.

The problem I've got with the phrase "customer service" is that it goes hand-in-hand (at least in people's minds) with the phrase "the customer's always right." And patients? Not necessarily.

I do smile, introduce myself, generally maintain a pleasant and professioanl demeanor etc. But when we've got a patient who's dropped his GCS from 14 to 3 in ten minutes, he's my priority, even in the tanty man three doors down wants to get out of bed right now. And dude - calling me a liar when I say all the nursing staff are tied up with an emergency down the hall isn't going to get you (HEAVY transfer with two) out of bed any sooner. Aaaand (bring this back to the point of the thread) telling me that I'm here to care for you in no way diminishes the duty of care I owe the actual sick person three doors down.

Up Vote Up Vote ×
I somewhat have to disagree with this. I think customer service is the backbone of nursing. I think its every nurses job to attempt to portray a positive image of themselves professionally as well as the facility they work for. Often times patients have a choice in which hospital they stay, and you should want it to be yours.

Now it goes without saying that sometimes things don't always go as planned, and some patients will always expect too much. But I think we should all strive for the best customer service possible. Its good for you, if gives the patient confidence in you and your hospital, and it does not require much more effort.

I've worked as a tech before. I'm nervous about the responsibilities of my new RN status.

I will continue to believe that customer service is an integral part of nursing. I feel bad that other people do not feel this way. It doesn't take that much more effort to smile, and be polite, and do extra little things. Perhaps its different where I am, as the max patient load is 6 patients, with an average of 3-4. It has always been, and will always be my personal mantra to provide the best care and customer service possible. If you don't agree, well its your opinion I guess. I feel it will make me a better nurse.

The problems nurses have with "CUSTOMER SERVICE" as it is implemented in most institutions are numerous and not without warrant. It has nothing to with nurses not wanting to portray a positive professional image, be polite, smile, or give a little extra. That's not why nurses are complaining about "customer service" or "customer satisfaction." NOT EVEN CLOSE.

Nurses WANT TO be able to provide the best possible care to their patients to ensure the most optimal outcome. The issue is that health care facilities strive for "customer satisfaction" with little to no regard for the health and well-being of the patient. The fact that nurses have to prioritize the care of their patients is completely left out of the equation by administration. Facilities are promising the moon and when nurses fail to deliver THEIR promise the nurses are penalized. When LATTES have more importance than maintaining adequate ventilation, than there's a problem.

Facilities will spend a fortune on flat-screen TVs, gourmet chefs, valet parking, internet service, or satin sheets with a mint on a pillow. However, if they did not claim to have the finances to maintain or obtain necessary equipment and adequate staffing, than there wouldn't a problem.

It's a problem when a patient or their family/visitors are allowed to completely disrupt an entire unit, thus endangering other patients. Other patients get ignored to placate the squeaky wheel, and forget about setting limits on inappropriate behavior, it just doesn't jive with administration's notion of "customer satisfaction."

The bottom line is that nurses want to provide the best possible care for their patients to ensure optimal outcomes and the way hospitals are implementing "customer service" programs are in direct conflict with that goal.

Up Vote Up Vote ×
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

:eek:OMG..that was the patient from H-e-l-l. That was horrible & sickening. How could a person do such thing I have no idea:no:. Kudos to you for maintain patience and staying calm.

Up Vote Up Vote ×

Here is another example of the system setting you up by promising the world, but not providing the resources to deliver. We have one pharmacist that works in the central inpatient pharmacy at night for the whole hospital. ONE! so when I send down orders on my new admit it can take quite awhile for these orders to arrive in the pyxis and computer system for me to sign off. When I am admitting a patient I am supposed to talk about their "rights" some of which are to have their pain treated adequately and their medications delivered in a safe and timely manner. How timely is it when a patient arrived at 11 pm and the medication orders do not show up until 2 am? Now I can override certain things such as certain amounts of dilaudid/morphine or acetaminophen, but not Toradol or oral ibuprofen and other meds or many of the antiemetics (i can override zofran but not anything else). But a patient who wants to get their regularly scheduled medications that they have not taken yet today before they go to sleep could be waiting hours for that to happen, depending on how busy the pharmacy is. Now this isn't my fault but because all the other departments are the "unseen" machinery that makes a hospital run, when they aren't able to get the job done in a timely manner, be it housekeeping, dietary, pharmacy etc..., it reflects on nursing because we are the staff members that coordinate the care of the patient. It's not my fault ,but it reflects negatively on my practice. Not a fun aspect of the job.

Up Vote Up Vote ×
Specializes in NICU, PICU, PCVICU and peds oncology.
Here is another example of the system setting you up by promising the world, but not providing the resources to deliver. We have one pharmacist that works in the central inpatient pharmacy at night for the whole hospital. ONE!

Wow! I'd give anything to have an on-site pharmacist at night. I work in a level four trauma center in the PICU. Our hospital has about 600 beds, six ICUs and a hugely busy ER. But we have NO pharmacist from 2230 to 0730 daily. Most of our transplants are done at night and the pharmacy won't send up the meds until the patient is actully on the unit. Even though they might know about the patient at 4 in the afternoon, the meds won't come up until the patient is out of the OR. Something about wasting the drugs if the patient doesn't make it... but is it really a cost savings if they have to pay the on-call pharmacist $10 an hour to be on call and double time (about $100 an hour) to come in from home - including their travel time to and from the hospital? I don't think so Tim. And really, they don't let people die in the OR all that often here. They'd rather have them come to the unit, even for a short time, and have them die there. So we STILL need the meds!!

Now this isn't my fault but because all the other departments are the "unseen" machinery that makes a hospital run, when they aren't able to get the job done in a timely manner, be it housekeeping, dietary, pharmacy etc..., it reflects on nursing because we are the staff members that coordinate the care of the patient. It's not my fault ,but it reflects negatively on my practice. Not a fun aspect of the job.

You've got THAT so right! How many hats do we have to wear???

Up Vote Up Vote ×
+ Join the Discussion