Please Don't Judge Patients

Its not easy to be a nurse, nor is it easy to be human at that. We make mistakes. We have feelings. We have opinions. And we also have judgements because thats human nature. Nurses Relations Article

Its not easy to be a nurse, nor is it easy to be human at that. We make mistakes. We have feelings. We have opinions. And we also have judgements because thats human nature. But we are nurses. We should strive for excellence in health and it is our job and duty to do. So although after 10 hours on shift we may be tired, irritated, frustrated, and quite possibly stewing over the judgements we have made about this patient or that patient. I believe as nurses we can rise to the challenge of trying not to judge our patients. It is not easy and of course we may catch ourselves doing it, but in the moments we do catch ourselves lets try to just take a step back, breathe, and remember we are all imperfect humans. Plus...it never hurts to try.

Last night was a rough one. As I attempted to lay a patient down for the 15th time I slowly found myself in a state of total irritation. Thinking in my head why does she keep doing this? I swear this only happens to me! Ok, now she is doing it on purpose! And lastly I found myself thinking wth is wrong with you?!? But as slowly as the irritation came on it quickly subsided when i heard her say..."Im sorry i cant sleep, my brain wont."

This stopped me from what i was doing as I was reminded of why i was there. I was there bc she needed help, because she needed to be safe and well. I was there to do a job, not to judge her and wonder almost aloud what was "wrong" with her. I took a moment, we sat down, we watched TV, we talked about why her brain wont work. She smiled and laughed for no reason...so did I. After an hour, guess who was ready for bed? After doing the bedtime routine for the umpteenth time I found myself alone and in silence.

But I also found myself with a new way of thinking and the simple way of thinking can change so much for so many. Because as nurses our job is to provide care to people during what is likely some of the most difficult and trying times of their lives. We also tend to major catalyst in the way someone is cared for. We are all human and during rough times we may not always be at our finest moments or remember how much our small actions and thoughts affect the way we treat others and reflect how we feel towards them. We must remember this about our patients always but we must also remember this when it comes to our fellow nurses and all humans alike.

When you see the man yelling at all the staff down the hall and you think to yourself geez what a grumpy old man. Or when your brain injured client ask you the same question 13 times in 5 minutes, you think omg why do keep asking the same question?!? Or when you never seem to see the parents of that 4 year old peds patient and think to yourself, I would never leave my kid alone in the hospital. Well during these moments remember to stop, take a breath and not judge. Maybe that old man knows he is dying and is having a difficult time coping. Maybe that brain injured client didn't ask to be hit by a drunk driver and spend the rest of her life permanently confused. And maybe that parent you never see is struggling to work full time and provide for the other 3 children still at home.

In times of sadness, illness, life changes, and everything in between let's all stop to remember our patients are only human, just as we all our. Our job is not to judge those whom we don't know, but to heal our patients and provide them with care and comfort during times of distress or need. Sometimes a simple smile or words of encouragement go far beyond what you know. And sometimes when we open our eyes just a little wider we learn to accept the fault of being human and we also allow ourselves to see our patients as they truly are...not as just another patient but as a person.

Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Read the Merriam Webster online dictionary entry for prejudice. You'll see it doesn't just refer to actions.

preconceived judgment or opinion (2) : an adverse opinion or leaning formed without just grounds or before sufficient knowledge

Ok, and?

You can be prejudice & not do anything about it. I'm sure there are lots of nurses who hate a certain race/ethnicity/etc but still take care of the patient fairly. It is not until they do something about the prejudice they have.

The other definition does in fact say action. So again, this is going beyond what the thread was about. You cannot & will not get in trouble for an opinion you have unless there is action. Which for the thousandth time, is *not* what this thread is about.

You have not provided any proof that having an opinion (you keep to yourself) about a patient is wrong. Please reread the original thread for clarification because you seem to be confused about what we are discussing.

Until you can provide me with solid examples of proof that I can lose my job or license due to my thought on a patient, my stance will not change.

I feel like I'm crazy. That is acting out on a judgment. This whole thread is about having an opinion, she never once mentions treating patients different due to said opinion. Can I get in trouble for the opinions I have that I keep to myself & don't act upon? Because clearly that isn't covered in the code of ethics.

While a nurse may believe they are keeping their opinions/prejudices about the patient/their family to themself there's actually a very good chance their behavior is reflecting their prejudices even if they are convinced that isn't the case. Patients and family members are not stupid; they are often very aware. Yes, if we don't check our prejudices patients and family members can discern them through our body language, words, and our responses to them even if we are doing our utmost to hide them from the patient. And patients/family members do pick up on these things. Quite possibly the nurse who rebuffed my request that my family member have something to eat because they hadn't eaten since yesterday and they get hypoglycemic and were looking it, and who didn't assess my family member, believed they were acting appropriately in dealing with a "demanding family member." However, my family member paid the price for their judgement/prejudice.

Specializes in M/S, LTC, Corrections, PDN & drug rehab.
While a nurse may believe they are keeping their opinions/prejudices about the patient/their family to themself there's actually a very good chance their behavior is reflecting their prejudices even if they are convinced that isn't the case. Patients and family members are not stupid; they are often very aware. Yes, if we don't check our prejudices patients and family members can discern them through our body language, words, and our responses to them even if we are doing our utmost to hide them from the patient. And patients/family members do pick up on these things. Quite possibly the nurse who rebuffed my request that my family member have something to eat because they hadn't eaten since yesterday and they get hypoglycemic and were looking it, and who didn't assess my family member, believed they were acting appropriately in dealing with a "demanding family member." However, my family member paid the price for their judgement/prejudice.

Actions vs. thoughts

I'm getting off this merry-go-round because it is clear you cannot discern between a thought & an action. This whole thread was started because of a thought. You keep bringing up points that have no connection to the original thread.

How do you know that said nurse in your story was prejudiced? How do you know *for 100%* fact she judged you/family member wrong? Just because she didn't want your family member to eat doesn't mean she is prejudiced. Maybe the nurse was having a bad day/shift, maybe she just got lectured by her NM or it could be a million other things. You are judging her for one action that you have no proof (of judgment/prejudice) for.

Have my family members or I ever gotten poor care before? Of course. But I don't assume the nurses are judging me. Especially when I have no proof. There could be a multitude of reasons why they are acting the way they are. None of which include prejudgment or prejudice.

You have yet to provide me with concrete example of getting fired/trouble/losing a license due to an opinion in my head. I find it funny that every time I solidly prove you wrong you try to go in a different direction & don't bring up what I said that negates your statement(s).

Are there nurses that treat patients poorly due to a judgment or prejudice? Yes. But this thread is not about that. Maybe you should start that thread.

I feel like everything I'm saying is going in one ear & straight out the other (metaphorically speaking). I'm so dizzy I need to lay down.

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

I thought I'd add this:

  1. Relationships with Patients
  2. 13 Nurses establish relationships of trust and provide nursing services according to need,
  3. 14 setting aside any bias or prejudice. When planning patient, family and population centered
  4. 15 care, factors such as lifestyle, culture, value system, religious or spiritual beliefs, social
  5. 16 support system and primary language shall be considered. Such considerations must
  6. 17 promote health, address problems and respect patient decisions. This respect for patient
  7. 18 decisions does not require that the nurse agree with or support all patient choices.

Setting aside. Which means the ANA knows nurses aren't perfect & will judge others but to leave it at the door. Don't follow through on your bias/judgment. For the trillionth time, following through on bias/prejudice/judgment is not what this thread is about. You can have said judgments but don't do anything that could harm the patient due to said bias/judgment. Once you cross that line, obviously there are ramifications. But not for having judgments in your head. You could probably sue if you were fired for something like that (having thoughts in your head you don't act out on).

Unless you can prove to me where the code of ethics say opinions kept to yourself can get you in trouble, in black & white, I will no longer continue this conversation. Because what you are discussing has no grounds in this thread, as it is about thoughts/opinions/judgments/prejudices we keep in our heads.

Have fun on the merry-go-round by yourself!

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I'm sure we'd all like to believe that is true.

We got it. Your nurse was mean to you. Now, back to our regularly scheduled discussion about being/not being judgmental.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I just said in my post above that "No-one is condoning abuse, but the majority of patient/family behavior is not abusive." Are you going to state that this is not the case, and that the majority of patient/family members are verbally abusive? And no, you are not forced to work when you are ill; you are voluntarily employed. And the reason you get paid is because of the sick patients who bring in income to your facility. You are not providing charity care for which you receive no payment in return.

It depends, in large part, on where you work. Work is a small community hospital where everyone knows everyone else and their ancestors and descendants, possibly the majority of patient and family behavior is not abusive. In large, urban hospitals quite possibly more than 50% of patient and family interactions ARE abusive. Verbally and often physically as well.

I'm not sure where you're going with this attitude that it is OK for patients and family members to be abusive to nurses but nurses are never supposed to judge anyone. Perhaps you're still playing that rousing round of "my nurse was mean to me."

Specializes in ER.
It's a sad thing for your patients if the Code of Ethics doesn't mean anything to you.

Why, Bless your heart dear. I'll pray for you.

Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Why, Bless your heart dear. I'll pray for you.

:roflmao: LOL! I imagine this being said in an old grandmotherly, southern accent.

Specializes in Psychiatry, Community, Nurse Manager, hospice.
You have your opinion, we have ours. No one is perfect & even though we are nurses, we are not angels. To expect nurses to stop judging patients is just plain crazy. I have worked corrections & LTC, I know how dangerous & hectic working conditions can be. You can't expect people to have the same opinion as you.

I was simply confused by you previous post as it wasn't clear to me. I never questioned your creditials, just wanted a better understanding.

You also can't expect people to have the same opinion as you.

That's what you're doing when you say that to expect nurses not to judge patients is just plain crazy.

I disagree strongly with that. I expect nurses not to judge patients. And I'm not crazy, and the idea is not at all crazy.

Not judging does not mean not having feelings. It's the difference between saying, "I'm angry at my patient right now." And "My patient is a total jerk who doesn't deserve care." The former is being human and is acceptable. The latter is unacceptable.

It's not about being an angel. Angels don't make mistakes. Nurses are people and are going to make mistakes. The point here, is whether or not passing moral judgment on a patient is professional behavior for a nurse and I think it isn't.

Maybe you think it is. Obviously, some people do.

Specializes in Travel, Home Health, Med-Surg.

Let's face it, even nurses are human beings that will have negative thoughts and do things that we shouldn't. That being said, I do not think that nurses should act on those negative thoughts is a spiteful way towards patients and I don't think that most nurses do. There is a big difference between judging someone personally and having to make judgement calls. Nurses have to make judgement calls everyday, its part of our job. In a busy hospital, nurses decide who gets the care either first, or at all, based on priority of acuity/need. If you have 2 patients with the same need you make a call who to see, and patients/families attitude will play into your decision (are they noncompliant etc), is this being judgmental? Only if you are judging them personally, and I believe that most nurses do not. I think they (nurses) are making a educated judgement where to spend their time, which is what we are supposed to do.

Specializes in M/S, LTC, Corrections, PDN & drug rehab.
You also can't expect people to have the same opinion as you.

That's what you're doing when you say that to expect nurses not to judge patients is just plain crazy.

I disagree strongly with that. I expect nurses not to judge patients. And I'm not crazy, and the idea is not at all crazy.

Not judging does not mean not having feelings. It's the difference between saying, "I'm angry at my patient right now." And "My patient is a total jerk who doesn't deserve care." The former is being human and is acceptable. The latter is unacceptable.

It's not about being an angel. Angels don't make mistakes. Nurses are people and are going to make mistakes. The point here, is whether or not passing moral judgment on a patient is professional behavior for a nurse and I think it isn't.

Maybe you think it is. Obviously, some people do.

Like I stated before & posted a link to, people pass judgment on others on a subconscious level. The deciding factor is whether someone acts on those thoughts. Because judgment happens on a subconscious level it is impossible to tell people to stop something they are doing subconsciously. However, acting on those thoughts can be prevented & should be. But that is for a different thread as this one is only about the thought process.

How do you know a coworker is passing judgment if they don't do or say anything? People pass judgment all the time without telling anyone. Have I judged a patient before? Yes. But I don't let it affect the care I give them. No one would've known how I felt about that patient because I don't act on my judgments. But like I said forming opinions about a patient is completely different (& a different thread entirely) than acting on those opinions.

Specializes in Psychiatry, Community, Nurse Manager, hospice.
I've long thought this whole no judging thing, popularized in the 70s and 80s by quoting the famous Bible passage by Jesus (totally out of context BTW), has contributed to the moral decay that we have today. God forbid a decent person have an opinion and they are condemned and vilified. Good people are supposed to accept with open arms all manner of sin, lawlessness, recklessness, and general abuse of individuals and society as a whole.

There's an excuse and a mental health diagnoses for any and all wrongdoings. Citizens and taxpayers need to keep their mouths shut, 'cause 3 fingers will be pointing back at them for being so judgmental.

I would not argue that moral judgment is never appropriate.

There's a place for moral judgment. When you are making moral decisions, moral judgment is paramount.

If you are a juror, a teacher, a parent, there are always sitiations in which it is appropriate to use moral judgment.

But in the nursing care of a patient, moral judgment is never appropriate.