Please Don't Judge Patients

[NurseLife88]

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.

[FolksBtrippin, BSN, RN]

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.

We have a fundamentally different way of conceptualizing thought and emotion. I see this differently than you do, but we are on the same topic. When I claim we should not form moral judgments about our patients I am also talking about the thought process.

If what you are saying is true, and moral opinions about people are subconscious, then you can't control them and it is not fair to expect nurses not to judge. So I see where you are coming from.

My understanding of moral judgment is that it is not subconscious, but that it is a choice. I have a choice about considering whether a person is polite or rude, mean or nice, worthy or unworthy. It is sometimes important to make a judgment like this, and sometimes not important. Sometimes it is important NOT to do so and nursing care of a patient falls under that category.

I do think I have subconscious experiences, but I equate them to emotion and I do not necessarily let them form into judgments. I often do not feel anything negative when caring for difficult people, because I have put myself into a little bubble of not taking anything personally. But sometimes, especially when I meet with something unfamiliar, I get frustrated, overwhelmed or angry at a patient. The subconscious part has happened and then the feeling hits me and right then and there I decide to process the feeling without deciding anything about my patient. I decide that the feeling is there to tell me something about me. It's telling me that I don't yet know how to handle this particular experience yet. That I have something to learn or some way to grow. Then I process it, and move on without deciding anything about my patient.

I believe in always deciding not to judge patients. But there are times when I think it is important to judge. For example, if I am deciding whether or not I want a person as a friend, it is appropriate for me to judge. Let's say I am in a coffee shop with this person and she tells me something someone else told her in confidence. I will judge her as a person who does not keep confidences. Let's say she says something disparaging about a particular race of people. I will judge her as a racist and I don't choose racists for my friends. I will let the negative feelings I have about her develop in a way that puts her at a distance from me emotionally and socially. This is fair because racists and gossipers do not deserve my friendship. They still deserve nursing care.

I hope this doesn't come off as superior. I think it is certainly enough to treat everyone the same way no matter how you feel about them. But I think that it is easier to treat everyone the same if you don't harbor negative feelings about them in the first place. And if you can control that, then I think it is a good idea to do so, but if you can't, then it makes sense that it would seem obnoxious when people are telling you not to judge.

[kbrn2002, ADN, RN]

Are you actually working as a nurse? I see that you just recently passed boards and this does not sound like a nurse experience ...especially the part about sitting down to watch TV with the patient.

This is kind of what I was thinking. I would love to know where OP works that sitting with a patient for an hour is an option, and more important how can I get a job there?

[OrganizedChaos, LVN]

We have a fundamentally different way of conceptualizing thought and emotion. I see this differently than you do, but we are on the same topic. When I claim we should not form moral judgments about our patients I am also talking about the thought process.

If what you are saying is true, and moral opinions about people are subconscious, then you can't control them and it is not fair to expect nurses not to judge. So I see where you are coming from.

My understanding of moral judgment is that it is not subconscious, but that it is a choice. I have a choice about considering whether a person is polite or rude, mean or nice, worthy or unworthy. It is sometimes important to make a judgment like this, and sometimes not important. Sometimes it is important NOT to do so and nursing care of a patient falls under that category.

I do think I have subconscious experiences, but I equate them to emotion and I do not necessarily let them form into judgments. I often do not feel anything negative when caring for difficult people, because I have put myself into a little bubble of not taking anything personally. But sometimes, especially when I meet with something unfamiliar, I get frustrated, overwhelmed or angry at a patient. The subconscious part has happened and then the feeling hits me and right then and there I decide to process the feeling without deciding anything about my patient. I decide that the feeling is there to tell me something about me. It's telling me that I don't yet know how to handle this particular experience yet. That I have something to learn or some way to grow. Then I process it, and move on without deciding anything about my patient.

I believe in always deciding not to judge patients. But there are times when I think it is important to judge. For example, if I am deciding whether or not I want a person as a friend, it is appropriate for me to judge. Let's say I am in a coffee shop with this person and she tells me something someone else told her in confidence. I will judge her as a person who does not keep confidences. Let's say she says something disparaging about a particular race of people. I will judge her as a racist and I don't choose racists for my friends. I will let the negative feelings I have about her develop in a way that puts her at a distance from me emotionally and socially. This is fair because racists and gossipers do not deserve my friendship. They still deserve nursing care.

I hope this doesn't come off as superior. I think it is certainly enough to treat everyone the same way no matter how you feel about them. But I think that it is easier to treat everyone the same if you don't harbor negative feelings about them in the first place. And if you can control that, then I think it is a good idea to do so, but if you can't, then it makes sense that it would seem obnoxious when people are telling you not to judge.

I'm putting this link here for now & when my gallbladder isn't flaring up I'll come back & leave more of a comment. Let me know if the link works.

Bad Request

[calivianya, BSN, RN]

I really only judge people by how they treat me, but I don't act on it. I find I can't help but take insults against me personally, and I will definitely think unfavorably about the patient after I'm insulted. It's probably a good thing I work in an area where most of my patients are unconscious.

I really don't care that that one's here for shooting up heroin, for example, and that she doesn't have custody of her four kids because she lost custody when she neglected them in favor of doing things to obtain her heroin. Some of my coworkers will be upset about that - mostly the ones that have children of their own and see her as very selfish. I personally don't really care if she's selfish or not. All I care about is her attitude towards me. Be nice to me, and I will go above and beyond for you. Be rude to me - and I will still do my job, but I will be entirely professional and clinical and just do my particular job and nothing else.

Same thing with the diabetic example - I don't mind getting a diabetic ten cups of ice cream as long as he's polite. Is he killing himself? Sure. Is that my personal problem? Nope, that doesn't affect me at all. However, once he loses his temper at me, that's a whole different ball game, and that's when the judgement starts for me.

Everyone at least gets good nursing care from me. I will do what I'm supposed to regardless of how I feel, but you really have to attack me personally for me to start judging you.

[smartnurse1982]

This is kind of what I was thinking. I would love to know where OP works that sitting with a patient for an hour is an option, and more important how can I get a job there?

Private Duty Nursing.

I do have to tell you though that the type of shows we watch probably won't interest you,unless you can watch hours of Blue's Clue's and Fairy Oddparents.

[Apple-Core, ASN, BSN, RN]

I also judge when I see the COPD patient with cardiac issues and an oxygen tank insisting on smoking or eating that box of donuts yet making another trip to the hospital. Yet they complain how "illegals" and poor people keep using their taxes for food stamps. ��

This reminds me of someone I used to know who had chronic COPD, was in a wheelchair, wore a mask and wheeled an O2 tank around with him 24/7, and yet he continued to smoke BEHIND THE MASK. Yep - the whole mask would be full of smoke, which he would occasionally tilt to release a huge cloud of fumes, then resume smoking. How he didn't blow himself up or something, I will never know...

[OrganizedChaos, LVN]

We have a fundamentally different way of conceptualizing thought and emotion. I see this differently than you do, but we are on the same topic. When I claim we should not form moral judgments about our patients I am also talking about the thought process.

If what you are saying is true, and moral opinions about people are subconscious, then you can't control them and it is not fair to expect nurses not to judge. So I see where you are coming from.

My understanding of moral judgment is that it is not subconscious, but that it is a choice. I have a choice about considering whether a person is polite or rude, mean or nice, worthy or unworthy. It is sometimes important to make a judgment like this, and sometimes not important. Sometimes it is important NOT to do so and nursing care of a patient falls under that category.

I do think I have subconscious experiences, but I equate them to emotion and I do not necessarily let them form into judgments. I often do not feel anything negative when caring for difficult people, because I have put myself into a little bubble of not taking anything personally. But sometimes, especially when I meet with something unfamiliar, I get frustrated, overwhelmed or angry at a patient. The subconscious part has happened and then the feeling hits me and right then and there I decide to process the feeling without deciding anything about my patient. I decide that the feeling is there to tell me something about me. It's telling me that I don't yet know how to handle this particular experience yet. That I have something to learn or some way to grow. Then I process it, and move on without deciding anything about my patient.

I believe in always deciding not to judge patients. But there are times when I think it is important to judge. For example, if I am deciding whether or not I want a person as a friend, it is appropriate for me to judge. Let's say I am in a coffee shop with this person and she tells me something someone else told her in confidence. I will judge her as a person who does not keep confidences. Let's say she says something disparaging about a particular race of people. I will judge her as a racist and I don't choose racists for my friends. I will let the negative feelings I have about her develop in a way that puts her at a distance from me emotionally and socially. This is fair because racists and gossipers do not deserve my friendship. They still deserve nursing care.

I hope this doesn't come off as superior. I think it is certainly enough to treat everyone the same way no matter how you feel about them. But I think that it is easier to treat everyone the same if you don't harbor negative feelings about them in the first place. And if you can control that, then I think it is a good idea to do so, but if you can't, then it makes sense that it would seem obnoxious when people are telling you not to judge.

Ok, I think I'm feeling better for the moment. At least enough to respond.

I believe we make judgments we don't realize as soon as we see someone, patient or not. Even before they speak, we judge them without even being aware of it. If you're talking to a patient or we find out something about the patient that we don't agree with, then that is conscious. But that first impression can make or break how we feel about someone. If you first meet the patient & think they look like a hooligan then your mind will pick out things the patient does to prove your first judgment correct & vice versa. That first judgment we make is hard not to do because that is what we do unconsciously. As far as any judgment or acts after that, that is all conscious thought.

[Ruby Vee, BSN]

Private Duty Nursing.

I do have to tell you though that the type of shows we watch probably won't interest you,unless you can watch hours of Blue's Clue's and Fairy Oddparents.

When I did inpatient dialysis, we'd sit by the patient's bedside for the length of the run, and watch whatever TV he wanted to watch. I had no IDEA there were so many cop shows on cable! Or so many different shows like "Judge Judy." The guy was a former state trooper, very right wing and would shout at the TV . . . very interesting. I had to keep my teeth firmly clamped on my tongue when he'd refer to the defendants by racial slurs.

[SmilingBluEyes]

Or if you *must* judge, which as humans we do, leave that judgment at the door.

[Apple-Core, ASN, BSN, RN]

Or if you *must* judge, which as humans we do, leave that judgment at the door.

We all judge, all the time. It's a biological throwback from the need to survive. It's how our ancestors were able to decide who was a threat, who wasn't, and who was worth procreating with. It's natural, it's normal, and its human.

However, the same level of care and kindness should be offered to everyone in the clinical setting.

[NurseLife88, ADN, RN]

We all judge, all the time. It's a biological throwback from the need to survive. It's how our ancestors were able to decide who was a threat, who wasn't, and who was worth procreating with. It's natural, it's normal, and its human.

However, the same level of care and kindness should be offered to everyone in the clinical setting.

I really agree with a lot of what is being said here. Especially in regards to knowing it's human nature to judge and at times we may not be able to stop ourselves, or take a breath. Then yes it is important to leave those judgements at the door. Once you are on the job and providing care, every patient should be afforded the same respect as the next regardless of how we may feel on a personal level, at the very least because it is our job to do so.

[Wuzzie]

I really agree with a lot of what is being said here. Especially in regards to knowing it's human nature to judge and at times we may not be able to stop ourselves, or take a breath. Then yes it is important to leave those judgements at the door. Once you are on the job and providing care, every patient should be afforded the same respect as the next regardless of how we may feel on a personal level, at the very least because it is our job to do so.

I don't judge I "assess". If a patient throws poo at me because the doctor refuses to order Dilaudid for her ingrown toe-nail or I didn't push the Benadryl fast enough I assess them as being a jerk. I also assess that I do not like poo thrown at me and adjust my plan of care accordingly. This does not, however, give me license to be a jerk back to them.