"You are an angel!"

[Anna Flaxis, BSN, RN]

*Hanging dilt on a patient in rapid a-fib, she says she's hungry, "I haven't eaten all day!" (it's 9:00 at night).

Entire time I'm hanging the med; checking vitals, giving bolus, starting gtt, rechecking vitals, it's "Can I have a sandwich?"

Get everything going, patient is tolerating the medication, it's having its intended effect, no adverse reactions noted, so I go get the sandwich.

"Oh, you are such an angel!!!"

*Older man in for abdominal discomfort. Get a line in, draw labs, hook up to monitors, get EKG, give antiemetic and pain meds. Whole time, he sits there tolerating everything.

Get warm blanket, fluff pillow, raise and lower the head of the bed until it's perfect. Now he's gushing "Oh, you are such a good nurse!"

*Hanging IV antibiotics on a child with a UTI, Mom asks me for a snack for the hungry child. Of course I get the snack, and receive a nice "Oh, thank you!" from Mom.

I understand that patient comfort is important, and it's nice to be thanked for those little things we do to keep our patients comfortable, but when did people get such a one-dimensional view of nurses that they don't even acknowledge the things we do to make them well or keep them alive?

I was YouTubing not too long ago and I came across a home video made by some little girls. They were playing "nurse". One was the patient, and she was in a bed with tons of pillows and a little bell at the bedside. The other 2 or 3 of them were the "nurses". The "patient" would ring her little bell, and the "nurses" would all come running to see what she wanted, which was more pillows or some chicken soup, which they would all hurry to fetch immediately in a very subservient manner.

I understand that nurturing, caring, and being of service are integral components to nursing as a whole, but how did it get to be that these are the dimensions of nursing that are so prevalent in the minds of the layperson, almost to the exclusion of all of the other things we do?

[mesrn118]

The mentality of most people today is that they want instant gratification....NOW!

When I used to work in a Hospital, I remember wishing so much that the FAMILIES would GO HOME, as they asked for more stuff than the patients! Can you get me some coffee, ice cream and on and on! The patients were generally too ill to ask for much of anything, but the families and friends made up for it! Sometimes I felt like they thought they were in a Hotel instead of a Hospital.

One time, I had an admit, and when I went to the room there was a teen ager in the bed.....now I just was told that it was a 79 y/o f that I was to assess and admit! The old lady was in the chair in the corner and the teen ager in the bed lounging! And all the FAMILY was tolerating this! Unbelievable!

Another time, I had a 18 y/o f as a patient and when I entered the room there were 3 older teens in the hospital bed all together............so I say, which one is the patient????? They look at me like I am the crazy one!! The 18 y/o FAMILY was there and acted like this was no big deal. COME ON NOW!

You are correct Stargazer in your assessment. The answer is that (many) people just want what they want and they want it NOW! Spoiled and instant gratification is what has happened.

[Anna Flaxis, BSN, RN]

I was thinking maybe people get their idea of nursing from what they see on TV, but I grew up watching M*A*SH*, and Margaret Houlihan was my idea of a nurse! Can you imagine Nurse Houlihan stopping in mid-triage of a new batch of wounded soldiers to go fetch some ice water?

Now, I realize I'm not triaging wounded soldiers, however, it never ceases to amaze me how people seem to be so blind to the all we do for them, yet I bring them some ice water and suddenly I'm an angel!

[Isitpossible, LPN, LVN]

Entire time I'm hanging the med; checking vitals, giving bolus, starting gtt, rechecking vitals,

i think these are the "tasks" that are expected from nurses...but getting someone something to eat, fluffing the pillows, extra-sheets ect demonstrats the "caring" nature...thats what people are thankful of..i dont think its about instant gratification...its the little things that people find important...just my opinion

[Anna Flaxis, BSN, RN]

Entire time I'm hanging the med; checking vitals, giving bolus, starting gtt, rechecking vitals,

i think these are the "tasks" that are expected from nurses...but getting someone something to eat, fluffing the pillows, extra-sheets ect demonstrats the "caring" nature...thats what people are thankful of..i dont think its about instant gratification...its the little things that people find important...just my opinion

Yes, except that while I was doing all of this, I was also conversing with her, reiterating to her that the priority was to get her heart rate under control so that she would feel better (this IS the reason she came to the ED in the first place, after all), and that THEN I would happily get her a sandwich. Once the med started taking effect and she started to feel better, she did not say thank you nor did she tell me I was an angel for having given the medication that made her feel better.

How is administering a medication that relieves the symptoms of decreased cardiac output any less "caring" than bringing a sandwich? What is the more "caring" behavior; compromising patient safety by delaying the administration of the med to go fetch a sandwich, or promptly giving the medication and relieving the symptoms that brought them to the ED in the first place?

And why is the measure of a good nurse how quickly they can bring a sandwich?

And where do people get this idea?

[Altra, BSN, RN]

I totally hear you.

I've resigned myself to the reality that I will not get any kind of acknowledgement from the patient who I got an EKG or cardiac enzymes on just on a hunch that they didn't look right ... the 35-year old tri-athlete patient who was lo & behold having a STEMI seemed more annoyed than anything that my "hunch" generated a flurry of activity culminating in his being whisked off to the cath lab. Such an inconvenience, you see ... he had things planned for the day.

But when I have a free moment to help a coworker who is getting her butt handed to her, and I reposition a patient's pillow an inch ... I get a big smile and a hand-holding session and a, "thank you so much, dear."

The disconnect in reality is really grating sometimes.

[Anna Flaxis, BSN, RN]

I just wonder where it comes from. Obviously this is a sociological question. Something about American society in particular is where the root of it lies. I wonder, is it like that in every country, society, culture? I doubt it.

I'd be curious to hear from AN members in other parts of the world.

[canesdukegirl, BSN, RN]

Hey Star-

I understand what you are saying. On the other hand, laypeople don't understand what really goes on behind the scenes in our profession. They have no idea that we advocate for them, they don't know that we check, re-check and triple check meds. They don't know that we do research on our own so that we understand specific disease processes in order to deliver more effective patient care. They don't realize that we must complete CEUs in order to keep our licenses current. Why would they?

I don't expect laypeople to understand all of the things that we are capable of. The only thing that I care about is that the pt feels safe and well taken care of. If getting a sandwich, pouring ice water from their pitcher, and repositioning pillows makes them feel comforted, then so be it. I am keeping my patient safe by doing my job well. They don't have to know or even understand the intricacies of my job and the implementation of a carefully thought out, multi-disciplinary plan to improve their health while they are in the hospital. They have enough to deal with. I am perfectly content with working my a$$ of behind the scenes.

As long as my patients feel safe and comfortable, I don't feel the need to validate and explain the many facets of my job.

Star, is your main beef in relation to the general public thinking that nurses are nothing more than 'medical waitresses' and hospitality slaves? Forgive me if I have tracked you incorrectly...feel free in telling me to get bent:)

[rightintwo]

Entire time I'm hanging the med; checking vitals, giving bolus, starting gtt, rechecking vitals,

i think these are the "tasks" that are expected from nurses...but getting someone something to eat, fluffing the pillows, extra-sheets ect demonstrats the "caring" nature...thats what people are thankful of..i dont think its about instant gratification...its the little things that people find important...just my opinion

I agree with this, times in the past before I was interested in nursing, I never really paid attention to the fact that they were helping me in these ways...I guess I kind of thought well that is their job to administer me medicine, draw blood etc, but they don't have to fix my pillow or be genuinely concerned about how many blankets I have and if I am comfortable... Now that I am going to be a nurse I think a patients comfort is important to their health too but I can see how important the other aspects of nursing are as well. I would just be glad they said thank you for anything especially because I meet many rude people with no manners at all that don't say thank you for anything and expect everything

[brandy1017, ASN, RN]

I think a lot of patients don't realize all we do for them. They simply don't understand the complexity of their disease and the medical management and monitoring that goes into keeping them safe and sound and getting them well.

But when you get them something like food or a pillow that helps make them feel at home. Also they lose their independence in the hospital. They can't just go get these things for themselves like they would at home. They have to depend on us and wait on us to get something for them.

Solution is be attentive to their needs, delegate if need be, but also educate them on their disease situation and all you are doing to keep them safe and well. Then they'll realize all that's involved behind the scenes and the really important things you are doing to treat them and keep them safe.

[ErinS, BSN, RN]

I have to be honest, in our line of work just take the praise you get, no matter what it is for. Our patients can't always understand what the difference is when we start a new medication, but they know when we help relieve their hunger, listen to their life stories (even though there are 17 other people ringing their bell!), and stop to readjust a pillow. And honestly, I think that is what separates an okay nurse from a great one. An okay nurse does the tasks, the great one sees the patient and takes care of the whole person. I hope if I am in the hospital and feeling scared and sick, someone will get me a sandwich and warm blanket.

[loriangel14, RN]

I remember a elderly female patient that I admitted at 2 am one winter night. She had been sitting in the ER for some time before being admitted and was tired and scared when she got to the floor. After I got her settled I asked her if she needed anything.She very timidly asked if she could have something to eat and a warm drink. I got her tea and and a sandwich and then gave her a warm flannel from the warmer to help her sleep.I know what I did was not high tech and required no profound medical insight but when a someone feels awful it helps to feel like someone cares. You could provide all kinds of wonderful nursing interventions but if you ignore the little comforts people remember.