The Nurse on the Other Side

[Fancypants09]

Thank you for sharing! The core message seems simple enough as it's written out, but may be that much more difficult to actually put into practice.

[sheilagood52, ADN, BSN, MSN, RN]

Thank you for commenting. I'm not sure why showing respect for nurses as patients would be "much more difficult to actually put into practice." Every nurse, including you, will one day be on the receiving end of nursing care. I should hope you'll will be treated with respect when that time comes.

[bagladyrn, RN]

I had to come back to this to post a thought. I'm not sure you are going to like what I have to say.

First of all, I'm sorry you are having such health problems. I'm sure it affects your outlook.

However, it seems that you are being judgemental. You are basing your reaction on what you believe she is thinking "I heard them in my mind". In a lot of your post you are critiquing what you believe she is thinking and saying and even the way she writes and the set of her mouth.

Yes, caring for someone with much more knowledge and experience can be intimidating. I'm sure it impacted her interactions with you as she wondered if she was coming up to your standards. Perhaps if in this situation again it would help to just bring it out on the table and acknowledge the discomfort and let them know how you want to be treated - as the patient, not the nurse supervisor or instructor that you may bring to their mind.

[LadysSolo]

I would acknowledge that I am a difficult patient (I am.) I prefer to be left alone, and I will call if I want/need something. Answer my questions, and then leave. And that is what I say. I voice my expectations. I do the same with all my providers (dentist, optometrist, etc.) We are all on the same page that way.

[Anna Flaxis, BSN, RN]

I disagree with the premise that you should be treated with respect because you are a nurse. I think you should be treated with respect because you are a person. Nurse, baker, janitor, fast food worker, attorney, teacher, retired factory worker.....none of that matters. What matters is that you are a person

under my care.

From the tone of this "article", it sounds like you have a chip on your shoulder. Perhaps this is what the nurse portrayed here was picking up on.

[Hancock330]

Wait until you're admitted to a hospital where a small but significant number of the nurses are your former students. Then you can find yourself expected to "know all about" your diagnosis whether it's a one time event or not. And wait until you're expected to understand why, even though you have a wound that has some scant drainage with no response (yet) to any of the 3 IV antibiotics they've tried, the nurses really don't think they need to observe contact isolation precautions like gloves and a gown when touching things in your room.

And, when some of the nurses who AREN'T former students discover you're a nursing instructor, you get to watch as they freeze up in your presence as if you were the dragon instructor from THEIR student days (and if there's a nursing program with more that a couple of instructors that doesn't have at least one dragon I've yet to hear about it). Then they try to escape your presence as rapidly as possible, and you really question the wisdom of telling the truth when admissions asks about your job.

Then you have the nurse who refuses to even try to learn how to pronounce the generic names of your medications and those who have tried, and too often succeeded, to forget everything they ever learned about pathophysiology and things like medication safety. I once heard an RN state, categorically, they don't make unsafe dosage forms of drugs, for instance -- ignoring that what's safe for one person may be unsafe for another. These experiences can make it difficult to trust your nurses. And there are those (hopefully very rare) former students who squeaked through the program where you taught and whose mere presence in your patient room might make you die of fright.

Finally, by the time you've been a nurse for 5 years, much less the almost 45 I've had, you've HEARD and PARTICIPATED in too many of THOSE breakroom/hallway/report room conversations about patients. It becomes far too easy to let your imagination take over and imagine that other nurses are now saying those things about you. You fall into a trap of guilt compounded with anxiety and get anywhere from slightly to extremely paranoid. I think almost all nurses who provide direct patient care (I'm allowing for some outlier saints here) have said some very judgmental, politically incorrect things about at least a few patients along the way. Most of it wasn't meant to be vicious and was mostly in the category of venting to get it out of your system so it was less difficult to go back into the patient's room and be appropriate, but it was nevertheless said.

So, I'd say we all need to distance ourselves just a bit from our previous experiences and our current expectations. We need to ask ourselves what we would want if we were in the bed instead of standing beside it. What I want is for my nurse to ask me what information I want; to answer specific questions with precision -- even if that precise answer is "I don't know." I'd like to be assessed for what my current level of knowledge is -- not asked "Do you have any questions about your diagnosis?" but instead asked "Would you please briefly explain how long you've had this problem and what you understand about the problem, how it's diagnosed, and what the usual treatments?"

Best wishes to the OP for getting the kinds and amounts of nursing (and other) care she really needs and wants.

[FranEMTnurse, CNA, LPN, EMT-I]

I have been a patient in our local hospital so many times I have lost count and have had healthcare providers of all kinds with numerous different personalities. Admittedly there those who are nervous due just starting out in their new job, or a student, or unsure if nursing is the career they really want to embark on. There are also tired, stressed out overworked healthcare workers who might have a slip of the tongue on occasion, but not mean anything personal. There are also humorous healthcare workers who love to joke around and friendly healthcare providers who are super at what they are doing, but remember, everyone is different in some way. We all have special talents and abilities and personalities. After all, isn't variety the spice of life. My favorite hospital time is the day I leave to recuperate at home, but I love to leave with a smile on my face and in return, see smiles on the staff's faces too. That really can happen, because I have experienced it.

[banterings]

Thank you for sharing the TRUTH.

It is also NOT just nurses or physicians that this happens to, but any patient that has taken control of their own health and been educated about health.

There are going be those that deny nurses are anything but compassionate and try to say you don't know what they are thinking. You offer proof in the way your labs were (not) reviewed, biting of the tongue, attitude, demeanor, etc. What manifests itself here is a nursing paternalism.” This is rarely addressed due to being overshadowed by physician paternalism.

There are 2 main reasons that cause this reaction. The first has to do with the perception of nurses that you described as secretaries,” they feel that you are questioning their medical knowledge (if there was a problem with your labs, you would be told…).

The second has to do with the fear of getting caught cutting corners. This happens all the time in healthcare due to the workloads. It can be from the physician not laying out EVERY option to a patient to nurses leaving urinary catheters in a day longer than necessary.

What is most troublesome is how many in the profession deny these things even exist let alone how often they really occur. I find it amazing that every nurse on this board is the good nurse who has never done any of these things or witnessed them more than twice in their careers. The same is true of physician message boards.

All one has to do is work a single 16 hour shift in a hospital setting to know it is true and occurs more than most will admit.

This goes back to the first point I made, wanting to protect the profession and one's self from being besmirched and bringing the profession down. How much trust does the profession (of nursing), OR any profession earn when they deny the existence of real problems that plague it?

You only have to look at the catholic church and the sexual abuse scandal. It was not the abuse that caused the lost of trust, but the denial that it existed. Just recently Pope Francis apologized for Church's sexual abuse. His honesty, transparency, and commitment to change is what is winning back trust and respect for the church.

I wait to see how many posts attack both your post and mine, saying that we are wrong, our perceptions are wrong, this doesn't happen, etc. My response to providers that say they have never done these things or witnessed them is that they are the EXCEPTION and NOT the rule.

It also disqualifies them from discussing the issue because they don't believe that the issue exists. Before we can even begin to devise and implement a solution with those people, we have to prove that the sky is blue.

[Jewelsforme]

I'll drink to this. You certainly hit this nail smack dab on the head. I used to be a MedSurg and Hospice nurse. I was the nurse that patients asked for by name, even in our hospice community. Man, I thought I would work until I was a little bent over lady with white hair, limping in to care for people far past my retirement age. I absolutely loved being a hands-on, compassionate, caring nurse. That is until one day I could not get out of bed, literally.

So this is "chronic fatigue." I already worked with severe low back pain from an MVA as well as body wide pain from fibromyalgia. My endocrine and other body systems were all out of whack. I could not figure out why my right leg was so weak and I kept tripping on it. Then my right arm and hand went weak, then my vision and so on. I had home care off and on and used to joke to my home care nurses and friends that the only body system that is working is my SKIN, the integumentary system. But even that quit working right about 4 years after this nightmare began.

When I was last in the hospital for a run of SVT while on a monitor, I was placed on Tele in MedSurg for observation, in the same hospital I worked in, I can tell you that some nurses never touched me, talked to me, performed an assessment, even listened to my lungs or heart - many!!!! One that I used to work with only poked her head around the door to ask me if I was ok, need anything, then disappear for the rest of her 12 hr shift. I felt humiliated, shunned, completely rejected by my own nurse and doctor "friends" there at the same hospital, my previous colleagues. To this day, I have no idea how they filled out the charts without ever assessing me physically. Only one gave me a quick and thorough once-over, a previous friend, another kind soul, as she was DISCHARGING me for home. I never even used my call button because I knew the eyes at the nurse's station would begin to roll LOL!!!

Ever since then, I remain feeling ill to the core, every single maddening day, having to spend my life flat to keep my B/P from bottoming and blacking out. There is no freaking cure and this year the IOM has changed the name of chronic fatigue to SEID for short (but for those who do care, it stands for Systemic Exertion Intolerance Disease) and did not even get approved for one measly dollar of funding this year by the good ole' USA government, not one single dollar. It is still a very disrespected illness and therefore, we, the patients, get no respect or dignity.

I keep up with as many CMEs and updated videos about medicine and reviewing procedures as my mind can tolerate. I avoid going to doctors and ERs if I can help it, even when I thought I broke a femur during the last fall 2 months ago. My husband bought me used crutches to avoid the searing femoral pain if I placed any weight on it. But I realized it was just probably soft tissue and that once the visible bruising (enormous area) resolved, in time the inner bone pain would get better. It did last week.

After years of mistreatment and invalidation from physicians and nurses, this is why I veer away from reaching out for "care" in our medical field. But I will honor and defend our nursing profession as long as I still live, even if it's disabled, on my back or one side, staring at the beautiful birds outside my bedroom. Truly, with aloha, because my heart still feels and empathizes with others who suffer, especially those who are alone ♥

[Anna Flaxis, BSN, RN]

I've taken care of a lot of nurses and physicians and their family members, and I treat them the same as all of my patients. I don't assume that they know more than the average person about their diagnosis, and I try to meet them where they are at knowledge-wise and emotionally. When I discharge patients, I highlight the key pieces of discharge information and verbally read back any instructions, warnings, and follow-up information, and I do this for doctors and nurses and their family members, too. I don't worry about whether I'm telling them something they already know, or know more about than I do, because simply because they are a doctor or nurse does not mean they know all about this particular thing, or navigating the health care system from a patient standpoint. And you know, nobody has ever accused me of talking down to them because I do this. People across the spectrum seem to appreciate me taking the time to go over key information with them, no matter their education level or profession.

If they ask me a question that I don't know the answer to, I'll simply say that I don't know, but I know how to find out. If they want a lab result and I haven't had time to look at their labs because I've been running around like my hair is on fire, I'm honest and I tell them that, but I can quickly look it up right then and there.

I typically don't know what someone's occupation is unless they tell me. I don't go snooping into their chart to find out. If, in triage, the person is using a lot of medical terminology or otherwise behaving as if they are in the healthcare profession, I carry on as if they are "just another patient", and treat them the same as any other patient.

The fact is that *every* patient- regardless of occupation- has a differing level of understanding of their disease process, their medication regimen, their lab trends, etc. Individualizing the plan of care means meeting the person where they are at in terms of that understanding, and not making assumptions about what they know or don't know.

To the OP, I'm sorry you had that experience, but I find it hard to believe that this is the behavior of nurses across the board. What I think is that just as there is a wide spectrum on the patient side of things, there is also a pretty wide spectrum of professional/unprofessional conduct among nurses.

Am I wrong?

[girlvet]

Wow...really? You sound like someone with a real anger problem. It's like you went in ready to be angry. You need help.