The Nurse on the Other Side

[sheilagood52]

Me...the Patient

You thought I didn't notice the fake, tight smile you gave me, but I did. I heard the edge of irritation in your voice and saw the roll of your eyes as you turned away. And, for future reference, your mouth does funny things when you're biting your tongue.

I didn't hear the things you said to your co-workers as soon as you cleared the room, but I heard them in my mind as if standing next to you.

"God, the patient in 505 is intolerable." The others teetered as you described me.

"Bet she's a nurse; is she?"

I imagine you couldn't pull my patient record and demographics up fast enough in search of my occupation. You groan echoed loudly, "She's an MSN."

The others laughed at your misfortune and walked away.

You wrote your name on the whiteboard in my room with a flourish and told me to call if I needed anything. But, you didn't mean it. I saw the hurried and dismissive way you wrote resenting the nuisance board.

You checked the orders for the day, scanned the most recent labs for obvious outliers, made a note of the meds to dole out, and moved on. You didn't delve into my history, or the reason I ended up in the emergency room; you didn't have time. Yet, discovering I was a nurse, made you cringe.

Am I Your Worst Nightmare?

I'm your worst nightmare or so you say; right next to the physician-patient, you had last week. I'm your patient and I hold a master's degree in nursing. I know things, lots of things about medicine, the role and responsibility of nurses, and more about the disease ravaging my body than most physicians. Knowledge is a powerful thing, and, yes, sometimes too much is a dangerous thing. Physicians see me occasionally and this is my first encounter with you, but I live with the complications of my illness every day. If I had to choose, I'd take more knowledge over less any day.

But, why does finding out I'm a nurse, bring out the worst in you? Why the snippy attitude or rolling eyes? Why should I hide the fact I'm a nurse? We're supposed to be kindred spirits.

I'm not here to grade your performance or make you feel, whatever you're feeling. I'm here to get well. A little compassion from one nurse to another will go a long way in making that happen.

I no longer practice nursing, not in an official capacity, but I remember what inspired me. I wanted to be like Florence Nightingale, help the sick, cure cancer, or the next big disease threatening to wipe out humanity. I had big plans. I'd advocate for my patients, unique in their illness and they would remember me with fondness. Although my career was cut short, I still maintain my license and keep up with medical practices. Nursing is a way of life for me. It's who I am.

The Healthcare System

The whole health care system is unrecognizable to me these days. Nurses are still overworked and underpaid. Electronic charting and medical records have nurses spending more time in front of the computer than at the bedside, and patient care has become check-offs on a computer screen.

Remember the lab values I asked about?

"They were normal," you said. Did you bother to review the pattern of my previous labs? No, you evaded my questions and became annoyed. If you had, you would've realized they weren't normal, not for me. One size does not fit all.

To you, I'm the pain in the *** nurse-patient in room 505, but this is my life, my body, and my pain. I should have a say; I've earned it.

One day you will be me, the nurse on the other side, receiving instead of giving care. Tired, sick, and afraid, the truth of who you are will slip out as your own knowledge compels you to ask questions and push for answers. Clinging to the last bit of control you have, you'll pay attention to the care you receive as never before. Once a nurse, you're always a nurse.

That time will come faster than you can imagine. When it does, you'll want a compassionate nurse. One, who listens, answers questions, takes your concerns seriously, and treats you with the respect every nurse deserves no matter her age or circumstances, not one who rolls her eyes in impatient mockery.

[Susie2310]

elkpark said:

Of course not. I've had "unsatisfactory experiences" as a healthcare client, and with many other types of services and businesses over the years. However, I was able to recognize that the fact that I would have preferred a different experience did not necessarily mean that the providers had done anything wrong or been deficient in any way. Sometimes people have unrealistic expectations. Are nurses expected to, on top of what we are already required to do for clients, fully satisfy every individual's hopes and wishes for the experience, regardless of how unrealistic they may be?

We don't know that the providers did not do anything wrong or were not deficient in any way, as none of us were there. We only have the OP's experience, as told by her. But her experience, as told by her, does not mean it is untrue or inaccurate.

When patients fill out questionnaires about their hospital stays, their feedback is accepted as is. They don't receive another letter telling them that their feedback is just their own subjective experience, and is therefore of no value. Patients are considered to be capable of reliably expressing their own experience of health care they have received, whether good, bad, or indifferent.

[Ruby Vee, BSN]

Susie2310 said:

We don't know that the providers did not do anything wrong or were not deficient in any way, as none of us were there. We only have the OP's experience, as told by her. But her experience, as told by her, does not mean it is untrue or inaccurate.

When patients fill out questionnaires about their hospital stays, their feedback is accepted as is. They don't receive another letter telling them that their feedback is just their own subjective experience, and is therefore of no value. Patients are considered to be capable of reliably expressing their own experience of health care they have received, whether good, bad, or indifferent.

So this whole "article" had approximately the validity of a Press-Gainey survey. WOW!, that's even harsher than I was!

[Susie2310]

Ruby Vee said:

So this whole "article" had approximately the validity of a Press-Gainey survey. WOW!, that's even harsher than I was!

Why not accord to the OP the same respect that is given to patients who provide feedback on their health care experiences? The OP was a patient.

[NanikRN]

Susie2310 said:

Why not accord to the OP the same respect that is given to patients who provide feedback on their health care experiences? The OP was a patient.

I thought ruby did exactly that-- this story is as lop-sided and not based in reality as many, if not most, PG surveys

[Susie2310]

On the subject of surveys and the weight attached to patient feedback, my friend was recently hospitalized. A couple of days after they were discharged they received a call from a hospital representative asking about their hospital experience. My friend reported a positive experience. The hospital representative asked my friend about the nursing care, and said that they were working on this. My friend again gave positive feedback, and told the representative they had noticed an improvement since previous hospitalizations. My point is that nurses can be as dismissive as they wish about patients experiences of nursing care, but hospitals do listen to and value patients experiences, and take action based on patients experiences.

[elkpark]

Susie2310 said:

On the subject of surveys and the weight attached to patient feedback, my friend was recently hospitalized. A couple of days after they were discharged they received a call from a hospital representative asking about their hospital experience. My friend reported a positive experience. The hospital representative asked my friend about the nursing care, and said that they were working on this. My friend again gave positive feedback, and told the representative they had noticed an improvement since previous hospitalizations. My point is that nurses can be as dismissive as they wish about patients experiences of nursing care, but hospitals do listen to and value patients experiences, and take action based on patients experiences.

Well, then, the OP should be sure to complain to her hospital about the tone of voice and dismissive writing of the nurses she was forced to endure.

[RNsRWe, ASN, RN]

ak2190 said:

It seems like you're upset that your nurse was busy and didn't spend extra time with you giving you individualized/immersive treatment to the degree you'd like. Unfortunately for all of us, that's a reality in today's healthcare environment. I don't care if my patient is a nurse, physician, or CEO. My time is split among my patients according to acuity and prioritization. For example, last night my priority was a patient circling the drain requiring multiple transfusions, not the guy who wanted me to sit next to his bedside and go over his entire medical history with me when he's a relatively stable walkie talkie who is no longer having melena and H&H is stable. Would I like to spend 30 minutes going over his habits and practices to identify exactly how and where it all started and how to fix his myriad of issues? Sure. But looks like 403's pressure is 61/30 and now I gotta run. We don't have the staffing to focus on the extras, the stuff above and beyond keeping people alive, unharmed, and relatively comfortable.

Your post reminded me of a situation I've posted about before on AN. Had to do with a patient in Bed A who was complaining that she hadn't received her ice water yet...her water was ROOM TEMPERATURE.....and that she deserved as much attention as Bed B. OK, sounds perfectly reasonable, right? Except WHY did Bed B have nurses and techs running in and out, getting this and that for her? Why did HER needs come before Miss Thing in Bed A? Because Bed B was actively trying to DIE, and we were CODING her! Yep, the patient in the 'A' bed kept pulling back the curtain to see what "all the fuss is over her anyway".....and it took the nursing supervisor sticking her head over and saying STOP THAT! to get the behavior to subside.

I'm quite sure that Patient A believed she was being shunted aside because she was "less important" than Bed B. Was she? No...but at that moment, she WAS less of a priority.....to the nurses, at least, if not to her.

[azhiker96, BSN, RN]

I'm sorry you had such a poor experience. I had not heard of this happening before but don't doubt that it could. I have heard that nurses are the worst patients but that has not been my experience.

I give every patient from homeless man with addiction issues to hospital CEO the same compassionate care. Care is tailored a little for the the patient, as it should be. Considerations include culture, faith, other beliefs, and knowledge of medicine.

When I care for a nurse, I will include her in some decision making that might not be appropriate for most of my patients. For example, I'll ask what she prefers for analgesia and will list the options the doctors have given me. If needed, I'll call the doctor for an additional order if her preferred treatment was not ordered. Most of my patients don't know fentanyl from meperidine from ketorolac. However, a nurse is a more informed consumer and may prefer one over the others.

I will always talk with the nurse as I would any other patient but switch to professional jargon if she prefers. I consider it a privilege and an honor to be able to help one of our own.

The nurses I've cared for are aware of body functions and disease processes. They have sometimes surprised me with the frankness with which they approach treatments. They know what's been ordered and why it was ordered. They are usually the ultimate advocate in their own care.

Karma may come around to bite nurses who treat their comrades poorly. I strive to do my best so that when my turn in the gown comes, hopefully Karma will smile at me. And not just because the gown is open at the back.

[sailornurse]

As a retired nurse ( & you did not say how long you have been retired) you may not realize how much nursing has changed in the last 20 years.

Patients are so complex, more acutely ill then in the 1970s/1980s. Back in the day, an open choleycystectomy would be hospitalized for up to one week, with T-drains. Now it is an same day/outpatient procedure if done with laparascope. Deliver a baby & you were there for 3 days at least, now you go home the next day!

IMO, patient that are now on med-surg floors were the acuity that back in the day were in the ICUs. Patients in the ICU are surviving conditions/diseases that were terminal in the past. On the telemetry unit I have discharged patients 3 days after open heart by-pass surgery. The amount of patient teaching for discharge, the acuity of the patients has changed tremendously. Technology has allowed lifesaving techniques but also has changed the how nursing care is delivered. What has not changed is the caring, the professionalism, the dedication by this next generation of nurses. As a former nursing faculty, who has been a patient & was cared for by former students, I hoped they were not intimidated by me (with my MSN/FNP). I was proud to observe them being in charge positions, nursing administrator/supervisors etc.

Gone are the days where nurses and time to give back rubs, change the drawsheets, and do what was called HS care routinely for all patients, but having read all the posts, I have to agree that you have a bone to pick & came across as bitter about your experience & prejudiced towards the nurse in your perceptions & interpretations of her non verbal body language.

I last worked as an RN in 2002 in the ER, but taught in a BSN program for 10 years until 2011 after earning my MSN/FNP in 2001. I have 20+ years of med-surg experience.

Nursing has evolved in multiple ways. Nurses adapt. Some things have changed such as electronic medical records, Emars/barcode bracelet med scanners but standards of care have not changed.

Looked at your bio: Sheila Good is a writer of literary fiction and non-fiction essays. I think you took literary license and embellished your experience.

[Adelinet]

I am stunned as I read the replies to this article. After working as an RN for 20+ years I was forced to retire because of health issues and then became a frequent patient. As I read the article I could relate, but I've also had wonderful experiences with caring, competent nurses.When did it become ok for one nurse to literally "attack" another because of her personal experiences? I was taught and practiced the philosophy that a good nurse is accepting of everyone no matter who they are, what their opinions, their religion, race, etc. A lot of the nurses replying & offering their opinions appear to be uncaring, judgemental & plain rude people. I feel so bad for your patients! Maybe this article hit a little too close to home for some.

[Ruby Vee, BSN]

Adelinet said:

IA lot of the nurses replying & offering their opinions appear to be uncaring, judgemental & plain rude people. I feel so bad for your patients! Maybe this article hit a little too close to home for some.

The "I feel so bad for your patients" is a close relative to "I would never want you to be my nurse."

What's this about Godwin's Law?

[RNBillieBSN]

I think those of you with the negative comments are a bit naive'. sheilagood52 is right...nurses are discriminated against when they are either admitted in the hospital themselves or they have a loved one in the hospital.

Several years ago, my husband had a CVA and he also had a cardiac event because his troponins were elevated. I am an RN with my BSN and my husband worked in the ER in a Level I Trauma Center. His room was avoided like we had the plague. The Med Techs came in and checked his vitals signs and CBG's, the RN would come in in the morning and bring his medication in a cup...that was the one and only time we would see her. She did no neuro checks on him...nothing.

About three days following his CVA, he began having chest pain, SOB and nausea/vomiting. We turned on the call light...no one ever came, so I left him to go out to the desk. His nurse was sitting at the desk, eating a piece of pie. I told her he was having chest pain. She looked at the monitor (he was on telemetry) and informed me he was in "normal sinus rhythm". I told her you treat the patient, not a monitor, and asked if he could have NTG. She said they didn't have what the doctor ordered...we're on the telemetry floor now...so I asked what dosage the doctor ordered and what they had on hand. She said 0.8 mg was ordered and they only had 0.4 mg on hand, so I asked her to give him two tabs SL. We never saw that. One of the physicians from the ER where he worked called to check on him. I explained what was going on and he said he would send the ground transport for him. To go out and tell "that nurse". I went back out to the desk...she continued to be sitting there and as I walked up, she rolled her eyes at her friend. I told her ground transport was coming for my husband...the name of the physician and he said they would be there in 39 minutes. She said "yeah right". I looked at her and I told her my husband had elevated troponins, he was having chest pain, SOB, n/v...she should have notified his MD of the change in his condition, started him on O2', given him NTG and she should be more concerned! Never moved from her seat!

Ground transport from the Trauma Center arrived and they requested a nasal cannula from the nurse as well...she didn't even get one for them. They finally just loaded him up and got him out of there. He was in ICU at the other hospital for five days, then on the floor another two before I brought him home.

i wrote a letter to the Director of Nursing and explained the poor care he received...as above. That I did think in part it had to do with the fact that we both in the nursing profession. The nurses and techs at the hospital wear tags that show up on a computer read-out each time they come and go in the patients rooms. When she called me to discuss my letter, she said the computer backed me up...there was no evidence that she came in to check in my husband when he began having problems. I told the DON that this nurse had failed to practice according to the Virginia Nurse Practice Act.

I found out out much later this nurse had been let go from her job, which had not been my intention. I just did not want anyone else receiving the same treatment.