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.

[sheilagood52, ADN, BSN, MSN, RN]

This is not a work of fiction, unfortunately, and no my imagination did not run away with me. I could have gone into more detail, but felt I got my point across. And who said I didn't give, " the hard-working nurses a bit of understanding?" I never said, nor implied I as a nurse, should receive or expected special care. But, I do expect adequate and respectful care. Just because, "they got rushed through an academic based education that didn't emphasize clinical skills." I'm supposed to give them a pass? I don't think so, all patients deserve a nurse with adequate skills. And for the record, I never said or implied my nurses lacked clinical skills - they didn't. Your assumption that I was a "fussy patient," is also false. I wasn't. The fact I am bringing out, in the open, an issue made you uncomfortable and that is regrettable. If we ignore a problem or refuse to acknowledge a problem, it can never improve. You see it as me as someone, "who couldn't wait to go on-line and trash her." I see it as bringing an issue out in the hopes, nurses will think about how they hope to be treated when their turn comes.

[sheilagood52, ADN, BSN, MSN, RN]

I agree completely. Constructive dialogue does help to improve everything. The purpose of my article was to bring awareness and start a dialogue. Thanks for participating in the conversation.

[sheilagood52, ADN, BSN, MSN, RN]

I make no effort to pit my nursing knowledge against those caring for me. But, I disagree with you that patients shouldn't question their plan of treatment. That is their right, and while it may be inconvenient or annoying, a patient response goes a long way in allaying fears or concerns. As for seeing their records?

The right to access personal health information is a cornerstone of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, said Secretary Kathleen Sebelius. Information like lab results can empower patients to track their health progress, make decisions with their health care professionals, and adhere to important treatment plans.

In my state, I have immediate access to all my patient records and tests, results via the Patient Portal and for the record, my nurse had no problem showing and discussing lab & test results. Nor did the doctor. Thanks for taking part in the conversation.

[OHNBJL]

I agree that all patients, regardless of occupation, should be treated with compassion and respect. However being an experienced nurse is sure to bring attention to those nurses who are currently caring for you. I was on the patient end of nursing after my total knee replacement. I had a young I inexperianced nurse caring for me. I could tell she was terrified of me. She would stand away from the bed and couldn't wait to run out of the room. What complicated the situation was my room mate was a nursing instructor who also had a total knee. I tried to put her at ease by talking to her and asking her how she decided on ortho. Turned out she had failed at being in the ED and had been reassigned to ortho. She also didn't understand my cardiac meds and refused to give me one of them. I calmly explained to her why I needed it prior to PT. So my point is talk to those who are caring for you in a non threatening way. Ask them to explain your labs etc. Admit things have changed since you were 'on the floor' but you want to be kept up to speed with your treatments etc. As a patient / nurse teach patience and compassion. You can have a lasting impact on today's nurses.

[banterings]

I was referring to the perception of the public (that you alluded to) of nurses as secretaries. I never said that you called them secretaries...

[Mavrick, BSN, RN]

"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. I imagine you couldn't pull my patient record and demographics up fast enough in search of my occupation." You made this up.

"....fake, tight smile ... edge of irritation in your voice.... You wrote your name on the whiteboard in my roomwith a flourish and told me to call if I needed anything. But, you didn't mean it....dismissive way you wrote resenting the nuisance board....meds to dole out." Your own worse interpretation of this nurses non-verbals.

"And, for future reference, your mouth does funny things when you're biting your tongue." And this little twist of the knife is just pure snark that reflects more poorly on you than your nurse.

"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......treats you with the respect every nurse deserves.....Nursing is a way of life for me. It's who I am.....Once a nurse, you're always a nurse." Based on reading your one article, as I was not present during your hospital stay, this could easily be construed that you consider yourself a NURSE that deserves special treatment.

"Your assumption that I was a 'fussy patient,' is also false." No assumption, my conclusion is based on the small amount of evidence you provided in your article. As you demonstrated, we base conclusions about people on small bits of information we observe and put our own interpretation on. Your nurse wrote her name with a dismissive flourish. You read a lot into that single action.

[banterings]

Here are 3 trends that I am noticing on this post:

First, Physicians and nurses may know the human body better than anyone else, but a patient knows THEIR body BETTER than anyone else. Questioning of the care plan is NOT questioning the provider's knowledge of the human body. Furthermore, it is only the patient exercising their RIGHT to be involved with their plan of care. If anything, they are questioning why this right is being DENIED them.

Second, just because one has not experienced bad care at their facility, does NOT mean it does not happen.

"Absence of evidence is not evidence of absence!"

-- Carl Sagan

Finally there have been allegations made that some people need psychiatric help. Implying this is a slur against that person whether they need help or not. It is like calling someone the R word to imply that they are mentally challenged. It besmirches patients who are dealing with psychiatric pathologies.

[sheilagood52, ADN, BSN, MSN, RN]

I admit I am completely stumped by your responses. Rather than admit there is a problem, you prefer to attack me, the substance, and validity of my article. And since, you were not present for any of my hospitalizations, or privy to the care I received, you made some amazing assumptions about me.

The purpose of my article was to bring awareness and open a discussion about a behavior exhibited by some nurses to patients with a medical professional background. Whether the behavior is the result of a nurse feeling intimidated (real or imagined), or a demanding patient is beside the point. Every nurse has experienced demanding patients from time to time, including me, but the role of the nurse is to provide the best care she can in a respectful manner regardless of the patient's disposition.

I did not "make this up." Any nurse who has ever been a part of a shift change report has heard the remarks and/or jokes. Denying they don't occur, doesn't make it so.

Although, the experiences of which I write were real, the majority of time, the nurses assigned to me have been skilled professionals who provided excellent care. However, as a patient, experiencing this behavior, even once, is one time too many.

I believe nurses are amazing and strong people who start out with the desire to help people. It is unfortunate our health care system makes it difficult to maintain those original ideals. Nurses have always been overworked, under appreciated, and under paid. I admire anyone willing to step into a pair of nursing shoes. However, we do a disservice to our profession when we ignore behaviors like "nurses who eat their young," and those of which I wrote. Problems never go away when we keep our mouth shut. It is only when we speak out that positive change occurs.

It's my hope that those who read this article will think twice the next time they are assigned a patient with a medical background and realize, regardless of education and background we are all people first.

[Mavrick, BSN, RN]

sheilagood52 said:

It's my hope that those who read this article will think twice the next time they are assigned a patient with a medical background and realize, regardless of education and background we are all people first.

I have not had the experience of being treated poorly by staff nurses nor did I accompany you during your hospitalization and see anyone treat you poorly so I can't speak to any of that.

I am basing my conclusions on what was written in an article that did not at all convey the hope you state here. Based solely on your article, and I have already quoted why I was led to such conclusions; your experience was imagined and and your negative thoughts about your nurse were taking small observations to the worst possible degree that you were not getting the special treatment you deserved as a nurse with an MSN education.

You are now expanding what you thought you were expressing in your article to include all patients with a medical background being treated as just people.

".......the majority of time, the nurses assigned to me have been skilled professionals who provided excellent care. However, as a patient, experiencing this behavior, even once, is one time too many."

Here may be your error. A behavior happening once when the majority of the time it doesn't is not a problem that needs admitting to.

[sheilagood52, ADN, BSN, MSN, RN]

I stand by my experiences and my article. The fact you choose to draw erroneous "conclusions," is something I can't help. I appreciate, however, that whatever one may believe about the issue, I have raised, at least others are discussing it.

[Ruby Vee, BSN]

bagladyrn said:

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.

I have to agree -- I'm sorry the OP is having health issues, I'm sure it affects her outlook and she IS being pretty judgemental. Any time you assume you know what someone is thinking based on facial expressions, involuntary ticks, tongue biting (really?) and "fake, tight smiles" you're making a you-know-what of yourself. The OP really doesn't know what her nurse was thinking -- the fake smile may have had more to do with your attitude and demeanor toward her than any of the degrees you hold.

I've been a patient more times than I like to think about in the past decade, and I've been fortunate enough not to have experienced all the negativity the OP rants about. But maybe that's because I take care NOT to make assumptions based on minimal data.

If you go into the situation looking for problems, you are sure to find them.

[banterings]

Here is something that I do not understand;

I good nurse can pick up on subtlties in patient demeanor. They can tell if a patient is not being completely truthful, they can tell when treatments are not working, so why does anyone doubt that the OP can't pick up on how her nurses are feeling?

I have heard so many amazing assertions here that the OP might need psychological help, misperceived the event due to illness, her nurses had other things on their mind, all from just reading her story (not being there, knowing the OP's illness, etc.).

It seems these people have amazing deductive powers, yet the OP does not?

The denial that there is a prejudice when nurses have nurses as patients is unfathomable...