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What I Wish Others Knew About Nursing

  • Nursing requires knowledge, skill and judgment, not only caring and compassion. Nursing is a wonderful profession, and the public is right to believe that successful nurses practice values like caring and compassion. But what the public (and sometimes even other health professionals) don’t fully appreciate is the immense body of knowledge that nurses must master and implement every day in their practice. Nursing, in short, requires you to be not only compassionate, but also smart. You must assess your patients, advocate for them, and respond to quickly-changing clinical environments. Nursing requires your head as well as your heart.
  • Nurses are healthcare professionals, not servants or waiters. There are times when it seems like patients (and sometimes their families too) simply don’t understand that nurses are there to keep them safe – not cater to their every whim. Hospitals are places for sick people to heal, not hotels or resorts. While most nurses are happy to accommodate occasional requests to get patients a cup of ice, or to try to get a meal order changed, some patients fail to understand that the primary role of the nurse is to evaluate and advocate for their health and safety. Nurses are healthcare professionals, not personal assistants.
  • Nurses need to eat and take breaks – at least occasionally. It’s difficult to explain to someone who isn’t a nurse just how hectic many hospitals and other, similar clinical environments really are. By the time nurses have met their patients’ needs (in addition to the needs of patients’ family members, physicians, social workers, techs, and everyone else on the healthcare team), they’ve frequently neglected their own personal, emotional, and even physical needs. To be effective and avoid burnout, nurses who constantly give to others need to give some time and attention to themselves too. When nurses take a “break” to wolf down lunch in five or ten minutes, it’s wise to let us enjoy it! We need the time to re-charge ourselves mentally, physically, and emotionally.
  • I want to help you get better – but I want you to help yourself too. As nurses we will always do our best to assist our patients, no matter who they are, what they look like, what they believe, or how they act. But we’re human, of course, and it’s frustrating to care for patients who don’t seem to take their own health seriously, or who sabotage themselves. When patients repeatedly engage in behaviors they know are unhealthy, like smoking, heavy drinking, and using illegal drugs, it’s more difficult to provide care with the energy and compassion we strive for in our practice. As nurses we have a lot to offer, but it’s much more satisfying (not to mention much easier) to offer this care to patients who not only want to be helped, but want to help themselves as well.
  • Don’t shoot the messenger. As nurses, we’re usually patients’ primary “point of contact” with the rest of the healthcare team, simply because we tend to spend the most time with patients. One unfortunate side-effect of this fact is that when we must deliver bad news – about a delayed test or procedure, a botched discharge, or a consult that hasn’t yet been initiated– we bear the brunt of the frustration, and even the blame. It would be wonderful if patients and their families remembered that while we can (and want to) advocate for them, we’re not the primary decision-maker regarding the plan or the pace of care. As much as we might like to, we can’t solve every problem.
  • If it takes me time to do something, there’s probably a good reason. When patients make a request to their nurse, most expect that request to be fulfilled in a timely manner. What’s difficult to explain is how quickly a nurse can be diverted from fulfilling that request by any number of interruptions or other tasks – a phone call from a physician, a critical lab result, a transporter arriving to take another patient to a procedure. All too quickly, that request can be buried in a sea of other demands on the nurse’s time. This doesn’t mean that what patients ask for won’t be addressed, but it does mean that patients may not get what they want as quickly as they expect, even if they can’t necessarily understand the many reasons for that delay.
  • Physicians: please make the orders you write clear, safe and logical. Don’t cut corners. Physicians (like nurses) are often pressed for time, which tempts some to be less than precise when entering or writing orders. The trouble is that if an order is unclear, the nurse will have to waste time contacting the physician to clarify it – because the order doesn’t make sense, is incomplete, or in the case of handwritten orders and notes, is illegible. Physicians who take an extra moment to follow organizational protocols and to ensure that their wishes are clearly understood save everyone (including themselves) a great deal of time and angst down the road.
  • A good manager pitches in and helps, not only critiques and observes. As nurses, we need managers like anybody else. What we don’t need, however, are managers who know how to tell us what we should change or what we’re doing wrong without working alongside us, at least some of the time, to actually do those things. A good manager not only knows how to meet regulatory requirements and ensure proper staffing, he or she will pick up a patient, do an admission, or address specific patient and family member needs too. When managers (even if they’re former nurses) move “off the floor,” it’s all too easy for them to forget how hectic and demanding being a staff nurse can be. As nurses we don’t have the luxury of retreating to an office; managers who understand and respect the non-stop effort nursing requires are the ones most likely to gain the admiration, thanks and respect of other nurses.
  • When I’m “sitting down” I’m probably charting. When patients, physicians, techs, or anybody else sees a nurse sitting down, he or she should keep in mind that the nurse is most likely not just “hanging out.” Most of the time, when nurses are sitting they’re attempting to catch up on the mountain of charting, forms, progress notes, and the like that has become the norm in contemporary healthcare environments. This “sitting” therefore isn’t “resting”; it’s a vital and necessary part of what nurses do, and it doesn’t mean that a nurse can or should be interrupted at will.
  • Forms and charting take nurses away from their patients. While documentation is an essential nursing task, administrators, managers, and regulatory agencies should remember that the more charting a nurse must complete, the less time is available to spend with patients. This matters because observation is a vital component of assessment, and a nurse who spends less time with his or her patients is less likely to notice and respond to clinical changes in a timely manner. A balance must be found between charting and direct patient care, and every effort should be made to ensure that charting requirements are clear, concise and avoid duplication.
  • “Please” and “thank you” go a long way. Being sick is stressful, and nurses understand that; no one likes being in a hospital, and for some patients and their families the experience is truly distressing. However, this isn’t a license for patients to treat nurses disrespectfully, or to forget common courtesy. Patients who remember to thank their nurses for the care they provide earn nurses’ gratitude, and make their nurses more able and more willing to watch out for their safety, wellbeing, and best interests. In challenging environments, sometimes it’s the small gestures, and the good will those gestures display, that can make all the difference.