When I graduated from nursing school, I had a shiny vision of what my role in the healthcare field would look like. I spent four years memorizing medication reactions, practicing clinical skills, and studying to be the best nurse that I could be. I passed my boards with flying colors, and I landed a sought-after position as a new grad in a busy emergency department. I felt prepared and ready to make a difference in the lives of my patients.
I didn’t go into nursing for glamour, money, peace, or quiet. Despite all of the ethical, emotional, and physical issues that come with being a nurse, I have the opportunity to make someone’s worst day a bit brighter, and those moments make what I do worth it. As a nurse, I have the ability to hold someone’s hand when they receive a terminal prognosis, to make a child laugh with some horrible dance moves fueled by the Moana soundtrack, to hug family members after we get a pulse back, and to watch stroke symptoms reverse after I give a life-saving medicine. As a nurse, I am also verbally assaulted, physically abused, overworked, and underpaid. I’ve accepted these facts to be the payoff for functioning on the front lines of a patient-centered workplace.
I start each shift smiling and optimistic, but it’s rare that my hope endures for a full 12-hour shift. I spend my days running around to ensure that each patient has the best experience, to anticipate problems before they arise, to address issues as they unravel, to appropriately triage patients, and to save lives. In my pursuit, I am often met with rudeness, condescending comments, and disappointment from patients that I hope is due to miscommunication and unrealistic expectations of the systems that the hospital has in place. I wish you all of the health in the world and hope to never have to care for you at the hospital, but if you find yourself as a patient, try to keep these things in mind to make the most of your experience:
Understand the triage process
Despite popular belief, showing up to an emergency department is not a “first come, first serve” process. The primary goal of triage is to quickly obtain enough information to identify the patient in the waiting room that physically cannot wait to be seen by a doctor. It’s also important to keep in mind that the sickest person might not appear to be the sickest by the untrained eye. There are a plethora of factors that can make a person “high-risk” such as having a previously existing medical condition, unstable vital signs, or a certain presentation of symptoms. Please understand that we are doing our best to efficiently decide who needs to get to hospital resources most quickly. It’s a terrifying responsibility, and as nurses, it is not something we take lightly! Keep this in mind when you wonder why “that person came in after me and is being called back first.”
Acquaint yourself with how to properly use the call light
I have very conflicting feelings about call lights. When used properly, I believe that they can be a great tool for a patient to reach me. When overused or used improperly, they quickly become the bane of my existence. Here are great examples of when to use your call light: when you don’t know what’s going on during your visit and would like an update, when you have to use the restroom and need assistance walking, or when you have a change in your condition that you want to make the medical team aware of. I respond to all call lights as soon as I physically can, even when I’m with another patient, due to the fear that my patient is literally dying. Call light fatigue sets in for nurses when our phones are ringing, we leave a task with a patient that we’re concerned about, and we run to the alarming call light to find that a patient wants a second turkey sandwich. As with all technology, use it, don’t abuse it!
Keep your shoes on
It seems logical enough, but you’d be surprised at how many patients walk the hospital halls with bare feet. Out of all of the bodily fluids, trauma, and broken bones that I see in the emergency department, nothing makes me cringe more than watching someone shuffle barefoot in the hallway. Not only is it a safety concern to not wear non-skid socks or shoes while walking, but it’s downright gross. Sure, that floor looks clean because our environmental services representatives do their best to scrub and wax away the germs of yesterday, but I’ve seen enough blood, vomit, stool, and urine on hospital floors to know that my work shoes will never leave the hospital. Additionally, I don’t want to picture your skin cells getting trapped in the treads of my sneakers.
Put your phone away
If you come to a hospital to seek care, it seems intuitive that you would give your healthcare team your full attention. It always baffles me that in the small amount of time we have together to get patients back to their usual state of wellness, we are met by people who are glued to their phones and half-listening to the questions that we’re asking. I fully acknowledge that if you’re in the hospital, you have to update your friends and family on your condition, but there is plenty of downtime in a medical visit to do so. If you’re trying to communicate how you’re feeling to your medical team, that round of Candy Crush can wait.
Remember that the hospital is not a hotel
At the hospital, there are plenty of things that you can ask for to make your experience more comfortable. We offer warm blankets, pillows, socks, sleep masks, dimmed lights, snacks (if you’re cleared to eat), and an endless supply of hospital ice chips. I’ll go above and beyond to make you feel right at home, but please remember to keep your expectations reasonable. Kindly refrain from complaining about our selection of food, the softness of our blankets, the sizing of your gown, or how fluorescent the lights are. As a hospital, we only have so much money, and safety, infection control, and clinical-related resources take priority over comfort. We do our best to make it work.
Refrain from calling your nurse “nurse”
As a nurse, there’s nothing more irritating than hearing a patient yell “NURSE!” to get my attention. Don’t get me wrong, I worked tirelessly to achieve the R.N. credentials after my name, and I’m proud of what I do. But just as it’s strange for a grown adult to call a teacher “teacher,” being called nurse simply sounds weird and wrong. Get to know my name, show me some respect, and let’s be friends!
Use the pain scale appropriately
In medicine, we attempt to objectify the subjective experience of pain so that we can determine the severity of it, explore if it aligns with the clinical presentation of an illness, and track if our interventions help it to improve. Typically, hospitals use a scale of zero to 10 to monitor pain levels with zero being no pain and 10 being “the worst pain you could possibly imagine.” Everyone’s “three” is different based on their previous pain experiences, and your 10 may be quite different than my 10. However, if you self-report 10/10 pain while texting, chomping on Cheetos, and sippin’ on some Mountain Dew to get a certain type of attention, it makes it difficult for me to properly assess you. Saying that your pain is a “four” does not mean that you won’t get pain medicine. It just helps us to accurately decide what diagnostic testing we need to obtain, if our treatments make you better, or if your condition is declining during your visit.
Understand what NPO means
NPO is the term we use in the hospital to signify that someone cannot eat or drink until further notice. NPO quite literally stands for nil per os in Latin which translates to “nothing by mouth.” It’s always safe to treat yourself as NPO until you get clearance from your nurse or doctor based on your plan of care. In the mind of the medical team, every case could potentially be surgical until proven otherwise. If your abdominal pain proves to be due to appendicitis and you need an emergency appendectomy, we don’t want to delay a surgical procedure because you were snacking on some Chipotle while waiting for your ultrasound results. As with any surgery, you should avoid food or drink for a certain number of hours beforehand to reduce the risk of aspirating stomach contents into your lungs during anesthesia or sedation. We’re not trying to be mean; we’re trying to keep you safe and to get you to the operating room as soon as possible if you need it. We promise we won’t let you starve. If we are concerned about your fluid or glucose status, we’ll pop an IV in and start some fluids.
Yes, I have done this before
As a nurse, I have been trained to exhaustion on placing IVs, performing EKGs, administering medications, and bringing the highest level of care to your bedside. Despite fully explaining my moves before I make them, I am constantly being questioned on my abilities as a nurse. If a family member distrustfully hovers over me while I place a patient’s IV or a patient requests someone else to perform the task before I’ve even attempted it, it will put me on edge. I’ve placed five IVs a day for the past three years, and I’m pretty great at it. If I’m not comfortable with something or it’s my first time performing a task, I’ll be transparent, I’ll give you options, and I’ll ask for help.
Don’t assume that I’m not smart enough to be a doctor
I think that patients and their families mean well when they question “you’re so smart, why didn’t go to school to be a doctor?” Let’s get this straight: nursing wasn’t a backup choice. I had the grades and the drive to get into medical school, but being a doctor simply did not interest me. When I was deciding what career I wanted to develop in, I was attracted to the fact that nurses have the most face-to-face time with patients and that the career is so versatile. I chose the nursing profession based on my attributes and goals as a person and as a professional. If I didn’t love it, I wouldn’t be here.
Remember that I only have two hands
At any given time, I am juggling multiple tasks at once. I typically have three to four patient rooms at a time, and my mind is constantly sorting through the chaos to determine what needs to be done now and what can wait. I work tirelessly to multitask so that I can approach a patient’s care in the most efficient way I can. That being said, I am only one person, and I am human. There are plenty of times where patients take the rather interesting approach of barking out tasks more quickly than I can complete them, and I have to remind them that I only have two hands. If I had six hands, it would be weird as hell, but I would more clearly understand why some people have such strong confidence in my ability to perform six tasks at once. I promise you, as evidenced by the sweat beads on my forehead, my two hands and I are moving as quickly as we can. Please be patient.
As a nurse, I am on the front lines of patient care, and this is the part of nursing that attracted me to the field. I love that I have the ability to ease a patient’s worries, meet their needs, and develop a connection that will help make someone’s rough day better. At the same time, being on the front lines makes me a convenient punching bag when things aren’t going well during a patient encounter. I have always been one to own up to my mistakes and will take full accountability for my actions, but it is difficult to accept condescending language and rudeness for aspects of a patient’s visit that are out of my control. I put my heart and soul into making a patient’s experience as great as possible, so I take it personally when a patient verbally abuses me if they don’t get their way. Please remember that I am a human, and that I’m doing my best. A smile and a “thank you” go a long way.