What would *you* not tell your patients?
Tuesday, April 19, 2011
Last minute request for the Minions:
I have an interview tomorrow morning with a very nice person who's writing an article for Reader's Digest that's to be called "50 Things Your Nurse Won't Tell You." It's in the same vein as the ones she's written about what airline pilots and waiters won't tell you.
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34 comments:
ummmm, not much... i have told people outright (and deservingly and in context) that they are fat, made stoopid choices, lazy, to STFU, that they have a weird skin tag, have a hard to find urethra... it's a long list, i could go on and on....
i've even told them a diagnosis when the doc's have been too busy (and with permission).
i probably wouldn't tell someone that they made a bad decision bringing a child in to an Emerg for something i see as minor, teaching instead! (even though my inside voice CANNOT believe their lack of common sense!).
i think it's the nurses job to lay it all out there... people don't hear what they aren't ready to hear. it's not our job to censor information about their health.
oh, i thought of one! i wouldn't tell them that i'm not going to eat the home made cookies from mrs. VRE.... thoughtful! but ewww!
I know getting mashed potatoes for dinner is important to you, but that alarm you hear is my other patient's ventilator going off. Yes, that is more important.
When you ask me, "Have you ever done this before?" I'm not ever going to say "no."
Sometimes, I really don't want to hear about your bowel patterns.
I do not believe that your pain is 10/10 if you are happily texting and laughing with your friends until the second you spot me walk into your room.
I don't wear personal protective equipment because I think it's fashionable. And yes, you should wear it too.
You really have no idea how much work I actually do. There's much more to my job than getting you ice chips and putting you on a bedpan. I went to school for a long time for this, and telling me I'm stupid really isn't going to get you anywhere.
A simple thank you can really make my day.
Nurses really run the show...the doctors may never even walk in your room.
This is a hospital, not a hotel...I'm sorry the food isn't the best, and no, your boyfriend can't sleep in the room with you.
No no, it's really not a problem that I was literally in your room three minutes ago and NOW you decide to push the call bell because you have to pee.
Hmmm,
What would I not tell?
I don't always share feelings like
"wow, that's a big wound!" or "that pus really smells gross!"
because that is just not helpful.
Probably the biggest not tell is that many of us would tattoo "DNR" on our chests after participating in some awful fuitile resusitation attempts.
I'd never tell a patient that I was frustraited with their behavior. I would tell them if their behavior wasn't helping them, and how.
How lame they/their family is/are...
The last patient in this room had MRSA and C-diff.. oh, and they died!
I don't like your doctor. He is a jerk to the staff.
ya can't really tell them that their particular doc was the last in his/her class in med school, no matter how wonderful the bedside manner! and ya can't tell them they have an ugly baby or kid even if their offspring is homely!
OMG. You're seeing *that* doctor? Do you have a death wish?
-RNmon
Whether they live in urban, suburban, or rural areas, that *IT'S OKAY* nowadays for (young or old) patients to "look things up" online, particularly on reputable medical websites, about their signs/symptoms/conditions............ i.e., who actually hasn't-done and/or doesn't-do it, (as you yourself have done, Jo, about your polymorphous adenocarcinoma of your palate)? When patients then subsequently have normal, reasonable questions, they should NOT BE AFRAID to let----(not only their understanding nurse but also)----their G.P.; specialist; or other healthcare provider, know that they've "been doing" some online medical research.
If their G.P.; specialist; or other healthcare provider is sufficiently *SECURE* in himself/herself, this really shouldn't be a problem. If not, well, it might be time for a patient to rethink continuing their care with another healthcare provider who can............ *deal with it*............ without demeaning his/her patients FOR doing online medical research about their signs/symptoms/conditions. 'Just a thought, you know.
I won't tell someone if any of their providers are idiots. In fact, I always go out of my way to say something positive about the doctor/nurse/therapist/whatever, especially if they seem to be having misgivings. I find something positive to say.
(However, at the same time, I will acknowledge it if the patient doesn't seem to be happy with whatever the issue is, and (if indicated/feasible/relevant), that they have the right to change providers, and that person X might be a better "fit.")
1) If you push that call button one.more.time. to ask what time the doctor's coming in, I'm going to come down there, close the door, and give you some pillow therapy.
2) No, you didn't break your leg because you're unlucky, or because God hates you, or because the fates are keeping you from doing whatever you think is your destiny. You broke your leg because you thought you could skateboard off the roof and land on your feet like they do in the movies.
3) I have to make you drink this entire gallon of GoLytely because the guy doing your 'scope' likes to torture his patients. Why do you think I'M not gonna get it done?
4) I automatically multiply the number of drinks, hits, tokes etc. you admit to having taken by three or more.
5) I am not doing this to you because I like it. I'm doing it because your doctor ordered it---the fact that you're an asshole doesn't figure into it.
I have nothing constructive to add, but I think it's way cool you're being interviewed!!!
Probably too late for the interview now, but...
Saying things like "please", "thank you", and "I'm sorry to bother you, but..." will get you better treatment and your light will be answered first/faster. Being a demanding, threatening, condescending asshole will not. It will, in fact, have quite the opposite effect!
"This is not a hotel." God, how I want to say that.
I'm not a nurse, but a close friend is. From her lips:
"If you aggravate me enough, I will give you your lasix at 10 pm, right before bedtime"
Your Doc is known as "The Assassin"
Nurses wil probably NOT tell you that it's OK to stay all night in the ICU with your grandfather who just had his hip repaired...but if you ask intelligent questions, sit quietly with him (and do NOT ask for anything for yourself), help out by holding his hands and orienting him, and he is stable, they probably won't ask you to leave, either.
(from an RN who drove 9 1/2 hrs. to do just that...and bent the rules for other families IF they met all of the above criteria)
Something I do tell my patients, but most nurses and doctors won't tell you: You are the boss of you and have the right to refuse anything you don't want.
I dont always tell them the doctor just finished med school 2 seconds ago.
If your going to refuse treatment stay your ass at home.
I am not a waitress or your damn secretary.
To all the families who don't want to take elderly parents home people die in hospitals, old people get confused at night and fall, they sometimes get the wrong medication and they get drug resistant bacterial infections.
Patients need to rest. Don't bring
your sick kids to the hospital all day or the 12 loud family memebers
"I may not decide whether or not you need an injection, but I do decide the gauge of the needle involved..."
Oh all the comments and then some. Nurses just rock the world.
I used to tell my patients they were the consumer in the health care business and if they didn't like what they were buying (doctor's service) they could go and find another.
Good luck with your interview.
What wouldn't I tell them? Well, if I were annoyed...
"Don't order the meatloaf"
That operation usually fails and you'll be back again for a revision..
That the choice of your doctor says a lot about you...
"If you are supposed to lose weight and you haven't, taking off all your jewelry before stepping on the scale won't help."
I will never tell my patients, "we are understaffed"
not that I don't want to, mind you...
I would love to say to patients not to bad mouth other providers & expect me to join in. And being aggro toward me doesn't make me want to give you better careriathor
I will do my absolute human best for you, but the ultimate responsibility for your health rests with *you*.
I'm here to save your ass, not kiss it.
That the her husbands girlfriend just left then returned as her best friend!!!! Saw it!
oh many things come to mind ive been a nurse for almost two years now and work on an oncology unit/with medsurg overflow...your doctors an asshole who will kill you most likely, no mashed potatoes through a peg tube is a bad idea...when you decide to self medicate yourself on my watch through your picc line you forfeit your rights so yes I AM GOING THROUGH YOUR PURSE (bitch). lol love your blog its great I routinely put your blogs on our bathroom walls...we all loved the good ol bitch session!
Oh my gosh, I second everything Susan said, and anon 5:19/5:47.
Somethings I'd like to add...
-Use your call light. It's really annoying to staff for you or your family member to come out into the hall and grab any random staff member for something non-urgent. More often than not, we're actually on our way to help someone who actually *does* need something important.
-Don't distract me while I'm preparing to pass meds. It could be your mother/father/spouse/you I'm preparing to medicate, and distractions lead to med errors. Med errors can kill people.
-If you know there's a list of things you're going to need, do us both a favor and tell me everything you need at one time. I don't have time to be running back and forth from your room 30,000 times.
-I don't eat food you bring me, unless it's store bought candy still in the wrapper.
-Don't touch my ungloved skin/scrubs. Especially after I've just helped you to or from the bathroom.
-As important as it is for me to wash my hands, it's important for you too!
-I care about you, but more likely than not, I have several other patients, some of whom are probably significantly more sick than you. Please keep this in mind.
-If your family member stays the night, make sure they either 1) help with your multiple trips back and forth from the bathroom or 2) make sure their cot is clear out of our way.
And I reiterate "This is not a hotel!"... I'm also not a waitress and do not enjoy multiple coffee/snack runs.
I would never tell a patient I think they are being a big baby or a whiner, but I always tell a patient when I think they are courageous
Ummmmmmmmmmm, maybe because I have been an ICU and ER nurse forever that there does not seem to be much I will not tell a patient. I will not tell them their doctor is an idiot. While working in triage - I cheerfully greet the patients, assess them, chart on them, and send them to the next phase - I do not tell them they are not having an emergency. I have realized that although I know it is not an emergency - does not mean that they do not think it is an emergency. But I do offer them education, when they are ready for it, that in the future they may save themselves hours of wait time if they do XXXXX or XXXXX or XXXXX to prevent having to come to the ER.
And as a NP when someone is being an ass I am always tempted to order bilateral ABGs for comparison!
I agree with just about ALL of the comments above! ESPECIALLY the one about sitting with your elderly confused grandparent s/p surgery.
If you are going to constantly fuss over every little noise, snort, fluff that grandpa makes by BOTHERING me to tell me that something is wrong with your dear grandma/pa--then OUT the door you go, visiting hours are over at 8pm!
If you are going to sit quietly, help keep grandpa/ma in bed, assist to bathroom and NOT bother me, then you are welcome to stay.
More times than not, families are BIGGER PITA's than their loved one the patient!!
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