Nursing, from the other side
This past Monday I had a celiac-disease-related procedure to check out how my insides are doing after three years of following a rigidly dedicated gluten-free diet.
I was nervous, but not as nervous as I was the first time. I took my little cab over to the hospital and let the nurses in the GI suite take care of me.
I learned several things from the experience about nursing care. I’ve been lucky enough in my life not to encounter too many nurses “from the other side.” The nurse who takes my vitals and gives me flu shots in primary care, yes. The nurses who taught me for 18 months, yes. Watching other nurses do the nurse thing around me? Every day.
But, it is so, so different to be laying in a bed, scared, and having NO idea what is going on at all times.
Taking the information I gleaned during my short procedural visit at Georgetown Hospital, I tried to be a better nurse this week.
1. Yup: IVs do hurt.
2. IVs hurt coming out, too. Nurses told me before that it doesn’t hurt when they’re removed, other than the old “tape-pulling-off-all-the-arm-hair” bit. False.
3. Blankets = heaven. When patients ask me for their 40th extra blanket, I’ve found myself confused before. Now I either pre-empt them with four extras to begin with or forgive the fifth request. You’re naked in a gown under a sheet!! I get it now.
4. I forget sometimes that although I (kinda) know the way things work in the ER, many of the patients do not. I know that I come in, then I do stuff to them (take their blood, hang fluids, take them to CT), and then the doctor sees them later. They don’t get that, and I had been neglecting to consistently explain it.
5. People have NO feeling of control when they’re in a hospital bed—even less in the emergency room because they’re in pain or something is wrong. Giving them a choice—”apple or cranberry juice?”—is sometimes enough to make people feel much better. Even the little warning of “hey, this is going to feel cold” is incredibly helpful. (The cardiac monitor leads are cold! Who knew?!)
6. Some patients relate to their nurses more than their doctors. (Just as some patients relate to the doctors way more than nurses.) Even though I had met my nurse Brandy just 18 minutes beforehand, when I was being hooked up to anesthesia, 100 monitors, oxygen, and forced to put a giant bite block in my mouth and turn over, the person I wanted near me was Brandy.
7. Huh: the blood pressure cuff DOES get really tight. All the people who I silently thought were crazy before…I take it back. That thing pumps up hard!
8. I felt slight anxiety about the procedure even knowing exactly the medications (and their side effects and half lives!), the type of procedure it was, what was going to happen, and what I would look like at all times (we do endoscopies in the ER, sometimes, and I’ve been in Brandy’s position before). I can only imagine what patients who do not speak “medical” must feel. It’s always worth speaking in plain English: better to offend someone by overexplaining something simple than to assume they know what you mean.
9. I still find it difficult to imagine being rude or disrespectful to any health care provider, but I’m not everyone. People act differently when they’re hurting, or scared, or if they feel out of control or lonely. I am always as empathetic as possible, and I do try to read each patient individually to determine what they want from me. (Although to be honest, I don’t always have time for that step.)
Do you want my hand to hold? You got it (even if you dig your nails into my hand during the procedure). Do you want me to “stop saying sorry, I know you don’t mean it”? (which was entirely false, because I always genuinely mean it.) Fine. I’ll stop. Want to tell me how to do my job? That’s OK, I’ll forgive you, I won’t snap back, and I’ll do it how I do it anyway. Want to sing to me? Cool! I’ll sing, too. (That last one was fun.)
Remembering that everyone is different is helpful. Remembering that EVERYONE (patients, family, nurses, doctors, pharmacists, techs) in the ER is stressed out is also helpful. But remembering that people are human and usually will apologize later for words they honestly don’t mean to say is the most beneficial in getting me through a rough night or day.
10. The five or six nurses who took care of me last Monday all made a difference in my comfort level and in my experience during the endoscopy. And I didn’t get to say one word to them about how great they were, other than a brief and groggy-anesthesia-faced “thank you.” It is my biggest hope that often I am making a difference to people in some small way, whether I know it or not.
Here’s one word about your nurse: Just like patients, nurses aren’t all roses and rainbows. People are often critical of nurses, people think they are “slow” (as I was called last week) or that they don’t mean it when they say “I’m sorry.” There is no nurse who enjoys hurting a patient, or seeing a person in pain. That is not the vocation we chose. I’m not happy about having to give you an IV. I hate that I have to move you into the hallway—I do. I’m not pumped about giving you the nasty-tasting medication, either, and I am truly sorry that you have to wait 10 hours to get a bed in the hospital proper. I certainly hate inserting a catheter or a nasogastric tube or one of the many other horrible things that could be ordered for you by an ER doc. Everything I do I do because I am trying to help. Always and forever, that is the bottom line: I am trying to help you get better. Forgive your nurses sometimes when they are having a rough day, when they disappear, when they just lost a patient in the room next door, or when they haven’t eaten in 10 hours and have the worst case of the hangries ever documented.
Because, as an adorable older gentleman reminded me last week, “Isn’t it just so nice when everyone gets along?”