1. They're on a Bad Streak
Nurses are skilled professionals. They spend time perfecting their art of nursing, which includes IV sticks, lab draws, catheter insertions, central line care, wound packing and dressings, and the list goes on.
However, nurses are human. We have good and bad days, streaks of perfection and, well, streaks of failure. Some nurses seem to possess superpowers, those who seem close to godliness in the skillful way they find veins in the most edematous of patients and place a Foley catheter in the darkest and most confusing recesses of the human body. These are the rarest of nurses, and they make the rest of us feel quite inept.
So, if you ask a nurse, "how good are you at this?" or "how many times have you done this before?" the answers may vary, but we will always sound confident because pessimism does not work well in our occupation. If we're on a bad streak (specifically with IV insertion), we're hoping you'll be the lucky star who turns it around and sends us back to our streak of perfection.
Keep in mind that you can always request another nurse, someone more specialized, or a pediatric nurse (as they seem to hold the IV-insertion superpower). But whatever you do, please don't doubt our motive: We strive to be perfect at what we do, every time.
2. They Know Preliminary Test Results
Yes, that's right, we know the answer to your diagnostic test, but we're not always the right person to tell you. It has to do with hospital policy and politics. We often know results first, since nurses act as the messenger between pathologists, radiologists, and primary providers. Some nurses leave the results for the patient's healthcare provider (physician, PA, or NP) to deliver, while others use their own judgment to decide what they can safely share with their patients without digging a hole they can't get out of.
Your best bet? Wait for your healthcare provider to ask the important questions. It's hard to wait, but you can use that time to make a list of all the things you'd like to ask. That way, your mind won't come up blank when they finally show up, and you'll save your nurse a moral dilemma.
3. The Patient Next Door Is Dying
Nurses always seem busy, rushed, and quick to move on to the next patient, barely leaving time to make conversation or inquire more about how you're feeling today. That is because we are busy, extremely busy trying to stay focused, avoid mistakes, and above all, keep our patients safe. We're busy trying to keep confused patients in their chairs, hurting patients pain-free, post-op patients walking, coughing, and breathing, and dying patients comfortable.
Of all these people, the dying patients and their families require the most care, comfort, compassion, and attention. On a good day, nurses are typically given a lighter load when providing care to those destined for their celestial transfer, but even then, it's difficult to equally distribute attention to every patient. Most people don't come to the hospital to die, nor do they want to know if someone is dying, especially if it's their "neighbor." We're good at keeping secrets: Even if it wasn't mandated by federal law, we always strive to keep a straight face and focus entirely on the patient at hand. But it's hard to deny it when patients notice the somber faces of fellow visitors and the sound of tears next door.
So if you're ever in this position, please give your nurses a little extra patience that day because compassionate care is a difficult job and a little kindness goes a long way.
4. They Had to Google It
So, you're admitted with a unique and rare disease. It may be a condition that your nurses are not familiar with. Whenever we don't understand a disease or know the answer to your question, you can be sure that we are actively searching for the answer online. Let's just hope that your nurse uses a legitimate medical evidence-based resource such as UpToDate rather than Wikipedia.
Additionally, if you or your family member want to look up information, become an amateur diagnostician, or maybe just read more about your condition, please use legitimate medical websites and not Wikipedia or someone's terrifying blog account. It's nice to know things, but inadequate, biased, or fallacious websites can be a dangerous thing.
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5. They Don't Remember Your Name
Due to the Health Insurance Portability & Accountability Act (Title II), we keep patient information top-secret. To prevent revealing information to other patients and visitors in the hallways and shared rooms, you may overhear us calling you by your room number.
Many times it will be, "Will you please get 3B some ice," or "6C would like to shower now" to our fellow aides, but it's not that we don't care enough to remember your names. We truly do, especially if we have the joy of keeping you for our 3-day/36-hour stretch of the week. (This isn't sarcastic: We are genuinely excited if we can provide continuity of care and help you improve, especially if we can exchange end-of-shift reports with the same nurse). Sometimes, though, it's just easier and more efficient to call you by your room name.
But truth be told, there may be moments when your name eludes us. Believe me, I'm excellent at remembering names and even better at faces, but barely two hours into a morning shift, downing hospital-brewed Sanka that pretends to be coffee, and remembering I have six patients to assess, look up labs for, prep for tests, and give meds to by 10 a.m., my mind may come up with a blank when your family member calls, wondering how you're doing that morning. Don't worry, though, I'll have your name down by 7 p.m.... unless, of course, I've overused your name that day, and that's not always a good thing.
6. Being "Discharged" Does NOT Mean You Can Go Home Now
Okay, so this is something we probably want you to know.
When a physician tells you that you're going home in the morning, it doesn't always mean before 11 a.m. In the hospital world, there are a lot of "ifs" and "buts" to determine exactly when you will be discharged.
First: Why are you here? If you're in the hospital for any exacerbation of a chronic disease (heart failure, COPD, or uncontrolled diabetes, for example), you most likely require education before being sent home. New medications such as Coumadin or Lovenox also require extra education. Don't be surprised if this delays your discharge.
Second: Who said you could go home? Was it your specialist? If so, this simply means that they've discharged you from their standpoint. The rest of the process of discharge then falls to the remaining specialists, and if none remain, it is left to the primary provider (typically a Hospitalist or Internal Medicine group). If you are admitted solely under a specialist (for example, you're admitted under an orthopedic surgeon for a knee replacement), then it's safe to say you are truly discharged.
Third: "My doc says I'm discharged, so I'll go ahead and take my IV out in order to save my nurse some time, right?" The answer is NO! Please ask your nurse first, and please don't take it out yourself. Many things can delay a discharge: laboratory tests, required repeat labs that were lost in the tube system or had erroneous results, a surprise fever, a case of syncope (passing out), or (god forbid) a serious event such as a heart arrhythmia or cardiac/respiratory arrest. These are some of the reasons why you should not take out that IV; your nurse will thank you.
Fourth: Above all, be patient. If you've asked your nurse when you will be discharged more than four times in a single hour, you've most likely delayed your discharge even further. Every trek back into a patient's room to reassure them that they will be discharged "soon" takes time away from passing out meds, toileting patients, and sending them for tests so that the nurse can finally sit down and write out your discharge papers. If you're constantly asking when, we'll never be able to finish our tasks so we can work on yours.
7. They Don't Know Why You're on This Medication
One thing you should know about are your meds and why you're taking them. The nurse isn't customarily in charge of explaining this to you.
Nurses are smart. We know hundreds of diseases and diagnoses, the medications that treat them, and how they work to treat each condition. However, many meds have multiple indications and various uses. For example, let's say we know you have high blood pressure (hypertension), and you're scheduled to receive three meds. These three meds can be used for hypertension but have very different mechanisms of action. We can find out why you're taking them, but reviewing a patient's history is kind of like reading a recorded version of the game "telephone." Depending on who entered the information, who reviewed it, and assuming they haven't missed anything important, we may safely infer that you have fairly resistant hypertension, and that's why you're taking these meds, but it's much better and easier if you take some responsibility for keeping track of what your doctors are prescribing and why.
On the other hand, clear communication is key when you're in the hospital, and we know that sometimes you need to ask more than once to get things straight. Never be afraid to ask the question, "Why?" But then make sure you listen to and understand the answer!
8. They Think You Should Be in the Intensive Care Unit
Nursing is an art, and it takes experience to build skills like developing a gut reaction. Sometimes, you can just look at a patient and know that they should be in the intensive care unit. New nurses may not get it right away, but experienced nurses (as well as other medical staff) can sense an emergency from just a few feet away.
Many of us have various rituals to ward off these bad spirits, which may include plugging in the code cart just a little closer to your room or withholding lunch just a little bit longer to see how you'll do. If your nurse or aide seems concerned about you (visiting you every ten minutes, constantly checking your vitals, and incessantly asking how you're feeling), just tell the truth. Stoicism doesn't work well in hospitals: not for pain relief, not for nausea, and especially not for "feeling the worst you've ever felt."
If you feel that something is just not right, tell us. Sometimes our patients get that ominous feeling before we do, but all it takes is a little initiative to get us to take a longer look into your trending vitals, labs, and recent tests to determine if we need to call your provider to take a second look.
9. When You Say You're Allergic to All Pain Meds Except Dilaudid...
We may roll our eyes. Just joking... okay, well, sort of.
"Pain is always what the patient says it is: Always." However, if your pain is truly a 10/10, then joking, laughing, texting, and answering your phone when the nurse is asking you serious questions is not the best way to appear sincere.
Withholding pain medications for a person in pain is against the rights of the patient, and nurses don't withhold pain medications when a person is in pain, but be honest. Even a little pain is cause for intervention, but it's not only the degree of pain you're experiencing but the sincerity with which you express it that will get you the compassionate care you deserve.
10. Get Out of the Hospital as Soon as Possible
Hospitals are gross, period. We strive as hard as we can to sterilize, clean, and disinfect the thousands of germs that are harbored in the recesses of your hospital bed, remote control, bathroom, and floors, but it's just not enough. And the longer you stay in the hospital, the greater risk you are of being infected with a nasty hospital super-bug.
Yes, there are horrible germs that cause everything from ventilator-associated pneumonia to MRSA and result in thousands of additional dollars in care. They may make you even sicker than you were in the first place. So if you're fine but think one more day of rest in a nice hospital with friendly staff and prepared meals is a good idea, think again. Get out as fast as you can.
That being said, you're always welcome to visit when you're well again. We always appreciate thanks from patients we've helped recover. You don't need to bring cookies or treats; just a simple card or visit will do to remind us why we keep doing what we do. The smiles of previous patients make the long hours, stressful shifts, and overtime worth it. We didn't choose this profession to be money-makers but rather to provide honest and compassionate care so that you can return to a normal, happy, and healthy life.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2012 Kelly Wagner
menamia on October 06, 2018:
I spent a week in ICU for a pericardial effusion that developed out of nowhere. Most people were wonderful, but then you always get the few people that are just legitimate idiots. I had two specific nurses that acted weird and did things i thought were weird. They always gave me meds pulled out of the package and a little medication cup. One evening before a shift change a male nurse ran in and handed me something he said was urgent I took for my blood pressure because he called Dr. on call and they said I needed to get my bp under control. The thing is my cardiologist was just there and we spoke about how the day before my BP was all over the place and he said I know you have told us if your BP drops too low you will be very weak. It took a few hours to get my pain meds changed but this nurse got a change in literally five minutes the monitor acted weird. I refused the meds and said I am not taking this and he looked at me and said it's your choice but the nurse before him who gave my family a hard time said I needed it. Fast forward and my husband and family said to me later that if I didn't refuse the meds they would have launched him in the hall because he had hero syndrome and acted weird. After he left I was asked about six times if I wanted my standard BP meds that I have been taking. I kept refusing and still couldn't get them to remove off my chart. A day later when I moved to a regular room I saw a younger chip on her shoulder nurse treat my roommate poorly. I didn't know her history just heard her crying and nurse said I can't keep coming in here and the poor lady had a reaction to antibiotics couldn't control her bowels and had to pee. My family got up 4-5 times to call nurses to help her and she was annoyed! Next morning she came in nasty grabbed my arm took BP and gave me the look of say something and I will be back! Poor old lady sat in urine from 2am to 8:30 am . She said I'm older but understand and have never been treated so poorly! Whom do we report this nonsense to without being the terrible patients? No-one should ever be made to feel scared of a nurse and their attitudes! There are too many absolutely wonderful ones out there and these idiots ruin it for others!
Adam Wilson Sherman on October 04, 2018:
I love, Kelsey Elizabeth Batson!?!
clif bond on February 04, 2018:
A pizza delivery to your nurses station will go along way toward making their day better.
Jason on September 05, 2017:
Just an article for begging for a pat on on the back. I never have had a truly horrible encounter with a nurse, na, ra, pa, np etc until recently. I understand their wanting to be loyal to one another and professionalism is secondary for some, but the bottom line is that they for the most part aren't special. Some are great at what they do do cause they are good or maybe just passionate. A great number of them are just terrible. Shortages of nurses and half ass educational opportunities abound. I don't think my mechanic should be placed in a new area of gratitude purely reserved for doing what he is trained and paid for
It's offside trap of wanting to know if there was no longer in service of on September 05, 2017:
The following document untitled document document copy of your help and advice and help you to the store is a good time and effort you put it back in the car wit me to do it in the OP is talking about now so I will
Buttercup101 on August 25, 2017:
The truth is, nurses are too under educated for their jobs. If you can't start an IV you have no business being a nurse. No one buys it when you blame the patient or their veins. It does no good to tell the nurse your health problem bc you will just have to repeat it to the doctor. I've told nurses of health problems only for them to look confused or have to be on google like they admit above. Anyone can get on google. Then I will talk to the doctor and they know exactly what I'm talking about.
What's really scary is nurse practitioners playing doctor unattended. They don't have the education bc they have not went to med school which is a completely different ball game. A nurse is a nurse and doctor is a doctor. They are no where near the same. It's sad how everything is turning into walmart healthcare. If I see a nurse practitioner and only getting half the care then I should only have to pay half the price.
I've learned if you have any health questions be sure to ask a doctor bc the nurse simply doesn't know. They will act like they do, but when you have health issues this usually proves harmful. Always double check anything a nurse tells you, bc you can't trust their opinion.
They always have a ton of work at the hospital, but they are usually delayed due to gossiping at the nurse's station. When you hit the button they act like it is a huge inconvenience. They are also the ones that increase hospital infection risk. A lot of times they will insist on a catheter even if you don't need one. This is simply bc they don't want to have to deal with taking you to the bathroom. Instead they would rather risk you getting a uti or kidney infection. This is also something they admit. They will blame it on being "under staffed."
Most of them are the rudest and absolutely hate their lives and jobs. I went to a nursing school graduation and they all admitted they have had no idea what they were doing, but couldn't wait to apply for jobs. Very scary. The thing is nurses should just be nurses only. They keep receiving more and more responsibility they that don't have the capacity to handle. They really should be required to have an extra year in nursing school and then an extra year of clinical. Not 6 weeks.
Bigwillystyle on June 06, 2017:
I had a nures to help me pee and she actually held my dick in her hand and helped me pee . was she supose to do that ?...... Dont have a problem with it just wondering if shes suppose to help out that much :)
Sasha on June 05, 2017:
Some of the dumbest people i know are nurses. It is a fact that stupid people often strive to become nurses because it is doesnt require brains, just hard work. It is probably the most financially rewarding job for a dumb person to take.
Joe on May 11, 2017:
#4 is a lie, the truth is patients get discharged all the time but the RNs don't want another patient after you leave so they BS the patient till the end of the shift
Danika on February 09, 2017:
As a nurse, we NEED to know why you are on certain meds. Even if it is as simple as advil, we need to know. That is part of our job.
WowWow on September 25, 2016:
Sisterwhocares: Your first question might be to the pharmacy that provides meds for the SNF. Occasionally there are shortages and back orders on certain meds. If that is not the case, then you might try to find out if the SNF is ordering the meds in a timely manner. Next, if the meds he needs are out of stock or back ordered, the SNF can ask the MD to order something else that is more readily available. Finally, if the availability is not as issue, then the SNF needs to tep up their game with ordering.
sisterwhocares on September 24, 2016:
Can someone explain to me why, for the third time in 10 days the skilled nursing facility has run out of meds for my brother? (he's only been there for 10 days!) He had his leg amputated in an accident three weeks ago. Somehow, his long-acting morphine keeps "running out". I am really disturbed by this trend. He is an inspiring patient, excelling at his physical therapy and has kept his sense of humor. He is friendly to his nurses and fellow patients. They just don't seem to care about making sure the patients meds are current (other patients have reported similar issues during conversations with them).
myocardialarrest on September 05, 2016:
Dear MDs: Hi! I'm a nurse, and I know & agree that you are smart & that you and I are both human. Thank you for being helpful and for having my back! That said, when it comes to pain and pain meds, I have a request. If/when you decide to decrease the dose or frequency of a patient's pain medication (perhaps for the patient's safety, or maybe to get them home and recovering more quickly, or maybe because they haven't had a BM for 10 days,), could you give me a heads up, or better yet, have a little talk with the patient? I ask because if a patient is asking for, and getting, dilaudid every 2 hours, they're definitely going to notice when I can no longer do so. And if they're unhappy about this, they're going to take it out on me & maybe even fill out one of those patient satisfaction cards & say mean things about how I didn't do enough to control their pain, which, then management will feel obligated to have a big talk with me, and on and on. . . But if we can set some expectations, things tend to go more smoothly.
And patients: if you tell me that your pain is not controlled, I will always always attempt to get you whatever the MD or the pain team determines is right and best. But I simply cannot give your pain medicine more frequently than I'm allowed to give it. Not if I want to keep my job. And if you are over-sedated, if your blood pressure and heart rate are unusually low for you, I will exercise my best judgment. This is not because I don't believe that you feel what you say you feel, this is a matter of safety. (I'm not in hospice, by the way, where the playing field is a little different.)
Great article, by the way!
Thelma Alberts from Germany on May 18, 2016:
Wow! This went viral. Thanks for sharing this to us. I would have never known. Thumbs up for this insider knowledge of being a nurse and for writing this well. Well done!
Sandi on May 04, 2016:
Nursing is not for wimps. It is not about making money, or having a God complex. Nursing is a group of professionals trying to give you back the highest quality of life we can, even if you treat your body poorly. I love being a nurse, but there are days I want to hang up my stethoscope and call it quits. We work all sorts of long hours, without breaks, miss so many events such as holidays, birthdays, weddings and on and on, so we can take care of you and your family. I not only got through nursing school, I have to continually educate myself to keep up with what I need to know to look after you well. Next Thanksgiving or Christmas, as you sit around having a meal and enjoying your day, think of all those dedicated professionals who are spending 12 hours of the very same day, missing all of it to look after the sick and dying. Nurses give up a lot to do what they do and all we want is to see you all walking out the door and back to to living your life. Like you, we just want a little patience and understanding.