Amidst the cacauphony of I.V. alarms, bed alarms, chair alarms, call bells, overhead pages for code blue, code purple, stroke alert, ringing phones and the chatter of nurses, nurse’s aids, doctors, therapists and social workers, a nephrologist walks up behind me at the nurse’s station where I’m trying to get a handle on my patients’ (all 6 of them) history, medications, lab results and scheduled tests for the day as well as doing my required log-on charting. (Deep breath… that was a long sentence and that’s usually how I feel about 5 minutes into my shift at work. Deep breath Sheila, deep breath).
The nephrologist asks a question aimed into the general vacinity of the nurse cluster.
“Who’s the nurse for room 22?”
Her question is nearly drowned out by the noise, but since I’m inches from her I stop what I’m doing, look at the nurse assignment in my hand, look up at the doctor and tell her the name of the nurse. No one knows where 22’s nurse is, so I call her on vocera. She answers. She’s in a patient’s room doing a dressing change, can I take a message, she asks. I turn to the nephrologist, who heard the radio conversation, and she says, “That’s fine, just tell her I started her patient on lasix and ordered some labs for the morning. Her blood pressure is ok, but she is very edematous. Please be sure to get an accurate weight on the chart.” And then she grabs her bag, and swiftly walks away, white coat flapping at her pace.
This little vignette, which took me a few minutes to write occurs non-stop for 12 hours on most hospital units. The fast-paced, noisy, environment that presents demands from signs, alarms, questions, comments, phone calls and call bells are all aimed at one person: the nurse.
I always say nurses are the filter for everything that reaches the patient in the hospital. And whatever the patient wants to reach in the hosptial, has to also go through the nurse. The fact that nurse’s are interrupted every 55 seconds by issues that require their attention, even if only for the time it takes to delegate that interruption to someone else, is nevertheless problematic where nurses are pushed to fetch high patient satisfaction scores.
I’ve been a nurse for almost 18 years and over the years the increasing demand to bring in these high patient satisfaction scores has largely been directed, you guessed it, at nurses. The reason is because the nurse is the filter. And there’s nothing wrong with being the filter. Nor is there anything wrong with wanting a patient to be satisfied with their experience at a hospital. But I take issue with the goal being patient satisfaction and not patient safety.
When nurse’s are pressured to be sure they deliver thorough assessments of their patients, detailed, accurate charting, and be the filter through which all things in the hosptial go to reach a patient, with the goal being a “happy costumer” and not a well-informed, well-cared for, safe patient, nursing becomes a juggling act with a fake clown smile. And it shouldn’t be.
Without fail, every shift I work I hear complaints from my patients, not about the poor assessment or education their nurse gave them. Not about the lack of kindness. But about the missing mayo on their lunch tray. That it’s noon and no one pulled the shades up. That they pushed their button 3 minutes ago and no one came to pick up their dinner tray. There’s an attitude of entitlement amongst many of the patients I work with and in part I think it’s due to a lack of understanding about what nurse’s do and what the hosptial and healthcare system is for. I think there’s a misconception perpetuated by hosptial advertisements that make people think when they go to the hospital they’re going to a 5 star resort. But it’s a hosptial, where people are really, really sick! And people, not robots, are taking care all those sick people.
Deep breath Sheila, deep breath.
I am a Christian. I believe deeply that loving my neighbor well, including my patients at work, is evidence that Christ is real and lives in me. I believe serving others opens the door for testimony of the good news of Christ. I’m all about loving people well. But catering to people’s desire to be pampered should in no way be part of what people expect when they seek healthcare or go to a hospital. There’s a distinct difference between love and pampering.
There’s a healthcare crisis in America. We are getting older, we are obese, have diabetes and are chronically ill. According to the CDC 1 in 4 adults in the U.S. has two or more chronic diseases. Heart disease, cancer, stroke, diabetes, chronic lung disease, alzhiemers, and chronic kidney disease are what many of us in the hospital have two or more of. And many of these are preventable. But there’s an attitude I’ve been sensing over the past couple years among my patients that concerns me. There’s an expectation to be pampered by the healthcare system and a lack of ownership for our choices. There’s a lack of willingness to learn or change. And there’s a lot of pressure on nurses to make us happy.
As a mom, I feel like this is antithetical to what it means to care for another person in love. Love does not rejoice in evil. It does not coddle. It does not pamper. It does not tell you what you want to hear when you have diabetes, heart disease, an infection and want the nurse to make you happy by bringing you extra ice cream.
I am not saying we should be rude nurse crachets to our patients. I’m saying we need to enter the healthcare system as patients being our own best advocates. We need to want to make changes in our lives so that we can be healthier. We need to want to know what medications we’re taking and ask questions. We need to learn about our diseases and how best to control them.
So in summary, as a PSA, from a nurse who very much wants you to be happy, in the long run, and healthy as you can be, please take ownership of your health. And if you enter the hospital, please go there to get better and get home. Don’t go there to get pampered.
*P.S. This post is not talking to people who can’t even access healthcare. That’s a whole other PSA aimed at Christian doctors and nurses and people in positions of power and it goes something like this: Taking basic care of our neighbor’s human body is the right and dignified thing to do. Stay tuned…
Sheila Dougal 
Great points, Sheila! The lack of desire to change our eating and exercise habits so that we can be well is pervasive and sad. And the pressure on the nurses at the hospital is unrelenting taking care of demanding patients! As a populace, we Americans needs to step up and pursue good health as our best way to help solve the healthcare crisis. I’m speaking as a person with a chronic illness, an autoimmune disease. Over the past five years, my focus on good diet, exercise, and actually doing my assigned physical therapy is gradually bringing improvement. All the health care professionals I interact with express your frustration with people who won’t do the things that will make them healthy. I hope people he’d your public service announcement!