I’ve thought a lot recently after work about what I wish I could tell my patients that they don’t know or show them things that they don’t see. I work in a HDU were each nurse looks after 2 patients. It doesn’t seem like a lot to most people considering ward nurses usually nurse around 6-8 patients on a good day and even more when they are short staffed, but our patients need a more intensive level of care, although not quite to the level of ITU patients.
I can have a patient in one room who needs IV antibiotics making up, has infusions keeping their blood pressure up and others stabilising their blood glucose level, running blood transfusions, needing high levels of oxygen, hourly blood pressure monitoring, having specialised lines put in their artery or getting central access so we can give them the stronger medications to stabilise their condition. In the next room I can have a patient who has just been admitted to the unit following major life saving surgery who needs assessing by the doctor, has drains and wound dressings that need seeing to and monitoring, they need to be observed for signs of bleeding, we need to start carrying out the post op instructions outlined in their notes at the same time as filling out admission paperwork, checking skin, catching up on medication, updating the patient, updating relatives, trying to keep the patient orientated after having a general anaesthetic and medications that can so easily lead them to being confused after such major surgery. The patient in room one does not know about the patient in room two. The relatives of both patients don’t know what is happening in the next room. And yet somehow we prioritise our time to make sure the most important tasks are carried out as quickly as possible. Nobody ever knows what happens in the other room. I can walk out of a room that was filled with sadness and stress, pause to put on my gloves and apron, smile and then walk into the other room and never let you realise what sort of day the patient next door is having.
Even on my busiest or most stressful days when I feel like giving up I can have a good cry or a staffroom moan, get it out of my system and get back to straight thinking and realise at the end of the day I love this job.
Something else that helps me keep going through the difficult days is my understanding of how it feels to be on the other side of the healthcare system. I get it, being on the receiving side is difficult, and in the most vulnerable times of your life you feel like nothing can be more important than a doctor coming to see you straight away, or the nurse being at your side 100% of the time to help you on the road to recovery.
I understand how it feels to be in both sets of shoes, and so I started putting together 2 lists of things I wish the other person knew. A list of things I wish as a nurse that my patient could understand, and a list that as a patient I hope that the nurse can understand. It originally was just for my eyes only, a way to get out what I was feeling after what feels like a rough patch. But then I wondered what other peoples’ thoughts would be on the lists, I know a lot of nurses and I know a lot of patients. I only know a few nurse patients. What do you wish the nurse knew when you were in hospital?
For my patients:
Waiting is not a terrible thing, waiting means there is time, your problem is not life threatening. It may feel like a major inconvenience but trust me, if your issue can’t wait we won’t make you wait.
If I ask if you mind if my student can carry out the task it is because I am confident they can do it, if I have any doubt I would let them observe me do it.
Nurses are people too, I have a life outside of work, a family, commitments, stresses and troubles. If I am working a holiday or a weekend or a night, I am probably missing my family or a party or delaying my own holiday plans so I can help you. It’s a 24 hour a day, 7 day a week, 365 (and a quarter!) days a year job.
I am always trying my best for you, the day I stop giving 100% to my patients is the day I will stop nursing..
I often get attached to my patients. Especially if they stay with us for more than the usual length of time.
I treat you as I would want my family to be treated, please treat me how you would want your family member treated if they were a nurse.
I may look young, but I have experienced a lot in life and work, I am definitely old enough to be a nurse. I don’t think HR would have let me have an interview if I wasn’t!
Sometimes we may have just finished a stretch of night shifts one morning and then come to work the next day for a long day shift.
There are so many times we come across patients or situations when we could probably do with some counselling afterwards, but once the bed space is cleaned theres usually the next patient already on their way and we have to be ready to carry on. Sometimes we get a debrief days or weeks later, but mostly we don’t have an allocated slot of time to try to process what we have witnessed, we are ready to face the next challenge that comes our way.
Don’t lie to me, it won’t help you or us in any way….and I’m also not stupid, a lot of the time I know the answer before I ask the question. And similarly I will probably add at least 10 to whatever number you tell me you smoke or drink in a week.
Paperwork is the worst part of my job. By the end of a shift I have signed my name so many times it looks like I’ve spelled it wrong. I can’t just complete a task and be done with it. We explain procedures to patients to ask for their permission to complete it so that they are involved and aware of their care, we carry out the task, write what we have done on a paper chart, then write it up on the computer in our daily writing, then fill out a form related to the task we have done and then finally at the end of our shift we verbally hand over what we did in the task.
Please, please, PLEASE do not “help” us by getting yourself off a bedpan, it usually makes matters worse for you and us! As I’ve already said I’ve seen a lot in the years I’ve been nursing. I forget what your bum looks like before I’ve even make it to the staffroom to eat my lunch.
And while we are on the topic, don’t ever put your tissues/wipes in the bed pan. They can’t go down the drain and they can’t go in the macerator….they have to be taken out somehow!
When you ask for medication that we don’t keep stocked in the locked drawer with your other medications at the bedside and I say I will go and get it, I don’t mean I will be back within 10 seconds. I will make sure somebody can cover my room so you are still safe and looked after, then I will go to every nurse on the ward asking for a specific set of keys to access the medication you are after, for some medications I also need to find an available nurse or student to be able to sign the medication out of the cupboard and then come back with me into the room to witness you taking the medication. Even worse is if it’s not prescribed, I have to find a doctor, explain the need and hopefully get something prescribed for you. Don’t wait until you have 10/10 pain or nausea before you ask if you can help it. If it gets to 4/10, tell me, I’ll offer you something and you will have it before you even get near a 6/10 if I can help it!
Please think before you act or react, we don’t do these things for the good of our health, we do them for the good of yours. And if you want to leave the hospital and not come back then tell me, it’s a much easier process to sign a form and leave happily (we usually even try to rush a prescription through so you can take meds home with you!) going out “for a smoke” or “for fresh air” and not returning within an appropriate amount of time (or ever) means I’m taken away from my other patient trying to find you and make sure you are ok, or calling police and filling out tonnes of paperwork if you can’t be found.. It takes lots of people lots of time to sort out that sort of problem.
I really do wish there was a magic wand I could wave to make you better and fix everything, just as much as you do.
I am your advocate, we are a team, trust me.
When you achieve goals it makes my day as much as it makes yours or your family’s.
Sometimes when we leave the room we cry. A lot of times we wait until we get into our car.
Don’t believe everything you see on Casualty or in films, it is nothing like that in real life.
Nursing is demanding. Some jobs are physically demanding. Some jobs are mentally demanding. Some jobs are emotionally demanding, Nursing is all three. And I do feel that pressure every single day.
I hate having to wake you up to check your obs even more than you hate being woken up. But you are ill, I wouldn’t be doing something if it wasn’t necessary to get you better.
If you want or need something then just ask me. Don’t wait until your relatives or visitors arrive and tell them you haven’t had or done something. I can’t help you if I don’t know. Even if I look busy, please tell me.
I wasn’t allowed to use wikipedia or google to get my degree, don’t use it to diagnose yourself.
Sometimes we lose sleep worrying about you, worrying if we did the best thing, worrying about what you still have to go through. I think about you after my shift is done. I want you to recover and do well. I care about you.
It really makes my day when you say thank you or show gratitude.
Everything within me screams to run away from danger in every circumstance and yet every time the emergency buzzer goes off I will always run to help.
You are not a bother, you do not need to apologise, you are a priority for me, I want to help and I am there to help, just sometimes I need you to wait a little while until I can give you my full attention.
It doesn’t matter how much I know about my health or hospitals etc. please explain things to me in a simple way. When I’m sick enough to be in hospital I don’t always follow what is happening.
No matter what you say Fragmin or Inhixa injections are not a “sharp scratch”, and they don’t “sting a little”, sometimes using the phrase “burns like hell” is a lot more appropriate.
If you wake me up in the middle of the night to check my obs or give me medication and I’m moody, I’m sorry, it’s nothing personal, I probably haven’t slept for nights before I even came in to hospital.
When I need help to wash or use the toilet etc I will feel even more vulnerable than I already did, reassurance and a kind word goes a long way in making me feel settled and less nervous.
I may be just one of many patients you see in a day or a week, but for me, I will remember your face, I will remember how you made me feel, I will remember you.
I don’t want to bother you for the simple things because I know you have so much to deal with already.
If I have to wait then be honest with me, tell me I will have to wait, I just like to know what is going on.
Give me a chance to answer your questions…I may not be able to speak in full sentences but I can tell you what I need to, it just takes a few extra breaths between words to get it out. If you asked me a question and I started to answer, let me finish. If it was important enough for you to ask, then it is important enough for me to answer.
I’m more than my illness, I may be in hospital for one illness, but it is impacting a lot of things in my life and causing more and more stress with each admission or day.
Please don’t stereotype me.
My sats may be ok but I still can’t breathe. Sometimes saying things that are meant to reassure me doesn’t help. Offer reassurance, tell me I am safe, you are there to help, don’t try to tell me my numbers say I am fine, because right at that moment I’m not fine, no matter what my numbers say.
I’m stubborn, I will try to get by on my own and I will try to get by without help. I’m sorry if it makes things more difficult in the long run, I like my independence and I hate to give up control.
My “for nurses” list seems way shorter, probably because I know how it feels to be the nurse or the patient and so even as a patient, and even when I am really unwell I keep in my mind that I need to treat everyone who is helping me with a grateful attitude, and in a way I would want to be treated in work too. I guess trying to see things from the other persons perspective is always helpful. I haven’t really had many bad experiences with healthcare as a patient and I know I’m pretty lucky with that. I’ve heard about people who have had a bad experience and it makes them less likely to seek help in the future for fear of repeating that same problem. On the flip side, I have had my fair share of difficult shifts in work. The vast majority of those have been through no fault of the patient, when you become critically unwell you cannot always control how you behave, you cannot always this rationally and clearly, and I know that comes as part of the job when you work in critical care nursing.
I do love my job, and some days I just have to have thick skin and a smile on my face throughout whatever gets thrown in my direction. I always try to remember that it is a privilege to be a nurse. Sometimes I have to try extra hard to remember that! Most days my life is changed for the better by the people I look after and their family members. And as I said in my “for patients” list, the day I stop giving 100% and stop caring, or lose sight of why I first decided to be a nurse, then that is the day I will need to take a step back and reevaluate life.