I have been called kind, compassionate, caring, “a wonderful asset to our team,” and an “excellent and experienced nurse.”
I have also been called: “Nurse Ratched,” a demon, “b*tch,” and a “bag of C****.” I’ve been called other things that I really can’t even type out because removing the profanity will make them incomprehensible and some, well, some were not in English.
For clarity’s sake, I’ll point out that I’ve been called all of these things in the line of duty while caring for patients at their bedside at the hospital. Many of these patients were altered or had cognitive issues that contributed to the verbal abuse, but not all. Some of them were very apologetic when they had their faculties later and we had a good laugh about it. On the other hand, some were very cognizant of what they were doing and were intentionally being verbally abusive.
Some of the offenders were not even patients; some were family members; emboldened by being on the phone, feeling frustrated about care, and they took it out on the easiest and most accessible person. Some were family members at the bedside who felt that condescending words and threats would make a difference to their person’s care.
I’m going to take a moment to step out of my normally compassionate self and give everyone a little bit of perspective.
It was recently said (in my presence) that nurses provide better care when there is a family member at the bedside, “I [have] yet to have any family members inpatient and not had family being on-site make the care better because they were able to intervene.”
To say that I am irritated, frustrated, and shocked by this minimizes the actual feelings involved. This is from a mental healthcare practitioner, no less. Now, it’s possible that it might just be the facilities seen. It might just be the state these actions were witnessed in. It might just be bad luck.
But I don’t think it is. I think it’s a strange misconception people have that being the “advocate” for their family members will get them better care. Don’t get me wrong; it is important to be supportive and helpful to patients that are hospitalized and to help them verbalize their concerns and to even help them keep track of information. Nurses love this. We love educating families and sharing the information so that everyone can be a part of care. What we do not love is threats, demands, and this perception that nurses will do you wrong unless an “advocate” is there to navigate everything for you.
I’ll start by being the kind nurse that I am and I will say that research shows that having an abusive family member actually reduces the quality of care, at least in terms of time spent in the room. I’d love to show you the study (I did have a copy at one time), but when looking at nursing journals now, there’s a much larger emphasis on how to “de-escalate” with violent patients and families. When families do not trust the nursing staff, the nursing staff will also not trust the family. This means that our responses to you will likely be more measured, more precise, and frankly, delayed, while we ensure that everything is perfectly in line for when you present ourselves before you. We will not give you our off the cuff responses or our interpretation of the situation if we feel that you will advocate using us as an example later. We will ensure that everything is done strictly by the book. We will ensure that the care is done per policy, documented aggressively, and is performed competently. We will likely not go out of our way in order to make you more comfortable. We will likely spend as little time with you as possible because we know exactly what you are doing with your phone and notebook and pen.
We know that you are writing down the name of the medication and the dose and the time it was done. We know you’re writing down the date and our first/last names. We know you are second-guessing everything we tell you and googling it the second we leave the room. You are not the first. Sadly, you will also not be the last.
We do not want to be sued and we do not want to lose our licenses.
We will do exactly what is required for your family member, whether or not you “advocate” for it or are even present for it. When you “advocate” so aggressively, perhaps even abusively, in order to “intervene” we will tolerate it as long as we can and as long as legal counsel will allow us to do so.
But do not be confused: your advocacy and your attitude matters. If you advocate for what you want and not what the patient wants, we are taking notes as well. If you are abusive rather than simply assertive, you may find yourself escorted out by security.
Do not have any illusions: we love having family members there at the bedside to support and care for our patients. We love that you provide a type of security that even the best nurse can never provide. We love how you love and fight for and care for your families. We do. We want what is best for our patients and we want them to be well enough to leave the hospital. We want them to have a good experience. We want them to trust nurses moving forward and to come back to our hospitals.
Nurses and families should be working together, rather than judging one another and working against one another.
This will not happen so long as this idea of monitoring professional staff endures.
Published in Healthcare
Tags: #drgoogledoesnotknowall, #Ihavealicense, #nursingethics, #professionaldegrees, #stopaskingyourdoctorfriend, Healthcare
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