Anonymous Nurse is a column written by nurses around the United States with something to say. If you’re a nurse and would like to write about working in the American healthcare system, get in touch at firstname.lastname@example.org.
I’m exhausted. I had to call a code yesterday because my patient lost his pulse. The entire ICU team was there to help resuscitate, but my arms are still sore from doing chest compressions.
I see the patient and the emergent machine we had to place at his bedside to help support his heart yesterday. I’m relieved that he looks much better. I turn around and see a lady in tears. It’s the patient’s sister who flew in from out of town, and this was the first time she’s seen him since his surgery. She apparently hasn’t talked to his wife yet and wasn’t expecting to see him in the ICU.
Tears turn into hysteria, and she starts asking, “Why does he look like that? What is going on?” I tell her I’m her brother’s nurse for the day and find her a chair. I explain everything, from the surgery and the complications to the condition he’s in right now and what the medications and machines are doing. I tell her the plan of care for the day, and because we’re in the ICU, things happen very quickly and conditions can change very rapidly. However, he’s currently stable and I’ll be here monitoring him. Also, if she has any other questions, to please let me know, since I will be here with him for the next 12 hours.
She takes me up on my offer and continues to ask me what I’m doing, what the numbers on the bedside monitor represent, why are there alarms going off? I keep explaining as I go along with my work.
Then comes in the new resident in their white lab coat, and I notice the sister’s demeanor change immediately. The edge in her voice is gone. She’s no longer hovering over me.
“Are you the doctor? Can you please tell me what happened to my brother? What is going on? Is he OK?” she asks.
The resident gives her a breakdown of what I just said, and she seems satisfied.
She sits quietly and nods as if she’s hearing this for the first time.
As a registered nurse for 14 years, I’ve seen this scenario play out time and time again, when the doctor repeats the same explanation the nurse provided moments before, only to be met with more of a respectful and confident reaction from the patient.
In short: The words of a doctor always carry more weight than those of a nurse. And this could be down to the fact that the perception of nursing is still evolving.
The nursing profession, at its core, has always been about caring for patients. However, it was once a female-dominated career in which these healthcare providers essentially served as assistants to male doctors, caring for and cleaning up after patients. Over the years, however, nurses have acquired a lot more autonomy when caring for patients and will no longer blindly do anything without understanding why it’s being done.
And there are a number of reasons for this.
There are still misconceptions when it comes to the education levels of nurses. The nurse caring for you can have just as much education as the intern writing the orders for you that day. Although registered nurse (RNs) — nurses who are directly involved with caring for patients — only need their associate’s degree to pass the National Council Licensure exam, most nurses will go beyond this point in their education.
According to the Bureau of Labor Statistics, the typical entry-level education required for nursing in 2018 is a bachelor’s degree. Nurse practitioners (NP) need more education and clinical experience than RNs. They have the training and the ability to diagnose and treat illnesses and conditions with treatment plans or medications. They’re able to help a patient through the entire treatment process as well as follow up with the patient in further consultations.
After completing their four-year bachelor’s degree, they then must earn a master’s degree in nursing (MSN), which is another two years. Beyond that, they can get their doctorate of nursing practice (DNP), which could take another two to four years. Overall, it’s not uncommon to have a nurse caring for you with multiple degrees and certifications.
Of the average surveyed physicians in 2018, more than 60 percent stated they spend between 13 and 24 minutes with each patient a day. This is in comparison to the nurses in a hospital setting who work an average of 12 hours a day. Of those 12 hours, the majority of time is spent with patients.
Often, you’ll see multiple doctors during your hospital stay. This is because doctors often specialize in certain areas, rather than treating the whole patient. You may have one doctor look at your rash and give recommendations and an entirely different doctor who will come and treat your diabetic ulcer on your foot.
Your nurse, however, needs to know what all these individual doctors are recommending in order to carry out the appropriate care for all these conditions. Your nurse will understand your overall situation and see the bigger picture, because they’re caring for all aspects of your condition. They’re treating all of you instead of just your symptoms.
Patients dealing with sickness and injury need both emotional and informational support from providers. This level of care generally comes from nurses and has shown to radically reduce patient distress as well as even physical symptoms.
- High levels of nurse autonomy. This is when nurses have the power to make decisions and the freedom to make clinical judgements.
- Nurse control over their practice and setting. This is when nurses have input on how to make their practice safer for themselves and for patients.
- Effective relationships among healthcare team members.
In short, when nurses are given the opportunity to do what they do best, this has a positive effect on a patient’s overall well-being and recovery rate.
When patients and families don’t treat nurses with the same level of respect as doctors, it can affect the quality of care. Whether consciously or subconsciously, nurses won’t want to check on a patient as often. They may not respond as quickly as they should and miss the subtle signs of something that could be important.
On the flip side, nurses who develop good relationships with their patients are more likely to be able to provide advice, treatment plans, and other health information that’s actually listened to and more likely to be followed when patients return home. A respectful relationship can have important, long-term positive benefits for patients.
The next time you meet a nurse, remember that they’re never “just” a nurse. They’re the eyes and ears for you and your loved one. They’ll help catch signs to prevent you from getting sicker. They’ll be your advocate and voice when you don’t feel you have one. They’ll be there to hold your loved one’s hand when you can’t be there.
They leave their families every day so they can go take care of yours. All healthcare members go to school to become experts in taking care of you.