Close Encounter of the Nurse Kind

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You have got to be kidding.Let me get this straight,you are upset b/c the nurses were eating and laughing?You have been in the classroom way too long.Wake up!We are human too,we have to eat,we have to take breaks,we deserve to be happy.If they were not loud with the laughter.Everything you have described is acceptable.I see too many nurses sitting @ the computer and trying to document while also taking a lunch break,or answering call lights between bites.Not me,I have been nursing since 1976.I tell every new orientee take your breaks.
The nurses does not decide when a bed is available.

of AR 8:40PM January 01, 2009

I am a nursing student, and my brother for years have been complaining of pain in his groin area that comes and goes. He has gone to doctors but the time he went the pain was not present there was no bulge and so they were not able to diagnose the pain. One day while at work in another hospital in ICU I receive a call from his girlfriend also a nursing student informing me of my brother being rushed to the ER at another town. She was already in the ER with him when she called me, in the background I heard the most awful scream for pain my brother has ever yelled out. I felt helpless I was away, but that sound from my own family could not keep me away. I quickly left work and 1 hour later arrived at his bedside still in agonizing pain. His nurse arrives and he could not have showed less of a concern for my brother's pain. I was told by my bro's gf that the nurse earlier at one point told my brother to keep the screaming down because there were other people there that were in more pain than he was! I did not know that being a nurse means you know how everyone's pain tolerance rates. How dare he undermine his pain? He has lived with this pain for years and now it has gone beyond his tolerance and this nurse treats him as though he knew exactly what he was going through. The nurse was very sarcastic about every comment my brother made, when my brother said ouch when the nurse put the blanket over him he exclaimed "wow a blanket hurts you?" He completely forgot the meaing of empathy esp. in his profession. The nurse would then question my brother's response to pain because he was not screaming even though he said he was in pain, the nurse would say "well your not that much in pain your not screaming" of course by that time my brother just tried to shut the world out to avoid feeling the pain, and the nurse saw it as "no scream, no pain" hmm what school did he go to? by the time he was in his room after his hernia surgery with an incarcerated colon repair, he would sit in his room with the call bell ringing for almost 30 minutes waiting for pain medicine. Only to get an answer of " I will get your nurse" and of course another hour passes by 'til the actual nurse comes around... I do admit there were great nurses, nurses who knew how to treat a patient like my brother post op. they showed empathy, they knew when to give his pain medication, they knew to check him if he has not asked for it in a while. they knew to listen to what he is feeling and not just assume..thank GOD for these nurses..it was a learning experience for us to be on the other side, and wish to never undermine our patient's needs based on "our" assumptions!

Lyn of FL 5:55PM January 01, 2009

Anonymous and Comorow's response
spirometry
you don't blow, you suck.
Comarow response:
The explanation link is to MedlinePlus, and I've seen a spirometer used both ways.
Undoubtedly, the relevant use in her daughter's situation is inhalation ("sucking"). Periodic incentive spirometery is used to prevent/reduce atelectasis and to decrease the risk of developing pneumonia. (Sorry but Comorow's MedlinePlus link is for spirometry testing but that is NOT what is going on in this situation.) A better link and explanation is:
http://my.clevelandclinic.org/services/Surgery/hic_How_to_Use_an_Incentive_Spirometer.aspx
This is an important postprocedure intervention and should be explained properly to client's and families.

HWK RN of FL 12:05AM December 31, 2008

You can beat yourself up pretty darn well when your child is sick and you do not assess her accurately. And it really doesn't matter what anyone says to you about it. I have had to learn to forgive myself for not seeing the truth of my daughter's mental illness for most of her teen-age years. The signs were there, I thought she was dramatic and eccentric. When she finally went into a full blown psychosis the cat came out of the bag. The layers of years of supressed symptoms came pouring out and over her.
I am happy that your daughter is recovering and that she had you by her bedside doing what were the best and the right things to do.

Cassandra Wood of CO 11:27PM December 30, 2008

As a nurse who has been in practice for 27 years, been a patient in the ER but mostly worked in the ER, I can empathize with you as a mother. However, as a professor, I find it very sad that you are so unaware of how the Emergency rooms function these days or the realities of what the ER nurses go through. The so-called "entitlement factor" has run its course with ER nurses across the nation and has worn them out. Now with the Medicaid "Gold Card" we not only treat tons of patients who are not only able to work and won't but continue to procreate at an alarming status and pass on the "inside scoop" to get on medicaid to get all of these benefits. What does that have to do with your case, probably not much, but if someone were to see the abuse from our perspective, yes, you do get conditioned, hardened after being cussed out, spit on, verbally harrassed over nothing more than a bug bite at times. There are a few of us who do care, should know better than to treat someone the way your daughter was treated and I am sorry for that. After working in multiple hospitals, the triage training is very poor at many and most nurses are extremely slight in their assessments. Take it from some who has been there, it's frustrating working alongside with these nurses. They scare me also.
Our community health teachings are a failure; we pay for abortions but not for prevention nor do we teach mothers even how to buy and use a thermometer for home use as we have the ER at our beckon/call 24/7. So, maybe as an instructor you can make a difference by working on the system that has created this nightmare. As business goes, healthcare clinicians are the worst. We have created our own nightmare and now must live in it.
I am glad that your daughter had some compassionate assistance. I too have had the same surgery at age 44 with sepsis to boot. It was not fun. You did the best you could, so forgive yourself and realize you'll never do that again. Help the new nurses into reality ------------please.
Sincerely,

LALodholz,RN of TX 10:25PM December 30, 2008

I was touched that so much of what you wrote has been my experience as a mother of a 2 year old asthmatic and as a nurse with 10 years experience, including peds. I have had a really hard time seperating myself from the whole hospital "routine" when my son is in the ED or gets admitted. After all, this is MY child and none of these people can do as good a job caring for him as I can!!!
His illness has really helped me become a more thoughtful nurse. Yes, I have 7 or 8 patients that need pain meds or are puking or just can't seem to stay comfortable...But each of these patients is someone's loved one. Each of these people is going thru an experience that is not normal for them. My casual attitude towards their non-emergent problems is a slap in the face. Every pain pill that I bring, Every pillow that I help get "just right" is an important part of their stay. Thanks for reminding all of us how vital our role is as caregivers and how our everyday actions and words affect these patients and families when they are experiencing something that is not "everyday."

Jeanni of MS 1:23AM July 21, 2008

I have been a nurse for 11 years and am a mom of 3 beautiful children. This scenario makes my heart ache for both sides. However I don't think it is hopeless. For sure it opens up a whole host of issues that need addressing. First of all glad the pt is now doing well that is the most important thing. Let me just say in defense of the mom that yes, sometimes between working, raising a family, and running a household we can feel emotionally and physically exhausted. I bet there are more women out there (than are wiiling to admit) would have initially chalked the symptoms up to the flu. But I hope we all learned a valuable lesson to at least take a proper temp and call the family pediatrician to arrange a sick call. No offense Mom, but if a school nurse had taken your childs temp with her wrist and blown the complaints off I think you would have called her tx. inappropriate and lax.
However, if we can all calm down long enough to get to the deeper issues maybe some good can come of this whole ordeal. I just finished my R.N to BSN degree and during one of my clininacl rotations I was fortunate enough to do a semester at the ED at Union Hospital in Lynn Mass. Up until this time being a floor nurse I used to get annoyed when the ER nurses would call for a bed and recall us 15 minutes later if we did not assign a bed yet. (We do need to get out of report and at least look in our our other 5-6 pts before taking on another). HOWEVER! Here is where I learned what these nurses are up against in a daily basis. The ER coordiantor warned me on my first day of clinical "I know you have been a nurse for years, but you have not been an ER nurse so wear comfortable shoes, pee before you come on the floor and try to keep up.".I thought she was being overly dramatic but wholly cow she was probably making an understatment of the century! Although I fully understand and sympathize with how pts and their families may feel (and yes I have been at both ends of the bed and so have my loved ones) I must say between dealing with traumas, understfaffing, overcroding and everyone feeling like they are the most important pt in the world I see why these nurses don't smile a whole lot or have a lot of time to offer more TLC. Those nurses who truly do not care are very far and few in between. I think many are just overwhelmed and try to be stoic so as not to have a nervous breakdown or leave the profession all together. As part of the solution I would like to stress to every floor nurse the importance of never delaying in assigning a bed for an ER pt or delay taking report. If I am not done seeing my pts I at least get them a bed assisgned and either have another nurse take reoprt or check on my remaining pts til I get report. By speeding up the admit process we can help cut down on ER overcrowding and borders. At the same time the public needs to be TAUGHT when it is appopr to use the ED and when to use their PCP so everyone can get the care the need in a timely fashion!

Elaine Grant BSN of MA 11:34AM May 30, 2008

I am also a nurse who has seen, not only both sides of the floor, but also both sides of nursing and administration. While I wholeheartedly support the profession of nursing, over the last 2 years I have seen an increasing number of nurse's who do not seem to care, and have stated they only became nurses for the money. Until we start to be honest about ourselves, as well as the business aspects of management, we will never be able to fully evaluate and try to implement changes in our health care system.
I believe Professor Madsen was honest and forthright in her description of her experience. I have sat with friends and family members after surgery, and have discovered what could have been a very serious interaction/effect of medications/treatments that have been provided. Not only do we need to understand the nurse's difficulties, exhaustion, but also not forget the other side of what might happen.
There are no easy answers, so I simply take it one day at a time. Attempting to support each other as nurses, while also holding each other accountable for poor behavior when it occurs (and by this I do not mean taking time to eat), would be a step in helping nurses towards a better tomorrow.

anonymous of DC 7:47PM May 12, 2008

Why don't you go to the administration of this ED and ask to shadow one of their nurses for a full shift? You obviously didn't go through the proper "chain of command" to remedy the situation, you just felt the need to take a public forum with your limited knowledge and hateful opinion. You are taking out your guilt of "not being mom of the year" because you missed the signs for over 36 hours that your baby was ill, so that makes your incompetence an ED nurses failure? ED nurses wade through hundreds of patients a day to take all the life-threatening possibilities first, the severe illnesses second, and the bullshit at the end. Your daughter was in the second category. We don't use our personal feelings to assess our patients or our situation, we use our knowledge and skills. You used your personal feelings, not your knowledge. You probably haven't been out of the classroom in years, so you have no skills left. I am an ED nurse. I do have a soul and I usually feel horrible that people have to wait so long, but I also have to weed out who can die, and who can wait. YOU SHOULD PUT YOURSELF IN OUR SHOES LITERALLY....ASK FOR A SHIFT WITH AN EXPERIENCED NURSE IN THE ED, and put your words where your pen is...

Jennifer of MO 12:42PM May 12, 2008

You know the sad thing is that you are a nurse and you feel this way, but have you ever been the one to triage the patients, and when was the last time?? You know we are the front lines of any hospital in the Emergency Room at Cox we are seeing over 250 patients a day in a facility built to see 125 per day. We see almost every patient that enters our system, and unfortunately at triage we have the task of choosing who gets the one bed an hour that we can open up in the back, because we can't get beds upstairs because some departments don't have the staff to take patients. In the ER we can't close our doors if we are understaffed, it just means that people hold over or managers come in until we can survive a little better on our own. I hate making the decisions that we have to make at triage, but you know it is a combination between gut instinct and nursing intellect. Unfortunately until our society realized the ERs are not meant for primary care, and the use of Urgent Cares or After Hours Clinics becomes more utilized the problem is only going to get worse. I happen to work at Cox ER and have to tell you that there are some nights more and more now that when you come around the corner and see the department in total upheivel you just want to turn around and go home, but the nurse inside you as well as the compassion for your patients and your fellow nurses makes you stay. You put on your running shoes and take care of as many as you can, more and more places are starting to board patients because we can't move them upstairs or send them home!!........Its a shame we can't find a way to let you in triage see this, I know that you emergency is worse than everyone elses, but its always very difficult to tell you politely that its not. We do attempt to make rounds in the waiting room on the patients that we have triaged and we do start your labs while you are waiting so that your time in the back is decreased, but after you make a couple of attempts and get yelled at, spit at, or even things thrown at you! You don't even care for the rest of the shift. All I have to say is that I am sorry that this happened to you where you work, however you are in a position that you can help make changes, both in education of new nurses and in the politics of the facility. We are all supposed to be advocates for our patients and now you have more fuel than most of us to do so.

anonymous of MO 6:55AM May 10, 2008