Thursday, May 26, 2011

What does a patient want from a nurse?

One of my favourite healthcare bloggers, Those Emergency Blues, has written a post:
'Don't tell your patient this or that'.
She writes for her colleagues, more than for the public. Her posts are insightful and deal with various healthcare issues as they pertain to the emergency room, where she works. She has dignity, respect for her colleagues, and working experiences which have taught her how to treat both peers, superiors, and civilians in her ER.
Another nurse blogger was preparing for an article, and in response, she wrote:

But the more I thought about it, the more I thought the question as posed by Reader’s Digest was curiously framed. Nurses are supposed to provide information to patients; withholding information seems like, well, unnecessary power-tripping. In fact, I will tell patients things I am not supposed to mention, like about the cosmic suckiness of hospital food (because it does) and how an ECG looks — but if I bring you in right away after doing it, you pretty well know it’s not good.
So there is very little, in the end, I won’t share. There are some things, however, that are beyond the pale. Here’s my short list of ten things I will never, ever tell you, my patient...
The list is interesting, and you can read it here.
She posited the question:
At the same time, I wonder what patients really want to hear from us.

I love the positive nature of her question. What do patients want to hear? Now, I am involved heavily in healthcare, hospice work, advocating for (primarily) seniors with health issues.

Ten things patients want from their nurses
  1. Honesty; admit what you know or don't know; 3 more patients are on their way in in an ambulance, but stay put, hang tough, you're in the queue, or the converse, you are a high priority. 
  2. Information; I didn't know that after 8 hours of reluctance to go to the ER for a trivial thumb wound, they won't sew up my thumb. Who knew? Tell me what a good death at end-of-life looks like, sounds like (choking on food and water, pain management, death rattle breathing, Cheynes-Stokes periodic respiration) and help me through it. You may have to tell me twice, as I am stressed in your work environment, afraid and in pain!
  3. Respect; primarily for me, but also for my (sometimes embarrassing) family members, this hospital, and the entire Canadian universal healthcare system.
  4. Good listening skills; make eye contact with me, nod when I speak, even as you write my information down; look as if you care as much about me as the dude bleeding in the waiting room.
  5. Empathy; my pain may be 2 on a scale of 10 (compared to the woman on the stretcher in the hall) but it is pain; my GP couldn't/wouldn't see me, but you care.
  6. Every patient matters; Every patient is important, some are more critical. But as she kindly taped up my miserable wound, eyeing the tensor bandage on my foot (tenosynovitis, not tendonitis as the ER doctor thought), I was thinking how much I missed my mom's empathy, and found it in my triage nurse!
  7. Confidence; yes, we are overworked in ER, many are in many fields, but you are the pros; indicate that you know what to do; you have a team working and will be able to meet the needs of all.
  8. Advocacy and Advice; speak up for me, protect me from goofy Dr. Weanus, 'take a deep breath; put your head between your legs.'
  9. Truth; it helps, ER waiting time is 4 hours, hang tight, we care, X-ray is backed up.
  10. Look, act, behave professionally; even if I am wearing dirty underwear, forgot to shave my legs (which I noticed when I looked at my foot), don't look as if I have a pot to piss in... I am a human being. 
But then we don't have to tell all of this to the good ones!
    In return, as a patient...
    1. I promise to behave properly, not to yell at you (can't swear for my loved ones!)
    2. I will take my turn in line, according to your triage, not mine.
    3. Trust that the professional healthcare team are working as a team.
    4. Understand you've been running around all day/night doing your job.
    5. I will give you the respect you accord me.
    6. I will listen to you, even if you have to re-explain.
    7. I will have confidence in you.
    8. I will be honest with you.
    9. I will express my gratitude that you dealt with me firmly and fairly; work long shifts, dealing with nutbars and people in panic.
    10. I'll try to smile, as I know that I am lucky to have people like you in our healthcare system.

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