From my observations, may ER nurses treat patients like they’re stupid, like they’re a waste of time, like they’re a major inconvenience to the staff, especially if the patient’s complaint is not truly “emergent”. This attitude is often plainly seen by patients and their family members, which leads to friction, mistrust and complaints; it also effects if the patients will follow up after discharge.

I have observed that if you can come into the room with a non-confrontational, compassionate approach, and can convey to the patient that you are on their side, and want to make them better (by listening to their story from the start to the finish and really listening to what they’re complaining about) you will almost never get complaints–or angry patients/family members.

Then you have happy patients… and your day gets easier as a result. We all know how stressful it can be to deal with ‘ornery’ and ‘cantankerous’ patients and family members, but 99% of the time, they are only upset and mistrustful because they feel they are not being listened to, or that they are being swept aside.

I’m not saying you need to sit down and hold each and every hand, and wipe each and every tear, but be aware of your attitudes. The patients can read you much better than you think they can.

Then Wednesday night hit.  It was the beginning of a 24-hour period that had my adrenaline in overdrive.  One thing after another kept happening, and I was at my wits end by Thursday night.

Here is a brief overview:

The camp pastor fell on a horseshoe stake and injured his leg.

A 12-year-old boy fell off a 10-foot platform face first.

A 10-year-old boy was brought in on a back board after injuring his neck inner-tubing.

Another 10-year-old boy fell and injured his arm and ended up in the ER.

Now, between these injuries were several bee stings, a sprained ankle, a minor eye injury, and all the minor stuff mentioned above.  Those were easily dealt with and forgotten moments after they happened (for me, if not the patients).

It was the others that had me reeling a bit.  Three of them I was alerted to before I saw the victim.  The fourth happened in front of me.  I watched the fall through the lens of my camera.

In each case, my stomached dropped.  Remember, I’m a Family Practice nurse, NOT an ER nurse.  It’s amazing what comes to your mind when everyone is looking to you to deal with an injury.  Honestly, after the “Oh crap” thought left my head, I went into an immediate prayer.  It went something like this: “God, please help me to be sufficient for this situation.”  Short and sweet. 

I was completely aware that I might not have the experience needed to care for the injured party, but I was all they had in that moment.

I am smart enough to know that my very first responsibility is to remain calm.  If I don’t, no one else will either.  It’s all an act, of course, but they don’t have to know that.  Beyond that, I just start doing whatever comes naturally (or supernaturally in some cases).  I take control, ask questions, and pretend they are in extremely capable hands as I start attending to whatever need they have.

If you’ve been reading this blog for a while, you may remember that my first camp nurse experience didn’t go so well.  Actually 99% of it went fine.  It was the 1% named Tony that was the killer.  Tony was electrocuted by a fan in the camp kitchen and died.  He was 17.  I did everything I knew to do, but he died anyway.

We all face situations as nurses where we aren’t sure our abilities will be enough.  Where we don’t know if we know enough.  Where we feel insufficient.  Sometimes, in fact, it’s the truth.  But more than likely, we have everything we need to do the right thing for the patient.  Tony died because he was electrocuted, not because I did anything wrong.

And our patients deserve our confidence.   What could be worse than feeling terrible and have the person who’s supposed to be taking care of you acting like they don’t know if they can?  Talk about adding insult to injury!

So the next time you have to do something you aren’t sure you can,  fake it.  Even if you have to get some help, ask for it in the most confident tone you can muster.  You are a professional.  Other people assume you’re qualified.  Act like you are.  And if you’re still a little uncertain, you can always try my approach and pray.  Who wouldn’t want to believe there is a higher power who can bridge the gap between what they have and what they need?

A 14-year-old girl rings up an abortion clinic and says she wants an abortion. She lets slip that her partner is 30 years old. The girl asks the nurse, “Will you tell my parents?” The nurse on the phone only has a few seconds to help this girl. She says they won’t if she doesn’t want them to.

The girl then admits it wasn’t a real scenario, and happily joins the news crew in bashing nurses who deal with sexual health.

I was outraged. I’m a male nurse who works in a boarding school and deals with sexual health issues all the time. Here’s what really happens.

A girl, (say 15 years old) is worried she may be pregnant. The first thing she asks me: “Will you tell my parents?”

If I say I will tell her parents, she may not tell me what is wrong. In fact, I’ve had one student who assumed we would tell her parents, and she climbed out of a forth-floor window in the middle of the night and scaled down each floor using the balconies on each level. She was accompanied by three friends. If any of those friends had fallen, they would have been killed. They took themselves to a local hospital where it turns out she wasn’t pregnant.

What’s the point? People, students, kids, adults need to feel they have someone to turn to, someone safe, somewhere safe. They need to know that what they tell us is confidential. Your first concern is the immediate safety and health of the child.

What do I do when someone comes to me for help? I did have a patient who was 15 years old and pregnant. I told her I wouldn’t tell her parents. I did tell her I would talk to my colleagues and the school doctor.This encouraged her to tell me the whole story. After evaluating her situation, including family, boyfriend, etc., and discussing with my even more experienced colleagues I encouraged her to tell her parents.

Which she did, and they were supportive. The girl was so relieved–as well as surprised. Children are often surprised by how supportive parents can be when in true crisis. The parents came and dealt with the issue.

Back to Fox News scenario: they jumped on the anti-abortion band-wagon and highlighted how medical people keep parents ignorant.They inflamed the public. This issue isn’t about abortion. This issue isn’t about the parents (at first). It’s about the immediate safety of the child.

Hopefully, family can and will become involved, although unfortunately not all kids have good parents they can turn to. By providing a safe environment for the child she can be encouraged to deal with the fact her boyfriend is 30 years old. Hopefully, the guy can be thrown in jail for the rest of his natural life. (I’m a parent as well, I’m not a emotionally immune healthcare giver).

Fox news didn’t show what really goes on. They didn’t show the thoughts behind the medical people dealing with these ethical issues.They showed a nurse in a bad light, trying to make a political point. We all know news is never unbiased.

Our nurse/patient ratio is 1:5/6. I know that doesn’t sound like a lot to some people, but most of the patients we take care of have a list 20 miles long of medical conditions, which only adds to the work load. Not to mention the fact that people lose all functions when they come through the hospital doors.

Like many other places, we took a hit from the economy. We are down to 1 CNA for 32 patients during the weeknights who stays until 3am. We fend for ourselves on the weekend. We have a secretary until midnight, but only on weeknights.

Day shift is another story. Of course, they are max staffed and didn’t take one hit. In fact, they got our best CNA from nights.

I am at my breaking point after this work week. I came in with 3 patients (which is rare), walked out of report only to be called report of a patient transfer that I was unaware of. Now I’m starting off behind. The patient I received is a prisoner with a guard who was post arrest with stent placement and who needed further stents before d/c. The patient was extubated that day, and couldn’t yet leave the unit.

Needless to say, this patient went into respiratory distress numerous times throughout the night because he kept pulling his O2 off and getting out of bed (after the guard was told 5 gillion times to keep him in bed).

Patient #2 is the total care patient: dying, contact precautions, foley, rectal tube, recent bka, peg tube, picc line, restraints, lipids, turn q2h, suction, meds every hour and the list goes on.

Patients #3 and #4 – prepare for cath in am (not as heavy). Admission of #5 – C-DIFF rectal bleed (are you serious?) Required changing every 30mins.

I gave meds from 8-2am, tried to sit down and chart, and heated my food three times before I realized that I was going to have chewing gum for dinner. My coworker, who also had five patients, was kind enough to help me all night (it literally took two of us just for my patients).

My patient worksheets did not get updated before report nor did any other thing get done in a timely manner. I ended up leaving at 9:15 that morning, only to do it all over again the next night. I left at 10:30 the following morning of my second night. I was so exhausted, dizzy and nauseous from sleep deprivation that I could hardly finish my charting.

My question is:  When does it stop? At what point do they realize that patients (and our licenses) are in jeopardy? It’s not good patient care. It seems that they keep putting more and more on us and all we can do is continue to take it. I love what I do and I like the area I work in, but it’s getting to the point where I feel like I could walk out and not look back.

Now there are a bevy of responses you could come up with.  There’s the traditional response: “I want to help people!”

Then there is the spiritual response: “I felt called to it!”

I was asked this question at least a billion times during my time in college. So I came up with my own response: “I wanted to meet women!”

Guys who go into nursing get asked that question a lot! I’ll be honest.  Before nursing school, I was actually a computer science major. I quickly realized that working on computers was not for me.  I enjoyed using them as an aid, but I didn’t want to create them or build them.

So, there I was, a 19-year-old, single male with women on my mind!  And that was one thing the nursing program offered: a female-to-male ratio of 50 to 1 in some cases.  Surely, a guy like me could find a woman he cared about in that major?

As unbelievable as that sounds, that was one of the origins for why I chose nursing. But it’s not why I stuck with it.

When I went into nursing, I didn’t consider the negative stereotypes associated with male nurses. (Robert De Niro’s character in Meet the Parents did a great job insulting male nurses everywhere–and creating more of a stigma.)  Working against those stereotypes has been tiresome. But I’m glad I’ve stuck with it, because I love the profession.

I honestly want to help people. To change lives. To make a difference. To do all those things that are “cliche”–but so true.

So why did you go into nursing-and what’s keeping you in the profession?

I am really struggling with how to deal with some of these difficult patients. I just cannot understand the nerve of some people! Just last night, I was discharging a patient and the curtain wasn’t completely closed. The wife of a patient from the room next door peeked in and told me she was going home for the night.

As she began talking and asking for help, I interrupted her and said, “Excuse me, ma’am, but I’m with another patient right now. Please ask one of the other nurses for assistance.”

I have even had patients’ families actually come into other patients’ rooms while there is a code situation- or while I am doing CPR-and repeatedly ask me for pillows, test results, food trays, etc. How do people not understand that we’re in the middle of something?

I have struggled with trying to be polite, but I think in a way that only will encourage this behavior. I just don’t know how to be assertive without getting so upset at patients and their families.