To all my friends, and friends of friends, to everyone who will one day become a nurse: please take the time to consider a patient's account of what it means to be our advocate.
Unfortunately, I was recently a hospital patient for a week. During my week I came to become hyper aware of the importance of nurses, and how much I personally depended on them during my stay. I learned that some nurses are better then others, and I hope that someday that won't be the case. In sharing my story, my wish is tomorrow's nurses (or today's) will find something meaningful to take away from this article.
It happened very suddenly. One minute I was enjoying a summer morning with my grandma and cousin and in the next I was in a cold sweat, uncontrollably throwing up blood-streaked vomit. It felt like I had been repeatedly stabbed in my upper abdomen and there was no way I could move to make it stop. I have never been in that much pain in my entire life.
Next came my first, and hopefully last, ambulance ride, followed by an agonizing wait in the emergency room. I could tell the nurses there were not taking me seriously. In their eyes I was just a dramatic 19-year-old. They told me they would bring me something to dull the pain and after over an hour of waiting for some relief decided to offhandedly mention that they needed a urine sample before they would give me anything. By this point I could barely move, and I felt very dizzy and lightheaded. I looked at my mom, who understood I needed her to go with me to get them the sample. Next the nurse said something along the lines of "oh, you can't just go alone?"
Needless to say, I got them their sample - and while opening the bathroom door I passed out (another first and hopefully last for me). Somehow my mom managed to save the sample and catch me while I fell. At this point I felt like she was the only one who was really looking out for me. When we got back to the ER room the nurse stood there lazily waiting, completely unaware of the situation that just occurred. She had never even thought to offer her assistance in any way. If I had been alone, I probably would have still been on that bathroom floor, and most likely with a head injury.
Eventually, after a CAT scan and ultrasound and another wait, I was diagnosed with severe acute pancreatitis and told I would have to be admitted - after 10 hours in the ER. It was around 11:30 p.m. when I finally had a room available for me. It was there I was given the first pain medication that actually worked. Exhausted and relieved, I almost immediately fell asleep.
The nurse I had the first night in the hospital, and a few other nights, was one of my favorites. What made her one of the best was her genuine attentiveness and organization. She was also by far the most prompt and quick, and I think that's something some nurses didn't really prioritize. To a patient in pain, every minute counts. And yes we can hear when there is a lot of co-worker smalltalk going on in the hallway and nobody is answering our call button. It's a dehumanizing feeling. It's really sad, especially writing this in reflection, knowing that while some nurses are wonderful and prompt (or genuinely with another patient), others will finish their conversation before assessing whether or not you are in an emergency. Future nurses, please put yourself in the shoes (or shall we say "hospital socks") of the patient, and be that amazing prompt nurse that patients value so deeply!
I told another nurse she was an angel. Granted I was drugged and loopy, but she really was a little angel! She went above and beyond and well out of her way ensuring I was comfortable, she even offered to get any visitors I had water on more than one occasion. She did not have to do that. She paid attention to details and noticed I was particularly fond of ice packs for my abdomen and back in between pain medication doses. It got to a point where I didn't even have to ask for them, she was right on those ice packs! And I heard her let the nurse taking over her shift know the deal with my ice packs, she was very caring, and it was something that did not go unnoticed. She was incredibly genuine and another stand-out quality about her was that she made an effort to talk to me about my life outside the hospital. This made me feel like she saw me as a real person, not a room number. The littlest thing like that can really make all the difference. It also kept me feeling positive, knowing she was so sure and casual about me getting back to normal soon, even though at the time I was kind of a mess and finding it hard to picture myself ever being "back to normal" again.
The essential part of the idea of a modern nurse is that they are to be the patients advocate. While doctors fight the disease or illness, sometimes the nurse has to fight for the patient. One morning, at around 5 a.m., I had two surgeons who I had never met before come in and talk to me for maybe three minutes and then leave. They came into my room immediately interrogating and saying they had a hard time believing that my pancreatitis was not caused by binge drinking (It was not, I was with my grandma the night before, and am not anything close to a binge drinker anyways). I even explained to them I was well aware it would be of no benefit for me to lie to them. I wanted to know the real cause so I could prevent this from ever happening again! Plus once you get pancreatitis (no matter the cause), you can never drink again regardless because it would more than likely trigger another attack. So there would be zero motive for me to lie. Perhaps I was a little to assertive back for the surgeon's ego's...
My nurse that day (who I had been assigned before) later told me that the two surgeons I had seen had randomly taken me off all my pain medication. When she came in for her day shift she saw this on my chart and was literally outraged and horrified. They didn't even know me! It seemed like a bully move and my nurse was pissed off for me. They marched into my room, in short said "we don't believe that you didn't put this on yourself by partying the night before, or your alibi that you were 'with your grandmother'" and took me off all my pain medications without even telling me. At the time, as someone in a serious amount of pain, it seemed to me as if their intended methodology was to torture me until I "admitted" to a binge-drinking spree and they could stop wasting their time investigating other causes (they did mention because of me saying "it was no way alcohol related" that they had to spend "a lot of their time investigating other causes..." my apologies?
At this point in my treatment medication were still necessary. My nurse knew this and immediately called my main doctor assigned to me at the hospital and explained what these two surgeons had done. My main doctor ordered it to be switched back. My nurse had the problem fixed before I even knew there was a problem. That's the kind of nurse that patients want on their side. That's what I would call an advocate.
I had another "off" experience with a different surgeon later on. This time my nurse for the day was in the room with me. The surgeon came in, asked me one question, ignored the last sentence I said to her and then just walked out, it was very bizarre. I looked at my nurse confused and said "that was weird," and immediately my nurse told me "I had not met a lot of surgeons, but that's just what they are like. Things that we see as important they might not. In their eyes, if they assess that you are going to live then they don't need to be there." This is fair and logical and everything, but to just walk out without some kind of a closing statement is socially abnormal to the general population. When this surgeon walked out I had no way of knowing whether this was because I was going to fine or something was so medically alarming that she needed to rush off for backup.
My nurse intuitively understood that the situation could be perceived as "off" and potentially alarming to me and joked about her abrupt exit. Her doing this lightened the mood and also made me really aware that nurses are (or the good ones like this one) on team patient. The best ones put themselves in your state of mind and do a great job at easing both your physical and psychological discomfort. During my time in the hospital, I observed that in general (though not always), the higher up in the medical profession someone is, the less personable they tend to be. Perhaps it's the detachment that makes it possible for surgeons and specialists to save lives and create miracles, but that human support they lack in is just as necessary to a patients healing process as mental strength for healing. That's where I really saw nurses "pulling the weight" the specialists didn't bother with. I amend that and am grateful to all the nurses who recognize the importance of patients being mentally at ease.
Nobody ever wishes to have to stay in a hospital, but my overall experience there did really assure me that I do want to go into healthcare law and ethics as a career. Healthcare is not perfect yet. But now especially, I see the role of nurses as so incredibly quintessential to the medical profession. So to all my friends, friends of friends, and everyone who will one day become a nurse: please take the time to consider this patient's account. If you plan on becoming a nurse and have taken the time to read this lengthy article, you are likely already on your way to becoming the kind of nurse that the future needs more of.
