What a sourpuss! How’d you like your Anacin delivered by this angel of mercy! She looks like she’s ready to administer that entire box per rectum. How DARE you have a headache. How DARE you make her call the doctor
after hours. You. Will. Pay.
Her textbook for Essentials of Nursing 101 must have been “The Patient as Enemy: The Nasty Nurse Model”.
There are times in the Emergency department when even the most dedicated nurse can begin to feel that way. The department is full. You are holding three med/surg and two ICU patients until you can get orders/beds/nurses to move them up. You’re down a nurse because of a sick call and just try to get coverage on a Saturday evening. You have 8 people on the triage list and 14 sitting in the waiting room. Every other hospital in your county is on ambulance diversion, which means you must take the ambulance traffic. Dr. Surgeon wants everything STAT for the appy and Dr. Cardio is taking someone to the cath lab. Now. Ms. Scratchy Throat wants to know how much longer it will be and Mr. Groin Itch wants to leave without being seen. Thank god you are working with Dr. Efficient in the ER, but he’s yelling for the charts you haven’t had time to finish. You have been running for six hours, you haven’t eaten for ten and more than likely you’ll be overtime because someone just called in for the night shift.
In walks Mrs. Mom with her three children, all under the age of four, all of them with fever, all of them to be seen.
You want to scream. You want to pull out your hair. You want to laugh hysterically. You want to burst into tears. You want to yell at the top of your lungs, “NO FREAKIN’ WAY!”
That’s when you start to think of the patient as the enemy…….
Instead, you smile, ask “How can I help you?” while you do quick visual check of all three kids, take down their names and point them to the waiting room to await triage.
- Because the patient is NOT the enemy.
- Because the worst thing you can do to a patient is make them feel stupid, awkward or wrong for showing up.
- Because it is not their fault that they happened to show up on your weekly “Day of Hell”.
- Because they may not have the education/background/experience to know what they are dealing with.
- Because your hospital has spent beaucoup bucks advertising and promoting your facility so that people WILL come in.
- Because sighing and rolling your eyes is not professional behavior.
There are many opportunities during the patients’ stay in the ER to discuss the fact that they may have had other options. A call to their doctor. An Urgent Care clinic close to where they live. An appointment the next day. I mention this when I discuss the discharge instructions.
I tell patients that, while we are always available, there are ways of accessing health care that are cheaper, easier and often more timely than waiting in an ER.
The key to coming across in a caring way in the middle of “hell-shift” is to smile and focus. Smile at the patient. Focus on them when they are talking. Don’t have one foot out the door while you answer their questions. Be pleasant. Acknowledge that it is busy but that you are there for them.
It isn’t easy when you are tired and frazzled. But I find that just acting this way helps me to feel that way. It makes it a lot easier to get through the shift and your patients really appreciate it.
Because no patient wants to feel like they are the enemy.