August 28, 2006, 8:59 pm

Somebody’s Watching Me

angelOh dear….

It this the epitome of kitschiness or what?

Pardon me whilst I wipe up the sap pouring out of my computer.

Most patients don’t see me as an Angel of Mercy.

They see me as the Defender of the Dilaudid stash.

I don’t even wear my cap, although I want to.

My wings would so get in the way….

(Is it just me or does she look like she’s ready to check cervical dilation on two patients at once?)


Having spent some time with a relative in ICU, I realized that we are being watched.

And judged.

By the family.


It doesn’t matter where you work.

Nurses are watched.

And families listen.


That comment you made with a sneer when you realized a patient was returning?

  • The family member who beat the ambulance saw you. And heard you.

The times you left your patient exposed when you ran out of the room to grab a piece of equipment?

  • The family noticed. Each time. Every time.

That time you offered to help your co-worker with their patient?

  • You’re a professional.

The People magazine you were reading at the nurse’s station while your colleagues ran their butts off with 1:1 patients on multiple drips and a ventilator?

  • The family watched you. For two weeks.
  • The consensus? You’re lazy.

The vivid description of the concert you attended last night that the entire department could hear?

  • Numerous families were listening. Think they appreciated your description of your guitar virtuoso du jour?

Keeping the family and patient apprised of how their admission is progressing?

  • You’re efficient.

That F-bomb you dropped in the middle of a sentence while inserting an IV?

  • It wasn’t appreciated.

Oh, and that gum chewing, finger snapping, in-your-face attitude that you think is so cool?

  • It’s obnoxious. And so are you.

If all the world is a stage, when you are working with patients in a hospital setting you are in the spotlight.

Every move, every facial expression, every word you utter adds to the overall impression the patient gets of who you are. What you do as a nurse. Your professionalism.

Or lack of it.

It doesn’t matter that the patient’s perceptions may be inaccurate. Or that the family may have misunderstood.

We are there for them.

And when we are in sight or hearing range of those patients and their families we need to give that impression.

Even if we have to “fake it to make it”.

Because the family is watching.

And the patients are listening.


  • Susan

    August 28, 2006 at 10:55 pm

    That Angel of Mercy looks like she’s been hitting the Dilaudid herself.

    Re judging: yes, that’s exactly right. And conscious patients know exactly how staff feel about them.

    My mother had lung-cancer surgery a few years ago (they caught it at Stage 1, and the surgery got it all, and she didn’t even need chemo or radiation). She was in a very fine cancer hospital, but when she was helpless after the surgery, there was one aide who just didn’t like her — my mother never learned why — and my mother became terrified every time this woman entered the room. She didn’t trust that this person would give her good care, and there wasn’t anything she could do about it.

    Please remember how completely powerless helpless patients are, and how much at your mercy. Those wings may not be a bad idea, after all.

  • Peggy Lowery

    August 29, 2006 at 6:31 am

    AMEN ! ! Peggy, RN

  • intelinurse2b

    August 29, 2006 at 7:00 am

    Yet another lesson that isnot taught in Fundamentals, that should be. You rock Kim! (yes, Im in class right now, but its orientation, i.e boring, so Im reading…)
    And learning I might add!

  • TC

    August 29, 2006 at 1:52 pm

    Thanks Kim. And when are you going to become an instructor? Today’s nursing students need you!

  • Mama Mia

    August 29, 2006 at 3:15 pm

    100% spot on, Kim. You should submit that to one of the National nursing magazines or offer to speak at a nursing graduation and share those thoughts!!


  • Pk

    August 29, 2006 at 3:19 pm

    My mom drove me nuts in the hospital …because I knew she was one of the patients the nurses hated. I heard the comments as they walked out the door. I saw the eyes rolling. I heard the LITERAL groans when she’d hit the call button (turn it off, it’s probably nothing, she just asked for something a half hour ago) … um, make sure the patients door is shut and is far enough from the nurses station if you’re going to say stuff like that.

    The flip side …when I’m a patient … I’m the one that rarely calls …and the nurses come in with a smile, they come in to CHECK on me because they haven’t heard from me. They come in to carry on ‘real conversations’ …and I know what they think of other patients (I’ve heard about patients like my mom). I’m such a relief to be a nurse to. I’m a favorite. I am not demanding, I get attention.

    (the problem is, I’m usually trying to avoid the attention!!! 😉 )

    After my own 23 hospitalizations I’ve learned something about nurses …and doctor’s … and patients. … if you work together … and take each other’s needs into consideration …regardless of who’s in what position … the other person cares more.

  • Melissa

    August 29, 2006 at 11:39 pm

    That is soo true! I know that I am keeping a very close eye on the nurses that work with my son and I can smell the slightest bit of unprofessionalisim. I am there at every step and if something dows not seem right I will ask questions and nothing will get done until I am satisified that all is well.

  • PaedsRN

    August 30, 2006 at 2:28 am

    I reckon I’d look pretty good with wings!

  • Mother Jones RN

    August 30, 2006 at 8:16 am

    My nurse started looking like the one in the picture after she gave me Morphine for my kidneystone pain.

    I agree with Mama Mia, you should submit your story to Nursing Spectrum. It’s very good.

  • That Girl

    August 30, 2006 at 9:20 am

    Excellent. We once asked that a nurse be removed from caring for our son because of the things I overheard her saying to her co-worker (I was 3 feet away). Things like she was so tired she couldnt get any doasges right the first time today, etc.

    As we spoke with the nurse supervisor she assured us that this was an excellent nurse but as I kept repeating the nurse comments you could almost see her saying “OMG shut UP” in her head.

    A while later I realized that she was probably an excellent nurse saying things that everyone says to their co-worker but when your baby is in the ICU you dont really want to hear it.

    I really respected her by the time we left though because she never acted mad about being banned from my son and she often asked after him when I passed by the nurses station. She was probably an excellent nurse who didnt think about where she was talking.

  • Nurse too

    August 30, 2006 at 1:09 pm

    I have been a nurse for 30 years and a patient and caregiver for almost the same amount of time, on and off. I have been a terrible patient because I knew it all and the nurses never did anything good enough, mostly. I became a better caregiver when my husband was dx. with cancer. I realized I did better for him when I was nicer to the professionals and still stayed alert enough to make sure they did no harm. I still would never leave him alone though. I have learned that we are all human and not superhuman. Everyone welcomes courtesy and respect. Give credit when it is due. And finally, never, ever deny the patient his or her right of making as many decisions and taking as much control as possible. Sometimes deciding small things are the only decisions left. Peace..

  • Rafael

    August 30, 2006 at 1:50 pm

    A patient with an interesting tatoo on a rather sensitive part of his body was intubated. When some staff ran across it, despite his sedation, he was fully aware of the comments being made.

    When I got to him later, he looked pissed.

  • Jen

    August 30, 2006 at 4:12 pm

    I first learned about this “stage” when I waited tables. There was a “front of the house face”, and a “back of the house face”. I’ve carried this theory of a “stage” into nursing, and you are soooo right in your post here.

    “defender of the dilaudid stash” that is hilarious!!

  • Gail Rae Hudson

    August 30, 2006 at 6:02 pm

    I’m just catching up on my reading, too. Most of my week has been focused on preparing Mom and circumstances for the day trip from which we just returned.
    I have to tell you, kim, regarding the post you mentioned in the much appreciated comment you left on my site, today, I think you DID write the post you mentioned, twice; once at my site and once here!
    Every time my mother is blessed to be attended by an excellent medical professional like you (which is often, actually, and I’m ALWAYS careful to bring these people to the attention of hospital/clinic administration both verbally and in writing and always by name; I figure, the right to complain carries with it the responsibility to commend) I get scared. I’m not oblivious to the deteriorating conditions under which health professionals work. I’m surprised that more haven’t left the field to set up private practice, or simply left. Thank you, kim, personally, for continuing to tough it out. Although my mother and I may only cross paths with you in cyberspace, I know that those with whom you do come face to face as you practice have to be extraordinarily grateful that you are there when they need medical attention and treatment.
    I hope that, as medicine receives more and more attention, it will only get better and that medical professionals such as you will consider that you chose the right field and will want to stay through the touchy conditions now afflicting medicine.
    And, loved the picture, your interpretation and the many interpretations of the commenters (all of whom I’ve read). I especially like the one who “saw” this nurse while on a morphine drip!

  • Dawn

    August 30, 2006 at 6:26 pm

    I loved this post. As a new nursing student these are the things that I need to hear. I will remember this post when I start clinical rotations in a few weeks.

  • Prisca

    August 31, 2006 at 5:40 am

    Good stuff and an excellent kick in the butt. Thanks Kim! 🙂

  • Nurse Hells

    August 31, 2006 at 6:01 pm

    Very worthwhile reading. I may only be a new grad, but my stint in palliative care is really teaching me the benefits of caring for the family as well as the patient!

  • Barbara

    September 8, 2006 at 10:23 pm

    It is interesting how the nursing profession has evolved, or perhaps it is my perception.

    When I was growing up (40+ years ago) most of my friends’ moms were nurses. In general it seemed to me they were very strict with their children, very particular about cleanliness and always immaculate in their starched whites. This contrasted with my mom who was an artist and always had paint on her hands, the house was a mess, etc. So I grew up with a little bit of fear and apprehension towards nurses.

    In the present, my son is medically fragile, special needs and I have spent a lot of time in children’s hosptials. What a difference from my childhood perception. Todays nurses are so nice and so smart. My son can spot a nurse from 50 yards and he always smiles and bats his eyes – even in the supermarket.
    In the hospital, the nurses, after taking care of my son, always ask me if there is anything they can get me – and they mean it!
    They made difficult times bearable.

  • […] in a sticky situation, including and especially us ED RNs, one of my favorite nurses reminds us just how far the stage extends.During a lull in the action (a rare occasion in the ED), Dr. Dimov told me about some of his […]

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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