Thursday, August 19, 2010

Nursing Guidelines

Quite a few years back, as a relatively new nurse entering a big city hospital, I was happy to discover that my philosophy of nursing still holds true. I will admit I was a little nervous that I wouldn’t have the knowledge or skill to be successful on such a highly specialized unit like the cardiac access unit. After all, I came from a medical unit in a tiny community hospital with no cardiac experience to fall back on. However, I was relieved to discover that no matter what area of nursing you practice in there is a very simple concept that guarantees success every time. That is the concept of caring.

Many years ago when I first became employed as a nursing assistant in a hospital I remember one of the R.N.’s saying to me “You’re too nice to be a nurse. Don’t worry, after a few years you won’t feel the same.” That comment has always stuck with me and I often wondered if it would hold true. Would I become hardened, indifferent? Day in and day out of responding to every patient’s beck and call “can do that to a person.” So I pressed on, going about my business of nursing, doing what comes naturally to me. At the time I still considered myself a novice but found I had discovered what every nurse knows but not even some of the most seasoned nurses can commit to. A genuine sense of caring. In general, patients have very basic needs. And while each patient is an individual there are a few simple guidelines that if adhered to promise success 99% of the time.

Smile! Greet your patient’s with enthusiasm; it often catches them off guard. Be friendly; take an interest in not only their current medical condition but what their life is like outside of the hospital. I think this kind of personal interaction puts the patient at ease and makes the patient feel on equal ground with the nurse.

Listen. Believe me; I realize this can be difficult when you are pressed for time. When you do have time pull up a chair and really get to know the patient. Also take the time to personally talk with family members, especially if they call. Family members want to hear more than just “the patient had a good night.” I find they really appreciate any information you can provide (within HIPPA guidelines of course!). 

Be Smart. Perform your nursing care with confidence. When a situation becomes challenging I do my best to appear calm and in control. This helps the patient relax as well. Most importantly, if a patient asks me a question and I don’t know the answer I find someone who does.

Educate. Taking just a few extra minutes to explain a procedure or test results with a patient puts them at ease. Keep it basic and don’t scare them with words they will not understand. Don’t just assume they know what’s going on because most likely they don’t.

Be Punctual. I find this to be one of the most important guidelines. This is an area I have made a conscious effort to always maintain. If a patient rings for you and asks for something respond as soon as possible no matter what the request or send someone who can respond promptly if you are tied up. I don’t care what the patient needs, from chest pain to filling a water pitcher, I always do my best to ensure that the patient or family’s request is tended to asap. I find this builds a strong sense of trust between you and the patient. I want my patients to know that when they call I will be there.

Care. This, of course, is the essence of nursing in my eyes. If you don’t truly care, why are you there? I am not sure where or when people develop empathy but out of empathy comes caring. I have been blessed with a great sense of empathy. I am always asking myself how I would feel if I were them. If I were faced with their situation, how would I respond? In having the ability to “put myself in their shoes” I find I am better able to understand their point of view.

Not too long ago, I was assigned to care for a gentleman who had been on the unit for a couple of days prior to my arrival. It was well known he and his wife could be challenging, in fact, there had already been a meeting with staff, supervisors and the patient care rep regarding the patient’s care. It was documented that only “experienced” nurses care for the patient. I was a little caught off guard when I was assigned this patient and by the outline of rules I was to follow that was handed to me as I received report that morning. As I read these “rules,” neatly typed on a piece of paper, I realized how silly it all seemed. Essentially what appeared on that paper boiled down to the basic concept of caring. The same kind of caring I provide all of my patients, whether they are a lawyer or an inmate from the local prison.

So, I entered the private room of this prominent man a little tentatively, and was pleasantly surprised. I proved to myself what I always knew. As humans we all have very basic needs especially in times of stress. In taking the time to prove to this patient and his wife that I truly cared by meeting some pretty basic needs, I was able to develop a trusting relationship with them. In the end, they were still quite demanding and it was then that I had to care the most and be empathetic to their situation.

Later that night as I was walking to the “T” in Boston after a long twelve hour shift, I found myself smiling. At first I wasn’t exactly sure what I was smiling about. Then I remembered how one simple act of kindess  had made one of my patients so happy that day. I had found the time to help an 89 year old woman wash and set her hair. She was so pleased as she shuffled over to the mirror and saw her reflection. I continued to smile that day because it was then that I realized the nurse who had spoken to me so many years ago….was wrong. I haven’t become indifferent or hard, quite the opposite, I have found a profession that suites me quite well.

1 comment:

  1. I enjoyed this post. As an aspiring nurse myself, I sometimes wonder if I can handle the high stress, long hours, not having time to pee or eat.. Wondering if I am "too nice".. But the desire to make a difference in people's lives really propels me to push forward in school. I look forward to more of your posts.. I have quite a ways to go (I'm still working on my pre-reqs) and I'm constantly reading nurse blogs to get a real feel for the field. :)