What Nurses Wish You Knew

Forget the doctors. Who knows what really goes on in a hospital? The nurses. We convened dozens of the region's best and asked them everything we've always wondered about: How can I get the most out of the health-care system? How do I choose an end-of-life advocate? What do you think of Google-diagnosing? How about "Nurse Jackie"? And are you going to get mad at me if I buzz you again?

14 // They’ve been through this before // Nurses know there’s a good chance that when they meet you, you’ll be going through one of the worst days of your life—and they want you to know it’s okay to lean on them. “Patients and families don’t get preparation for crises and trauma and terrible diagnoses,” says Mary Walton, nurse manager at HUP. Most nurses respond to your stress level and will do anything to help, from talking through your fears to reviewing end-of-life options.

15 // They don’t keep asking you your name to be annoying // You’ve been lying in that bed for a week now, so why does every nurse who comes in ask you your freaking name? Here’s the deal: Hospitals are busy and complex, and there are a lot of people involved in your care. When nurses continually ask you basic questions, such as your name, your date of birth and what medications you’re on, it prevents mistakes—and nobody wants mistakes. “When we first started doing this consistently,” says Mercy Fitzgerald’s Molly Hayden, “the patient would be like, ‘You know what? I just answered these questions.’ And we’d say, ‘Okay, great! That’s what you should expect at every point of contact in the health-care system.’”

16 // Be attracted to the Magnet // That would be the American Nurses Credentialing Center Magnet Recognition Program, the gold standard in nursing professionalism and excellence. It recognizes hospitals with structures—nursing autonomy, a participatory management style, career-development opportunities—that improve patient care and decrease nurse turnover. Magnet hospitals must meet certain staffing levels, and nurses are better educated in their specialties. “It really raises the bar,” says MossRehab’s Karyn Kling. “You don’t just pass your boards and show up for work.” Our region has an exceptional number of Magnet hospitals.

17 // There are reasons for the paperwork // Even though nurses estimate paperwork takes up half of their time (there’s a big learning curve right now, because everybody’s moving from paper to electronic records), what they call “documentation” is vital for several reasons. First off, there’s insurance reimbursement: If you didn’t put it in the computer, you didn’t do it. Then there’s guarding against lawsuits. But most of all, hospitals use the data they collect to report quality outcomes. (A good source of info on quality outcomes at Pennsylvania hospitals is the nonprofit Pennsylvania Health Care Quality Alliance, phcqa.org.) And that’s a learning tool: If you’ve had two patients with skin ulcerations in a month, you need to work on turning your patients. The biggest challenge, says Pennsylvania Hospital’s Betsie Williams, is keeping patients from noticing all the paperwork: “I’m trying so hard to get it done, but I want them to think 100 percent of my time goes to them.”