No matter what health-care reform winds up looking like, one thing’s certain: Nurses will play a bigger role than ever, taking over duties from doctors, moving out of hospitals and into the community, looking after frail aging boomers, leading the push to keep costs down and improve outcomes. So this seemed the perfect time for a consult with the people who really run health care in Philadelphia. As one nurse told us, “Doctors only think they’re the quarterbacks.” Here’s what nurses had to say about their work, their patients, life and death, and those little white caps they used to wear.
1 // It’s okay to buzz // Really. Go ahead. Room too cold? Need a pillow? Got a question about your meds? Use the buzzer; that’s why they put it there. “My 82-year-old mother was just in the hospital for a stroke,” says Presbyterian Hospital’s Michael Becker, “and she said, ‘I can only hit the buzzer two times a day.’ I asked, ‘Why is that?’ and she said, ‘Because they’re going to get tired of seeing me.’ I said, “No, no, Mom, it doesn’t work that way.’” If somebody’s pushing the buzzer all the time, nurses know there’s a deeper issue and work to address it.
2 // You don’t have to be afraid // Nurses understand that patients often don’t speak up because they feel vulnerable. But when we don’t voice our thoughts, they have no way of knowing what needs improvement—until the patient-satisfaction survey arrives after the fact. And they hate finding out there was something they could have fixed if they’d known about it. “It’s natural to be fearful,” says Pennsylvania Hospital’s Mary Del Guidice, “because you’re lying in bed with all these faces looking down at you. But don’t be afraid of us.”
3 // They still save your life if you’re an organ donor // “It’s not like we’re looking at you and going, ‘Oh, I bet you’ve got a nice liver,’” says Barbara Riegel, a nursing professor at Penn. Yet they’ve all heard the same fears about pulling the plug on organ donors. In their eyes, we’re looking at the issue backwards: “You’re my patient,” says Marilina Mancini of Mercy Philadelphia. “Organs are donated to someone else’s patient. I’m going to do everything possible to take care of you.”
4 // Get a second opinion // Everybody should get more than one opinion. And do some homework beforehand, so you have questions lined up. The most important question? “Ask what the person would do if this was their child, their husband, themself,” says Penn nursing prof Linda Jacobs. “Make them think about it on a personal level.”