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.”

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  • Sara

    I have been a nurse for 6 years. I can honestly say that there were very few things in this article that were accurate. “Substance abuse is rare among nurses”. False! I’ve never been around more addicts since I came into nursing. The pretty nurse that spends her weekends carpooling? She popped a fist full of Percocets last evening to relieve the tensions of work that day. “It’s ok to buzz”. False! Buzzing is annoying. Patients will ring at the busiest time to have their sheets pulled up or for the remote control 5 minutes after you leave their room. Then they want to talk your ear off like you have an hour to kill. It’s annoying! Maybe a nurse should have written the article. Then the information would have been accurate.

  • Robby

    Wow. This is in total contradiction to what nurses say behind the scenes. See for yourself:

    http://allnurses.com/emergency-nursing/rules-er-long-170440.html

  • George RN

    As a PACU nurse I enjoy helping my patients through a tough time in their life. I also advocate for them when they need to spend a night rather than go home after outpatient surgery. I’m sure there are some nurses who may feel the article is a crock but that tells me they don’t enjoy their work and they are in danger of burnout. The part about being honest with your nurse is dead on. I don’t care if someone is a heroin addict, it just means they tolerate and require higher dosing to get relief.

  • lola

    While there are some points that are accurate (wanting a patient to tell the nurse truthful information), for the most part this article is wrong. The one that nurses hate the most? People who buzz!! I don’t care if you ring for something important. It just adds on to our hectic days. They should have really thought about what they wrote before they wrote it. It doesn’t make any sense.

  • Ash

    “I don’t care if you ring for something important. It just adds to our hectic days.”
    Okay…this is terrible. I’m also a nurse and at my more busy times I may be irritated to hear the bell, but I’m NEVER irritated at my patients for needing something. Most people feel bad for ringing and if they could get it themselves they would. Why would anyone want to trust in their nurse hearing people say things like this? I agree with George RN…somebody’s in danger of burnout.
    Although I have to point out that substance abuse among nurses (health care professionals in general) is quite common.

  • amber

    FYI: Substance abuse among nurses is common, not rare. I’d be willing to bet there are more nurses using drugs than nurses who don’t.

  • susan

    I have been a nurse for 20 years. Ring that bell, ask me to hold your hand and talk to you.. I can explain your plan of care and answer your questions. I will always do my best and yes I am busy. Every morning I ask God to help me help these people who are sick. THAT is why I am a nurse. No drugs and the rare glass of wine, I am a scientist, a fighter and a healer. I like this article, if you, as a nurse aren’t up for the challenge, please leave…. these sick frightened people need a strong, smart professional who makes them feel safe and cared for so they can heal. I bring competence, compassion and humor to my unit and try to create an enviroment for healing. I was raised in the innercity, work in North Philadelphia and LOVE being a nurse. So yes Virginia, there is a Santa Claus.

  • Molly

    I was dismayed to read some of the negative comments posted by nurses! If you are a patient, please believe us when we say use your call bell. Read the article again, and believe every word. Those posted comments reflect opinions of nurses who need to stop providing bedside care. There is no place in healthcare today for that kind of attitude. Really.

  • Joanna

    I am a physician at a major Philadelphia hospital and was dismayed to read that this article plays right into the overdone RN v MD battle for who is better at taking care of patients. Many of the “witty” comments in the article are simply poorly disguised attempts to remove patients’ trust in doctors and dismantle the teamwork at the center of patient care. I’m saddened and a bit disgusted. Not all doctors are dirty-handed egomaniacs who speak only in medical terms and ignore the need for quality end-of-life care. Shame on you all.

  • Tom

    If you want the truth from nurses and how they feel about their profession, provide them with complete anonymity, you’ll get a more interesting story!

  • gigi

    I agree with the comment above saying that if you ask nurses anonymously you won’t hear what the nurses in the article said. This is the fluffed up version of nursing. Of course the writers aren’t going to write that nurses are using drugs just like nurse jackie, the nurses and doctors all sleep together just like grey’s anatomy and yes, they hate when patients ring.

  • K

    The comments posted here, especially the ones about the call bell or “buzzer” use, are a poor reflection of what most nurses are – caring nurses who chose to be a nurse because they love helping people. If you think that patients shouldn’t be using the call bell, maybe you need to retire and pursue another profession. See you later! A nurse like you will NOT be missed. I for one would rather my patient use their call bell instead of falling trying to get to the bathroom. Your job as a nurse is to gain the patient’s trust and make them feel safe. Being compassionate is part of the package. I work with wonderful nurses who care about their patients. I am not sure where you are working, but if the majority of your nurses are addicts, and possibly yourself, maybe you should be part of the solution and not part of the problem.

  • Rich

    This story must have been put out by a PR Firm. People die in Phily Hospitals every day. The problem is they did not have to. Talk to real ass kicking, life savers not the sell outs with all the letters after their name. Those RNs are owned by the industry and say anything to hide the truth.

  • hlhoiu

    i love nursing. this article describes nursing the way it should be: a 12 hour shift is a walk in the park every single day. i love when patients ring for something 2 minutes after i left their room. i don’t mind being yelled at by a doctor or family member. nursing is glorious. people who think nurses have it bad are silly and are sadly mistaken. hahahaha!! let me guess, their next article is going to describe the wonderful life of a soldier in iraq: safe, well paying and stress free???

  • Anastasia

    Everyone thinks what they read on te internet is the gospel and my years of schooling, experience and constant continuing education means nothing.They know more than me because of something they read on Wikipedia!

  • Tamara

    I applaud Philadelphia Magazine’s article on nursing, and am proud to be a nurse. I am deeply concerned about some of the negative comments some of my nurse colleagues have posted here. Nursing is NOT an easy profession to be in, nor should it be, and there are certainly problems in many health care settings. Every profession has its problems, as do most workplaces, but is not accurate to describe nursing based on some of the less-than-stellar aspects of daily work. Of course, nurses seomtimes get frustrated by patients, co-workers, and physicians. Of course, there is not enough time to do all we would like to do for our patients, and being asked to do one more thing makes us angry. Of course, nurses have problems with substance abuse because we are people, but the rate of substance abuse among nurses is just about the same as it is for the general public (8%). Of course, I have days when I wished I had learned to be a fashion designer instead of a nurse. On the balance though, nurses and nursing have a lot to be proud of, and we can offer a tremendous benefit to people, sick or well…

  • Renee

    There are some very negative comments here. There are some positive ones as well. As far as call lights go, yes, some patients misuse them, but some just don’t want to bother you. I would much rather answer a call light than have a patient with a broken hip, and if I think you are going to get up without using your light, I will probably put the bed alarm on. And yes, it is important to be honest with your nurse-because its the only way we can treat what is really going on. And yes, we care, but we also have 6 other patients that just had surgery and are in pain, so I cannot talk about your dog for an hour right now, but I will do my best to come and talk to you about it later. It is not because we are understaffed, it is because this is my job. I am human just like you. Patients should expect honesty from their nurses also. And if some of you are that burned out, maybe you should consider a job change-nursing has many opportunities away from the typical hospital bedside.

  • Michael

    I just graduated from Respiratory school and Dr. Oz spoke at my graduation ceremony. His speech consisted of the ’10 things he wish he knew when he graduated from college’, and his number piece of advice was “let love guide you”. As a student RT, I’ve been to many of the Philly Hospitals, and I can definitely say there are many RNs, and RTs as well, who need to rethink what they’re doing. I’ve seen people take some drastic short-cuts in patient care because their shift ends in 10 minutes, or they don’t care because the patient is practically dead anyway. It’s sick. I was raised to put your heart and soul into everything you do, and if you’re at the point where you can’t stand going to work, then do something else! Life is too short to live your life hating your job, abusing drugs, etc.

  • Aisha

    I am a nurse as well, and for those of you who are annoyed by the patients and claim that substance abuse among nurses is not rare among nurses, I think it’s time for you to find a new career! The moment you lose compassion for your patients or feel irritation towards them rather than empathy is the moment you begin to serve as a misrepresentation for the rest of us whom love our profession and patients. Please don’t speak for all of us- ever; but especially in open forums such as this one. You make us all look like bitter, heartless people!

  • Dvanna

    I disagree with the 6yr nurse who said that the article wasn’t accurate. It was real! No it didn’t getting into the nitty gritty of nursing, but it didn’t intend to. It was intended as advise for t

  • Megan

    I agree–If you disagree with this article and complain about call bells and god-forbid, patients and families holding a conversation with you–please remove yourself from the Nursing profession. There are plenty of nurses who give their heart and soul to their patients and families on every shift. Running up and down hallways to find blankets, pillows, tissues hell–vents, code carts and Swan Ganz machines for the sake of their patients because THEY CARE! If any of the few things I listed annoy you, be gone, please! It will help your follow nurses as well as the patients. This article was a pleasure to read and a pleasure to be seen on magazine racks nationwide. Thank you!
    Sidebar: As a ICU RN, it makes my day when I can TALK to my patients, assist them to the bathroom and most of all educate them! Hello, it means they are one step closer to going home!!

  • Kathy

    I have to say that I had a very serious surgery in a cancer hospital in Philadelphia and it was the doctor who operated and took care of the problem. True the nurses were there but it was the doc who

  • Kathy

    It was my doc who took care of me in the end. He is my top doc. He saved my life and held my hand through a very painful procedure.

  • Kathy

    It was my doc who took care of me in the end. He is my top doc. He saved my life and held my hand through a very painful procedure.

  • Jessica

    As a healthcare professional for over 15 years in the Philadelphia region I can’t even begin to tell you the number of BSN educated nurses who can’t even start an IV or don’t know the ratio of chest compressions to respirations. Give me a diploma nurse any day.

  • Stacey

    yes, I want you to use your bell, but don’t abuse it; I do not mind explaining things to help you through the process, but please designate a point person for family to go to after you get the info; a bad day is when you have an unruly patient/family that treats/speaks to you horribly & management doesn’t offer support; BSN does not mean better nurse; please understand that I do have 3-5 other patients to take care of; I do not decide when you will be discharged, the Dr. does; I will do whatever I can to make you comfortable because I do love my job, so please respect me as a person.

  • nopr

    from a physician’s stand point, I think comments associated with this article are very telling about a good number (not all) of nurses. Trust me, we (as doctors) see your attitudes and no just how bad (or good) you are taking care of your patients…because they tell us! We hear your gossip, we hear how you make fun of patient xyz done the hall, we pick up on your under handed comments. You ask yourself why dr so so is yelling at you? Because you aren’t doing your job!

  • Grace

    I’ve been a nurse at one of the Philly hospitals mentioned in this article for 5 years. It could be argued that the whole article is not 100% accurate for all areas of nursing, but I agree with many of the points made AND express the same ideas to my own patients on a daily basis. With compassion fatigue creeping in to nursing at a frightening pace and hospitals being viewed as a consumer product, I find it helpful that this information is available to patients from a magazine source. Yes, we all have our share of difficult patients and bad days, but if you truly have the heart of a nurse, you can see the positive impact this article can make in our daily care and our job satisfaction. To you the patient – you don’t have to be afraid, I will listen to you and be present to you, I want you to ask questions, I want you to ring your call bell if you need something, and please, share your expectations so you are not disappointed when you find out they are unrealistic. Overall, great article!

  • melissa

    I am a patient who has had the unfortunate chance to be in 10 of phillys hospitals most top for the last few years and esp the ones downtown the nurses are brash, nasty, judge you whether they think u r sick enough or evaluate if u r in pain and you find out most of them are on pain meds i wonder if when they tell us we dont need our prescribe meds they put they give them to us and take them themselves i am often billed for meds they refused to give me

  • Irene

    I am surprised there are negative comments to this very accurate article about nurses. I have been a nurse since 1963 and I’m still working in nursing. I would trust my life to the nurses I have worked with in four different states, on med-surg units, psych, ICU, and SICU, and I will probably have to do just that one day. Eventually, many of us need a nurse.
    I don’t understand the idea about patients being annoying. I have never, ever been annoyed by a patient. It just doesn’t happen. I know the patient has something going on if she is using the buzzer a lot. I try to find out what that is by sitting down and listening. I get annoyed in traffic and waiting on lines in stores. I am not immune to annoyance by any means. But it is a privilege to be with a person at such a vulnerable time in his/her life, and to know I make a difference every day. Nurses are heros because they do what is not possible and then then come back the next day and do it again…