• How to Be a Good Nurse

    by Christy Carl-Sillman

    I know a lot about being a patient in the hospital. What to do, what not to do, and who your friends are. I also know the difference between a good nurse and a bad nurse – from the patient’s perspective.

    Once I realized that nursing was my future career I made a promise to myself to keep this knowledge close to my heart and that the underlying motivation to my work would be my experiences as a patient.

    Steps to being a good nurse:

    1: When a patient is being mean, it doesn’t indicate that he or she is a mean person. Remember this when you have an uncooperative or frustrating patient. I consider myself a friendly, appreciative and nice person, yet I was a very uncooperative patient in the hospital, especially with my last open heart surgery. Keep in mind I was also 17 years old.

    I hit nurses, cursed at everyone, and flipped people off as I went down the hallway on the gurney. I wasn’t a bitchy teenager. I was scared, in immense pain, and fighting for my life. By the way, if you transport me in a bed to the floor unit without giving me pain medication first, you’re lucky all you got was my middle finger – having my chest sawed through and every rib broken, then getting bumped up and down the hospital hallway was not a pleasant experience.

    2: Think about what the patient is experiencing and then decide what you’d want in that situation. There are so many rules in the medical field, but we tend to forget one of the most important rules – the golden one. At 17, I barely had the confidence to go out in a bathing suit, and then suddenly I was lying in a hospital unit with my bare chest exposed, intubated (breathing tube place in my throat), restrained, doped up on medication, and no way to communicate to the nurses that all I wanted was to be covered up.

    The breathing tube is uncomfortable, and it is everyone’s natural reaction to try and get it out, especially when you’re on medication and slightly confused. All it took was one nurse to calmly explain to me why the tube was there, how long I would need it, to tell me to let it breathe for me so that I can rest my chest muscles, and to cover me up. I was a much more cooperative patient after that friendly explanation.

    3: Recognize what is most important to the patient. Whether it’s sleep, pain control or a family visitor, nurses need to assess and prioritize the focus of the patient in conjunction with the necessary medical procedures. In my case, I needed pain control and my family.

    As a nurse, one of the most interesting requests is a patient’s cultural or religious needs. Many nurses lack the cultural competence to prioritize cultural or religious accommodations.

    I had a patient whose family were Jehovah’s Witnesses, and something that is very important to this religion is not receiving blood transfusions. They believe that the taking in of blood will ruin their soul and prevent entrance into heaven. Unfortunately, the patient was extremely ill and we needed to give her blood to save her life.

    Since she was a child, the physician obtained a court order to administer the blood, and because it was an emergent situation, we were instantly granted the rights to transfuse her. I had to be empathetic with the mom. Despite the fact that we needed to transfuse her to save her life, her mother was more concerned with her afterlife and the integrity of her soul – what good is life when your soul is damaged? So I made a point of covering the tubing with blankets and towels when the blood was infusing. I wasn’t hiding what we were doing — she knew her daughter was receiving blood, but I was being sensitive to her feelings.

    4: recognize how white the walls are. When you’re fighting for your life, sometimes the hysteria of the hospital makes you forget exactly what you’re fighting for. I have a history of becoming very depressed with hospitalizations, and tend to feel hopeless and unmotivated. I don’t think I’m the only patient who has experienced depression. One of the best ways a nurse can motivate her/his patient is to remind them what s/he’s fighting for.

    I was extremely depressed during the now infamous 17-year-old open heart surgery admission, and again, all it took was one awesome nurse to turn my internal light back on. She was a night nurse and was doing something mundane like taking my vital signs, and upon seeing that I was awake staring at the walls, she began to ask me about myself. Did I go to prom? What did my dress look like? What are my plans now that I’ve graduated high school? It was just enough to remind me of who I really was and what I was getting better for. Talking about all my friends and getting me to think about my plans for the future reminded me that I had a future outside of the hospital. It made all the difference in the world.

    The key lesson here is that all it takes is one nurse to change everything for a patient. I’m not a perfect nurse and I have a lot to learn. Sometimes I get tired, overwhelmed and frustrated with my patients, but I always try to think of at least one nice thing I can do for them during my shift.

    And one more thing. It goes both ways.

    Steps to being a good patient:

    1: Remember that everyone is there to help you, not to hurt you, even if what they do to help you hurts.

    2: Bring the nurses chocolate.

    3: It isn’t a hotel, so don’t expect a hotel-like experience.

    4: Bring the night shift nurses extra chocolate.

    • Loved this. Passing it on to my friends who are nurses as well to everyone who could benefit from this story. Thanks.

      • David Lacy

      • February 20, 2011 at 9:47 am
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      My mom’s a nurse, loved it, and “shared.”

      She liked “step #4.”

      • Hank Fradella

      • February 20, 2011 at 9:54 am
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      Great column! I passed it along to several friends who are nurses.

      • Jesse

      • February 20, 2011 at 11:24 am
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      Thank you for this. I am not a good patient. I’ll remember the chocolate. Also, I want you to know that the white walls make me crazy. Next time I land in the hospital, I’ll need to pack some wall art to take with me. Can’t say enough about the blank walls. J

      • Camille Welton

      • February 20, 2011 at 12:07 pm
      • Reply

      “Once I realized that nursing was my future career I made a promise to myself to keep this knowledge close to my heart and that the underlying motivation to my work would be my experiences as a patient.” I couldn’t agree with you more. I’ve spent a large amount of time as a patient in various hospitals throughout my life. When I decided to go into health care (currently a nursing student in Sac State’s BSN program), I vowed to remember the things that made my stays tolerable, and the little things the nurses did to get me through every horrible moment that made time drag on forever. My experiences very much influenced my decision to become a nurse, and like you, I hope to incorporate this teaching into my daily patient care. I plan on sharing this with my classmates as well. Thank you for reminding me who I need to be!

      • Tara

      • February 20, 2011 at 1:02 pm
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      very awesome! I agree, when my patients are difficult I try to remember that its not personal, and its not about me, they dont feel good, and want the f out of the hospital!

    • Beautiful. Thank you.

      • Theresa

      • February 22, 2011 at 10:49 am
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      Loved this column, Christy!
      I am registered to start school in the fall and although I can’t immediately be admitted into the nursing program, that is my goal. I will absolutely keep this check list close 😉

      (PS: When I was in the hospital for pre-term labor, I remember how important it was to me that the nurses treated BOTH of us like patients; that they acknowledged the girls [I had pre term problems with both pregnancies] and not just me. I was so scared to lose them and when I felt like the nurse was treating my unborn child like an organ, it scared the crap out of me. The white walls bit is so true…)

      • Sarah

      • April 25, 2011 at 8:51 pm
      • Reply

      Such a GREAT read Christy! Okay, Now I hope you will edit this post and add how to be a good Parent of the patient. 😉

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