Be Nice To Nurses. . . Or Else!

– by Scott D. Thompson.

I say this to all of the incoming students at the beginning of the Physician Assistant program where I am often a guest lecturer. This is something I have come to believe that is at times, easier said than done.

After all, our knowledge base is more specific, more scientific, and more deliberate. We make the decisions, give the orders and consider the vast minutiae of the facts and concepts coursing through our brains while doing so. And besides, our time is the most valuable, right?

I consider myself to be, like most of you; a good person with a caring heart that chose a career in medicine. We should like to believe that we are non-judgmental of others, and compassionate about everyone – whether they are our patients or not. Right?

Well, I have to admit that these standards can often slip away during the momentary lapses of reason that take place during the occasional 3:00 AM pages regarding a patient’s CONSIPATION and my often very angry response and corresponding order (e.g. “WHY is this suddenly an EMERGENCY, at THIS TIME OF THE NIGHT?!, now GIVE the patient a soap-suds enema.”). Insert your example here:

However, I was taught a lesson early in my career by some very experienced nurses with senses of humor. I was working as a House Officer in Internal Medicine on the overnight shift when I admitted a patient to the hospital’s cardiac step-down unit. After assuring the orders were written and the patient stable, I set my sights on returning to the call room where I wanted to lie down. It was 1:30 AM, and had been a very busy shift to that point. This was the last patient I would need to see until dawn.

The patient asked me for a toothbrush and toothpaste as he settled in to his room. I told him “no problem.” Well, I returned to the nurses’ station to find that the entire staff was occupied with multiple patient-issues, and no one was available to tell me where to find these items.

So, in my haste and lack of patience, I wrote an order in the chart. It said, “Please provide the patient with a toothbrush and toothpaste.” The following was the result of doing so:

2:15 AM Page from step-down unit: “Did you prefer any particular color toothbrush?”

3:00 AM Page from step-down unit: “Can you specify – soft, medium or hard bristles?”

3:45 AM Page from step-down unit: “Please specify a brand of toothpaste?”

4:25 AM Page from step-down unit: “Did you want tartar-control toothpaste?”

5:00 AM Page from step-down unit: “Do you want one of those toothbrushes with the gum massager on the end?”

Lesson learned. Be nice to nurses. I gathered the nurses were very busy, working very hard, for very demanding patients. I could have waited an extra ten minutes for someone to help me find the toothbrush, and would have slept those three hours. I had insulted them by writing an order to do something they would have been happy to do – if I had the courtesy to ask in person.

I have since made a practice to “be nice to nurses.” This includes thanking them when they go out of their way to help, expressing interest in their own well-being, and reminding the nurses who apologize for calling me at odd hours that “it’s okay, it’s my job … let me know if this (treatment) doesn’t work.” It can be challenging when the nurse on the phone sounds unprepared; but there are great dividends in saying something like “I know you are busy, take your time or I can call back,” – in comparison to a loud and angry sigh.

Yes, the 3:00 AM call about constipation IS ridiculous, but is far less likely to be made by nurses who have come to know a kind and patient voice on the phone. I still get these calls, but mostly before bedtime and by nurses who say “I’m trying to think of these things and get them out of my way so I don’t have to call you later.”

It’s the Golden Rule, and it’s simple; but so easily overlooked when we as medical providers are 100% certain that our jobs are the most stressful. A friendly and patient voice can inspire these often overworked and overloaded people to go above and beyond, and perhaps make your patient their priority. Heck, they may even help by filling out your paperwork and helping you find that elusive toothbrush in your hour of need.

Happy Nurses Week, our thanks to all of you!

– Scott Thompson, MS, PA-C