Dr. Wes has a short post today, How to Optimize Your Care While Hospitalized that got me thinking. He writes:
…A lone doctor listening to some highly experienced and capable nurses, reflecting on their work:
“If the patient’s nice, it’s a lot easier to want to go back in that room with them. Their reputation travels at the nurses station. But if they’re mean, well, it’s not as easy to go back in there, so I might not stop by as often.”
“I agree, it’s easier to catch flies with honey than vinegar.”
Words to live by.
My first take: He and the nurses are right, of course: If you’re pleasant and courteous, nurses (and doctors, and physical therapists, and aides, and cleaning staff…) are more likely to spend time in your hospital room. The maxim applies in many realms.
But let’s take the conversation to the next level. What if the patient’s in pain? Sad, or maybe even crying? In that case, are the hospital staff less likely to enter? Probably so, but health care workers are a diverse bunch.
There are many nurses I’ve known who’d spend more time with an unhappy soul, or someone in pain. As a doctor, I think the same holds.
Maybe some people are grouchy because they’re uncomfortable, worried or lonely and just don’t have it in them to smile. They may lack insight or simply lack manners. They might be very upset, say, that a son or daughter hasn’t visited, or another unmentioned disappointment.
Perhaps it’s the professional’s job to see beyond the smile, or the anger.
Not an easy job -
—
Oh, you are so right, Elaine. Why should anyone feel happy, polite, cheery and chipper after they’ve just had surgery, a heart attack, a CVA or some other calamity that is bad enough to send them to the hospital? Most people do their best, truly, but I think we all need as clinicians to remind ourselves that our patient’s affect might be a symptom of something we need to pay attention to. I’ll never forget a patient I had in subacute rehab early in my career who became suddenly confused, teary, moody, uncooperative, and labile. At first, we thought she was having another CVA. She wasn’t. She was suffering from hyponatremia. Who knew? We were trying to control her salt intake because of her previous CVA and hypertension, and we controlled it a little too well! It was a lesson I never forgot.
People are complicated -
When nurses and other hospital personnel are well trained — meaning they understand that the patient’s behavior is often a manifestation of their physical state — then whether or not a patient is “nice” is irrelevant. I find those kind of labels fairly narrow conceptually.
I just spent two days at MD Anderson as a caretaker. Perhaps that colors my thoughts because our care was superb. Hospital staff barely have the time to go have lunch; much less talk about who’s nice and who isn’t. On our unit were patients with severe head and neck cancer; many involving reconstruction. The staff was devoted to making sure each was comfortable and had what he/she needed.
People ARE complicated; and looking at them as “sunny” or “optimistic” pigeonholes them at a time in their life that may be their most challenging. Understanding goes a long way.
Jody
I’m a nurse at a hospital. I completely understand what this article is saying. I am in a patient’s room more if they are hurting, crying, scared, upset.
I have a very hard time going into a patient’s room who thinks I am their personal servant to fetch lattes for them, or one who yells “get out” when I am trying to make sure that they are stable, or who thinks that all hospital employees are somehow “out to get them”.
Do I not go into the room or ignore call lights? No. No nurse I know would ever ignore a patient. But I will not be stopping in for extras like drinks/snacks/pillows UNLESS they put on a call light.
Jody, Thanks for your insights on this. Unfortunately, a lot of hospitals (read: nearly all) aren’t so well-staffed as is MDACC. A stressed nurse or doctor assigned to too many patients may have a harder time coping with a grouchy person who’s ill.
Ryanna, It sounds like you’re clear about your priorities! You’ve inspired me to write more on some of my experiences with nurses (from my patient’s perspective). Best wishes -
I think this article holds truth to it, BUT on another note as nurses (or other health care professionals) we do put the whole picture into consideration. We know there are factors/underlying issues that can cause the behavior. On that note, some patients are just plain rude, just because that is just the way they are. I myself, will politely call patients on their behavior, rudeness, demands. A majority of the time when I call them on it, the way they treat me changes.