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From a nurse with over a decade of experience working in acute care, adult populations on cardiac telemetry and critical care step-down units… here we go.
What Nurses Wish People Knew About Hospitalization
Hospitalization is not fun for anyone. As a nurse, it is what I do: I take care of people who have the great misfortune of meeting me under these circumstances. Given my specialty, it means they broke something or have had a neurovascular event or surgery. It is not a fun experience for people, by any stretch of the imagination. As much as I can, I try to inject humor into things, particularly as the hospital day moves forward. People can be easily frustrated, because almost all autonomy is taken away. Trust me, we do not enjoy torturing you (that’s the physical therapists).
You will have your autonomy taken away. Hospitals, by design, are meant to be a very controlled environment. On my unit, almost all patients are cardiac monitored. While we are lucky to have technology that allows one to be monitored more freely and not attached directly to the bedside monitor, it is still pretty restrictive. There will be wires and tubes everywhere. We will do our best to position them in such a way that you can move around in your bed. Let me, rephrase that. We will do our best to position the tubing and wires in such a way that you can wiggle around in your bed and possibly roll over a few times. Largely, you will not be allowed to freely walk around in your room or outside of it (particularly with COVID). Many times, there will be a bed alarm. More on that later. We will ask you to call us for everything. I’m not joking. Everything. Want to urinate? Great! Call us. Want more water? Call us. Want to sit at the chair instead of the bed? Call us.
You will not have very much privacy. We do our best to help maintain modesty, but biological functions being what they are and limited mobility being what it is, you may find yourself in need of someone to clean you up. Sometimes it will be more than just one someone. I guarantee you, this is not unusual. While you may feel embarrassed or upset that someone is doing this for you, it is often for the best. If you can help, we would love you to! If you have mobility, it’s best to use it. If you can wipe yourself with bath wipes, great! We are pleased to let you do it. There will be times that we do not let you alone: bathrooms and showers are a good example. It isn’t that we do not trust you. It is that you are in the hospital. Not only are there liability issues, but if anything ever happened to you (and sometimes is does), we need to be within arm’s reach to break your fall, guide you to the ground, and deal with whatever may arise. Really. We get no joy out of sitting with you at the toilet. It’s just necessary.
Please do not try to “be helpful”. If you are in a position to be helpful, you’re probably getting discharged. If you aren’t, ask the nurse if there is any way that you can assist in bathing, toileting, etc. Also, ask the aide. The aide is there for most of your bodily functions and they are an unused resource in the nursing world. Many of our aides have been CNA’s for longer than our nurses. One just celebrated her 20th Anniversary. Oftentimes, when people try to be helpful, there is a fall, or something gets dropped/broken, or people are massively inconvenienced. It often has the exact opposite effect of what you are trying to do. We appreciate the sentiment, really we do, but more than helpful, we want you to be safe and well. If that means that me or my aide are at the bedside grabbing your charger that’s just a teeny bit out of reach, so be it. It’s one stitch you didn’t pull and one doctor I didn’t have to notify.
Please use your call button. Please. PLEASE. I cannot emphasize this enough. Use your call button. Do you have questions for your nurse that need immediate attention? Use your call button. Do you need to go to the bathroom? The second you think you might, use the call button. Do you think you can make it to the bathroom alone and try to be helpful (see above)? NO. Use your call button. Often, people will be tangled up in multiple wires. There are also bed alarms (more on this later). If you do not use your call button and get us on your own, there’s a decent change that those wires will get pulled off and your IV, pulled out. This means that we’ll have to poke you again and more often than not, there’ll be a bloody mess everywhere that will require everything to be changed, floors mopped… just don’t do it. Please call us. We’re really much happier when you do.
Please, PLEASE, use your call button. Do not send family to the Nurses’ Station. Again, people think they’re being helpful by coming up to the nurses’ station rather than “bothering” them with a call. More often than not, that’s an excuse and it’s transparent. We know you want your family member to get assistance super quickly and you think that showing your face and asking at the station will get you what you want faster. This is incorrect. At the station, your nurse may not be there. When you say something like, “My mom needs to go to the bathroom” to someone who appears to maybe be a nurse at the station, we’re pretty confused. You see, we don’t know every patient. We certainly do not know every patient’s family members. We don’t know who your mom is and now we’re going to have to ask follow-up questions. “I’m sorry, I don’t know your mom. Who is your mom? What room?” Then we will walk over to the paging system and page. So now, instead of getting a quicker result, you have made things much slower, as well as demonstrated to the entire staff that you are impatient or think that your family member deserves special treatment. That may not be what they’re thinking, sometimes people think it’s nicer not to page. Let me reassure you: pages are where it is at. In my call system as well as many others, if a call is not answered within a few minutes (meaning someone actually goes in the room), it rolls to the next higher person until it hits the charge nurse. If a page isn’t answered, trust me, someone knows.
There will be new and unusual sounds and alarms. On my floor, there are many unusual sounds and alarms. Many of them do not mean anything to the patients. If you hear an alarm in your own room and you just got out of bed, sit back down in bed. That was probably a bed alarm and you probably aren’t supposed to get out of bed without calling someone first. If you are in bed and you hear alarms, feel free to call the nurses’ station and describe it. Mimic it, even. If you know what the sound is, tell us. It’ll get paged out and usually resolved pretty quickly. Other alarms will be softer; these are usually alarms for the nurse to be aware of. If you can tolerate it, great, tell the nurse when she comes in where the sound was coming from. That’s helpful. If you don’t know, describe/mimic it. This is also helpful. Sometimes when something needs to be plugged in, it’ll alarm. As soon as we plug it into the wall, it’ll go away. It’s really an easy fix. Please tell us. We don’t want you suffering through all of the alarms if we can help it. You might also hear hissing sounds. That’s your oxygen. If you hear a high-pitched squeal and you’re on oxygen please immediately tell your nurse. It’s not dangerous. They probably just forgot to vent your oxygen humidifier and it will pop off soon if they don’t. Then there’ll be a puddle on the floor and a pain for the nurse/aide. If you hear bubbling sounds, that’s usually your chest tube. There’s a water seal (often) and it bubbles. This is normal. If you don’t have a chest tube and you hear bubbling, please page your nurse. I have no idea what that is.
Some of the unusual sounds will be other patients. On a neuro floor, some of the usual sounds for us are our patients. It can be really, really distressing for other patients. When you hear someone screaming, literally screaming, “HELP! HELP! AAAAaaaaaaaaaahhhh!” it can be borderline traumatic if you are sick in the bed next door. It can be terrifying. You might call the nurse and ask them for help. They might tell you that the patient is always like that. If you hear things like this, please do ask the staff. We really cannot break HIPAA, but we can reassure you that it is not an acute issue, they’re being helped, etc. If you hear a nurse or staff calling for help, please do not hesitate to also shout for help for the nurse or to use your call button to call for help. If a nurse is shouting for help, it is usually because her hands are full and something is going on (either a patient is trying to fall or there’s an emergency). This time, calling is actually helpful. If another patient’s sounds are really bothering you, please let us know and we’ll try to shut the doors. Sometimes we’re able to move you to another room. Sometimes, we can’t. We can offer earplugs and reassurance. In neuro cases, patients often do not understand what is happening and may scream and we cannot be there the whole time with them and sometimes, even if family can be, it does not stop the shouting. We’re sorry it isn’t very restful, but these patients need care too. Please try to have some compassion and some patience. We are all doing our best.
Thank you to @garymcvey and @sawatdeeka for the suggestion. It started to get exceptionally long, so I am breaking this up into two or three parts. I will also have a sequel: “What You Can Do To Have a Better Hospitalization” with helpful hints for friends and family. It will be some of the ideas here compressed with others to help people have a smoother ride in the hospital.Published in