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  #1  
Old 08-31-2007, 03:36 PM
Marachne
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Default Are You a Nurse?

I first posted about this over at my blog, but I realize that it may make for an interesting topic of discussion.

Back in December, my mother was having knee replacement surgery. Six months prior she had had her other knee replaced, and there had been complications: delirium, probably from dangerously low sodium (116!). Her surgeon was going to discharge her despite the obvious mentation changes and had to be practically bullied into running blood tests to check her electrolytes.

So after the second knee surgery, when the hospitalist (with residents in tow) came to check on her, I started to advocate strongly for what I felt was a necessary level of care. About five sentences in, he turns to me and says "are you a nurse?" At first I felt a little defensive (I was afraid he was perceiving me as a meddling relative), however when I said "yes," his response was to say "OK, then I'll explain things in more technical terms, and you can explain to your mother."

Last night, a family member called in asking about their relative. I didn't know the patient very well, they had been admitted while I was off, but I was looking through the notes trying to garner more information, and as we were talking the caller started to ask more technical questions, as well as explain things about the patient that was not clear (or downright wrong) in the chart. Almost unbidden from my mouth came the words "are you a nurse?"

Pause.

"Well yeah."

"OK, then I'll go into detail about what this report states."

So here're my questions:

1) What are your experiences as a nurse and either a patient or an advocate for a family member/friend--how does being a nurse impact your interactions with other health care professionals?

2a) What is your reaction/are there any changes in how you interact with a patient/family member when you know they are a nurse?

2b) Is it different if they are another kind of HCP?

3a) Has anyone ever asked if you were a doctor? Or is always "are you a nurse?"

3b) Do you think there are differences in interactions with nurses compared to other HCPs when they are in that patient/patient advocate role?
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Old 09-01-2007, 03:49 PM
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1) What are your experiences as a nurse and either a patient or an advocate for a family member/friend--how does being a nurse impact your interactions with other health care professionals?

They other HCPs immediately seem to relax and speak to me in a more medically-oriented fashion, whether I'm the patient or a family member. I'm also given a lot more information than I think I would normally be given as a family member.

2a) What is your reaction/are there any changes in how you interact with a patient/family member when you know they are a nurse?

I do exactly what I described other HCPs doing to me! I tend to give more technical descriptions and more information.

2b) Is it different if they are another kind of HCP?

Not really. I always ascertain that they have understood what I've told them, though. I can't assume that even if they are a nurse, that they understand what I've said. They may work in a different field. Same with other HCPs - for example, RTs. I'll speak in more technical terms, but I don't assume they automatically understand it.

3a) Has anyone ever asked if you were a doctor? Or is always "are you a nurse?"

I get asked a lot if I'm the doctor. I don't even wear a lab coat, just scrubs.

3b) Do you think there are differences in interactions with nurses compared to other HCPs when they are in that patient/patient advocate role?

I think nurses tend to open up more. We love to teach and we tend to ask more questions.
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  #3  
Old 09-02-2007, 01:33 AM
bcp
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I've been asked if I am a nurse and I've been asked if I am a doctor, but rarely asked if I'm an NP.

Either way, it has it's good points and it's not so good points. When my son was a baby, I found out the hard way not to say anything. Assumptions were made that I knew how to take care of this 7 lb little bundle that kept me awake at night. Later, they assumed I knew what reactions he would have with that first immunization. Being a new Mom has nothing to do with being an RN/NP!

So for his growing up years, we never told anyone else. When he was in an accident (age 16) and I was asking all sorts of questions, someone approached him when I wasn't there...saying "Your Mom certainly knows a lot." His response - "oh, she reads all the time". It's sad, but I felt like I could keep us "safe" back then.

Today, I tell everyone. I want to know the technical information and I want to make sure my family is cared for. I make it clear I'm first and foremost a family member/advocate for the person in question - I just happen to be a professional as well.

I think a good lesson for us all is to remember that the family member is just that - a family member. She/he may not be able or willing to take on the role of a health care professional, and indeed, may even need more support because of the their level of understand.
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Old 09-02-2007, 03:44 PM
Marachne
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I think that really is the crux of it -- on the one hand, you want to be seen as someone who can understand the technical and more in-depth information, but on the other hand, you want to be seen as who you are in that role--a family member.

And it also can get tricky in terms of what we do/don't do. I know when my mom was in the hospital and had been given MOM for constipation, and then developed terrible diarrhea, I wound up cleaning her up several times because I knew the staff was busy and I didn't want her to be lying there in feces. That said, I didn't want there to become an assumption that I would do that for her all the time I was there, that I still expected them to give her the same care as any other patient.

I think the hardest is when we can't take in the technical information because of our own emotional response, and yet there is an expectation that we will: a terminal diagnosis for a loved one is going to cause the same brain-shutting-down stress in a professional as in a lay person.

And to contradict myself: when my dad was dying, and I went down to be with him, my hospice colleagues warned me that "it's not the same when it's your own family." Yet I found having that knowledge and being able to do what I knew how to do helped me because I didn't have to feel so helpless (and it helped my family because I could act as an intermediary for them.
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Old 09-03-2007, 12:45 AM
MyOwnWoman
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I guess I'm a little different in my approach in teaching patients and their families; even if I know that their family is in the medical profession.

My first approach is to the patient directly. I tell them what is happening, about to happen, what they may feel, not feel, what their lab tests and xrays are showing, etc. I speak directly to the patient and then ask them if they have any questions. Then I turn to the family member(s) and ask them if they have any questions. If the family has more technical questions, I answer them as best I can and then turn to the patient and explain what the family member and I have just discussed.

I try to explain everything to patients and families on the level that they are comfortable, but I also make sure that the patient understands what I am discussing.

This is a lesson I learned from my father. As soon as health care professionals knew I was a nurse, the conversation immediately turned to me and the explanations were give to me in technical terms leaving me to "translate" for my father. This did two things. 1.) It ticked him off because he felt that since he was the patient, it was their responsibility to talk to him and not treat him like some "idiot" that just got off the banana boat. (He's 75, strong, able and a bit opinionated ) 2.) There are times that I want to be a daughter first and a nurse second. The nurse is always there, but I have been his daughter a lot longer than I have been a nurse. I'll ask what I want to know, as I think most nurses will, sometimes to the dismay of the physician, but oh well, they'll get over it.
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  #6  
Old 09-04-2007, 12:12 AM
jojodow
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Quote:
Originally Posted by Marachne View Post

1) What are your experiences as a nurse and either a patient or an advocate for a family member/friend--how does being a nurse impact your interactions with other health care professionals?

2a) What is your reaction/are there any changes in how you interact with a patient/family member when you know they are a nurse?

2b) Is it different if they are another kind of HCP?

3a) Has anyone ever asked if you were a doctor? Or is always "are you a nurse?"

3b) Do you think there are differences in interactions with nurses compared to other HCPs when they are in that patient/patient advocate role?

1. I was forced to become Nurse advocate when my stepfather was dying. After convincing my Mom to call the Hospice,they were too lax in doing anything to help her. She kept telling them she had everything under control when she didn't. I had to step in and talk to the hospice nurse to make sure they got everything they needed. (Oxygen, suction, commode, etc). I had to stop myself from getting all Nurse-like and be the family member. I wanted to encourage my mom to D/C the feeding tube as a family member...the nurse in me kept stopping. Either way...it still wasn't my decision.

2. I think it helped that I was an RN because the Hospice took me seriously when I said "He will Fall without a Bedside commode" etc.

2B. I think it could be with some MDs. They are used to having control and want to take over. I imagine that must be hard. I've seen it with my patients who have MDs in the family.

3a. Only in RN school, when they made us wear Labcoats to things...lol.

3b. Yeah, Like I said about MDs above. I think Nurses are better at stepping back and relinquishing control when they need to. It's great to have someone making sure what is done is done right and correctly....but you've got to let the HCPs do their jobs.
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  #7  
Old 09-04-2007, 03:05 PM
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Quote:
Originally Posted by bcp View Post
I've been asked if I am a nurse and I've been asked if I am a doctor, but rarely asked if I'm an NP.

Either way, it has it's good points and it's not so good points. When my son was a baby, I found out the hard way not to say anything. Assumptions were made that I knew how to take care of this 7 lb little bundle that kept me awake at night. Later, they assumed I knew what reactions he would have with that first immunization. Being a new Mom has nothing to do with being an RN/NP!

So for his growing up years, we never told anyone else. When he was in an accident (age 16) and I was asking all sorts of questions, someone approached him when I wasn't there...saying "Your Mom certainly knows a lot." His response - "oh, she reads all the time". It's sad, but I felt like I could keep us "safe" back then.

Today, I tell everyone. I want to know the technical information and I want to make sure my family is cared for. I make it clear I'm first and foremost a family member/advocate for the person in question - I just happen to be a professional as well.

I think a good lesson for us all is to remember that the family member is just that - a family member. She/he may not be able or willing to take on the role of a health care professional, and indeed, may even need more support because of the their level of understand.
That is so true - I remember everyone thinking that I knew exactly what to do with my first baby because I was a nurse.
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  #8  
Old 09-04-2007, 03:09 PM
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I like the idea of telling the patient and then checking with the family to see if they have any questions.

I did that with a patient in theie 90s and the daughter thanked me for talking directly to her mom because no one ever did that!
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