Friday, August 31, 2007

Are You a Nurse?

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. 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?"


"Well yeah."

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

Nothing like having the shoe on the other foot to gain better understanding of how we humans behave.


deakat said...

Does one have to be a nurse, though, to be treated with the same respect? While I'm not a nurse, I do have some basic training in medical terminology (hospital ward clerk certificate) and the intelligence to interpret much of the information that might be provided.

marachne said...

I think anyone who starts asking questions in a more technical manner is likely to then receive a more technical response. It's not a matter of respect per se, but getting a sense of how to best deliver information.

I think it may also be a matter of attitude--I may get in trouble for this, but I think being a patient advocate is such an integral part of being a nurse, particularly when talking with providers, that there is just a certain tone that sometimes comes into how we interact.

Part of what I was processing after this event was rearranging my own perception of the question. When I was asked it, at first I felt defensive--afraid they were going to resent me (which was not the case). I better understood the question when I found it coming from my own mouth.

I think if someone said "no, but I am a ward clerk," I would do something similar, i.e. recognize that this was someone with a certain level of knowledge and understanding and speak to that.