Lesson #17: Medical To-Do Lists

I don’t know about y’all, but I find the list of instructions from the doctor exhausting. Yes, I know that I need these prescriptions, to follow this diet and to get these procedures scheduled. But I also have a life that I’m trying to keep up with and even enjoy. So let’s be honest, sometimes I mess up on one (or all) of the above. So you know what I found helpful? I have a priority list with all my healthcare to-do’s and knowledge of the consequences of messing up. I was explaining this to a patient I was speaking with the other day. I could tell he was feeling overwhelmed with the many lab results as well as the medication and diet recommendations that went with them. He confessed that he wasn’t going to follow the recommendation on lowering the potassium in his foods. I explained that I get it. Completely. Then I asked him if he understood the possible consequences of having a high potassium. He shook his head no. After I explained how potassium works and how dangerous high or low levels could be, he was all about cutting out high potassium foods. We also went through other labs and talked about what happens if they are out of range. At the end, he understood consequences for the behaviors he was choosing. That’s how I deal with all of the medical to-do lists in my head. If I want to put off a test or indulge in something not on my diet, then I make sure I understand what could happen. I can’t be perfect all of the time so I make sure to know the things I better be pretty close to perfect on.  And don’t get me started on the pills. Good grief. This pill can’t be taken with these other ones, this one needs to be taken on an empty stomach, other ones with food and some multiple times a day. I’m a nurse and I get confused! Maybe not as confused as just trying to find enough times in the day to take all the pills. I really just want to give some perspective to the other side. I really think we mean well, but we forget that when we go over the list of things to do with patients that some of them feel like we are speaking another language. And they are overwhelmed. So maybe you could offer some suggestions or make sure they understand what things could kill them instantly & what things they have a little wiggle room on. Teach them priorities and potential benefits vs. consequences. And as always, remember to give grace because you never know when it could be you sitting on the other side.

Lesson #16: Am I blushing?

Even though we are healthcare professionals, we can still get embarrassed. I know that some people don’t feel comfortable talking to patients about  sex or their “private area” issues. But come on y’all, those tough discussions are part of the job. I actually learned a great lesson about this subject while being seen at a physician’s office. The experience was positive and left me thinking about how I probably had failed to do such a good job with my patients. I’m a nurse and am pretty comfortable discussing about anything. But even for me, there’s still some things I get a little embarrassed to talk about and probably won’t bring up to the doctor unless absolutely necessary. I don’t know the number of times that a doctor asked me if I had any questions & I just said, “No” (when I really had plenty). Well the physician I was seeing was so comfortable in her own skin, that she made me more comfortable in mine. She asked questions without seeming like it was any big deal. She told me things that I might be wondering without prompting and it made me open up and tell her more. It hit me that I may need to cover these tough topics without waiting for the patient to ask. For example, when I’m talking to a patient about having certain procedures done, I’ve learned that I should cover whether or not they can still have sex. Very rarely will a patient ask me the question, but time and time again when I just tell them, they usually say that is what they were wondering. Try to think of those hard questions that may be difficult for patients to ask and go ahead and open up the discussion. As a healthcare person, I may know that the procedure won’t affect their sex life at all, but they may not. Another topic that seems to be hard for patients is the financial part. I try to get that part off their mind at the very beginning of meeting with them. I’m not the person who handles that, but I do assure them that we have a team working on it & that we will make sure they have resources available. When you are comfortable talking about the tough subjects, it makes them more comfortable. Just remember, if it’s something you would wonder or be embarrassed about, it’s probably a thousand times more embarrassing for someone who doesn’t work in healthcare.

Lesson #15: Who loves all the phone calls?

Hooray for the endless phone calls to return, which will in turn lead to more work. Yep, I get it. And yes, as a patient I know how busy your office is with other patients. And I know that if this is a medical emergency, I shouldn’t leave a message but rather call 911. But there’s that fine line of, it’s not an emergency but it’s pretty important. And there are also the phone calls for refill requests, paperwork request, and on and on. Here’s my point- I’m not really sure who’s “fault” this is, but our system is broken in many facilities. Someone should be screening the phone calls instead of transferring every call to a voicemail. I think a triage system should happen with phone calls and this should be handled by a nurse. Immediate needs should be handled…well immediately. And I will echo some things I previously mentioned about how the return phone call is handled. Please don’t make me wait all day & then the minute that I run to the bathroom, let the phone ring once and then hang up. You know that you blocked your number, so I can’t call back without having to do the whole leave a message thing all over again. That’s just dirty. And please, if you want me to come in to be seen again, don’t wait until I’ve waited the entire day to tell me that. I’ve tried real hard to remember how this felt and do better. I prioritize the return phone calls and do my very best not to make patients wait forever on me. And if  I have to call them late in the day from my personal phone and block my number, if they don’t answer then I try to call back again. I just do my best to remember how it feels to be waiting on someone to tell you what to do or to call in that prescription. Waiting stinks, but especially when you’re sick. Another lesson learned. I will be considerate of when people are trying to reach me and respond within a reasonable timeframe.

Lesson #14: It’s not about you

I’m going to confess that I already had this pet peeve prior to my major awakening. However, I did get to personally experience it and that put a huge highlighter on it. What I’m referring to is the staff members who decide to tell patients their life story. Or tell them about how hard they work and aren’t appreciated & maybe about the nurses who called out sick today. Or how about one of my favorite stories, the staff who whined about not having enough money to feed her children to all of her patients. Or…I could go on and on. Sound ridiculous? None of those are made up events. I sincerely think the staff member justifies the behavior in their head for many reasons. I think they want to relate to patients & want to make the patients feel comfortable with them. Here’s the deal, sometimes I will tell patients that I have health problems too & I can empathize with them about what they might be going through. But there’s the line, in my opinion. I do not make the conversation turn into my therapy time. It’s not about me. The patient paid to come and be taken care of by us. This visit is and should be, all about them. They shouldn’t be comforting me or offering me money to buy my kids food. And they shouldn’t know if I’m sick but had to come to work anyway because we were so short staffed. They certainly don’t need to know that my cat died this morning and my cousin got arrested. Am I making sense? To me, this seems like such common sense. However, I’ve come to realize that it’s not a no-brainer for many people. So let me help you. Don’t tell the patient anything about yourself if you aren’t sure where the line is that shouldn’t be crossed. And if you mess up and realize you have somehow made the patient’s appointment into your therapy time, then stop it. You are getting paid to listen and take care of the person sitting in front of you. They need you to not pile anymore on their list of burdens. They also need you to shut up because they either a.) don’t care or b.) just don’t feel well and don’t feel like you rattling on. If you are short staffed, complain to management who can possibly do something about it. If you need sympathy, phone a friend. If you need money, go to the bank, find local resources or just learn how to manage money better. But for crying out loud, their visit is all about them! 

(Why did that Toby Keith song just pop in my head? I wanna talk about ME, wanna talk about I, wanna talk about #1…)

Lesson #13: Walk a mile in their shoes

One day I apologized to a long time patient of mine, for previously not being as thoughtful as I should have been. He hugged me and said, “Sweetie you were the first person I saw and you brightened the room when you walked in.” This was nice to hear and to know that at least some of my good intentions have shown. He didn’t even realize what he missed because I didn’t get it. Maybe we all don’t have to face health problems to start to walk a mile in our patient’s shoes. Maybe we can stop every once in a while and just really think about how it would feel to get life changing news. Or we could think about how hard it was when a family member went through a medical problem. People who have never been sick don’t understand when others are and can have little patience for the sick ones. They make such comments as “she’s sick again” or “he must not take very good care of himself.” Don’t be that person. Get it now. Nobody I know enjoys being sick and would gladly trade with you for your health. 99.9% of patients don’t want to burden you or drive you crazy. They need us and are the reason for our livelihood. This may sound so cliché, but we should be treating every patient like we would want to be treated. Or treat each patient like they are our mother, father, sister, brother or child that we are taking care of today. Have you ever been on the other side? Have you walked a mile in their shoes to know the burden of the news they received? Do you know how you would treat others if you found out you had a disease you would deal with for the rest of your life? Give grace today and know that you are meeting the person post illness, post bad news, post being up all night throwing up or whatever else. Give grace.

Lesson #12: Our Fancy Schmancy Medical Lingo

As I sat awkwardly on the exam table listening to the physician tell me about my results, I tried to listen intently to everything he said. But I kept wondering if this is how he would present the information to anyone else. By this point, this physician knew I was a nurse and definitely spoke to me in such a way. But I’m not a neurology nurse. And even if I were it’s me that is the patient now, and it’s different. He might as well have been speaking Spanish, because I picked up about every few words. Don’t get me wrong, I know he meant well and I appreciated that he was showing me professional courtesy. But I quickly learned that I needed to have a pen and paper with me at all my appointments. I would write down things as quickly as possible so that I could go home and try to interpret what it all meant. However, when I went to my cardiologist’s office, I didn’t feel the same way. She would explain the tests and results different, like how my heart was taking the side roads (and named roads) to get home instead of going straight on the highway to get there. This made sense to me, even when I was sick and could barely think straight. I appreciated her understanding that I didn’t feel well and was hearing really hard news, so I really needed it given to me straight and as simple as possible.

So once again, I  learned another valuable lesson that would help me as a nurse. I learned there’s no need to whip out all my fancy schmancy medical terms with patients. Yes, I will tell them the proper names for what they have or for their medicines. But I will break down the gist of what is going on with them in simple terms that make sense. And when I know a patient is a healthcare professional, I still won’t assume they are an expert in my field. I will tell them I’m going to pretend they aren’t a medical person but if they want me to fast forward some info, to feel free to tell me. I’ve actually already started doing this and I’ve had patients and their family members thank me. One person told me that she really appreciated that I didn’t pretend she knew about dialysis just because she was a nurse. She said, “I’m an OB nurse, so my knowledge in the renal field is very limited.” Yep, I get it. And if she felt that way, just imagine how people who aren’t medical at all might feel when we use medical terms to explain things to them. One more note on this topic- I want to be clear that I said to break things down for the patients but not talk to them like they are children (unless of course you work in pediatrics).