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Best Practices Newsletter
Always, always check out your assumptions about a patient’s well-being!
August 30, 2007 | by supportfornurses | Permalink
While it is not uncommon to make assumptions about people, the way to ensure that your assumptions are correct is to always check them out. This is particularly important for a nurse, and here’s an example why: Carol is a new nurse in a big city hospital where she recently started working. She is learning how to treat a diverse group of patients, which is sometimes a real challenge. Carol recently cared for a patient, Gerta, who was friendly but quite reserved; when Carol asked Gerta how she was doing, Gerta characteriscally said, “fine, no problem”. Gerta also noticed how busy Carol was and had a tendency to ask Carol how she was doing during rounds.
Although Gerta lived in the United States for many years, she grew up in a country where the norms regarding expression of feelings and needs are frowned upon. Carol, on the other hand, enjoyed treating Gerta because she expressed herself clearly and never made demands. In fact, Carol felt particularly appreciative of Gerta’s non-demanding character, because she was new and the staff shortage in the department added to her stress.
Carol’s relief treating Gerta turned to concern when she overheard Gerta telling her daughter how much pain she was in and how uncomfortable she was. This was an important ‘wake-up’ call for Carol, since she realized that she needed to be more attentive to Gerta, including asking her specific questions about her level of pain. Carol had assumed Gerta was doing fine; after all, her vitals and coloring were good,
and she didn’t appear to be uncomfortable. When Carol realized that this patient needed to more attention (not less), she spent her time with Gerta in a more productive way. During subsequent rounds, she asked Gerta specific questions about her pain-something she hadn’t done previously; she ask about the level of pain, the precise area of the pain, and she educated Gerta about options available to treat her pain. Also, Carol was careful not to insult Gerta by telling her that she should ’speak up’; she simply educated her, including letting her know that she didn’t need to be in pain and that treatment was available.
A nurse may be thankful and feel blessed when treating patients who are pleasant and not demanding, particularly in busy, understaffed hospitals. Having said that,it is always important to make sure that such a patient’s needs don’t get overlooked; that is not good patient care! Whether a patient expresses her
needs (or doesn’t), a nurse always needs to ask the appropriate questions, sometimes probing more in order to truly understand a patient’s condition. Vital signs are obviously important indicator regarding how a patient is doing.But spending time with a patient, asking the appropriate questions, a nurse can really find out what a patient truly needs.
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