Doctors and Providers
75 Secrets Nurses Wish They Could Tell You
Doctors are sometimes clueless about what really happens in the beds, rooms, and halls of hospitals. That’s why we went to the experts: nurses.
This is what I mean when I say to get a second opinion
“We’re not going to tell you your doctor is incompetent, but if I say, ‘You have the right to a second opinion,’ that can be code for ‘I don’t like your doctor’ or ‘I don’t trust your doctor.’”—Linda Bell, RN, clinical practice specialist at the American Association of Critical-Care Nurses in Aliso Viejo, CA Here’s how to find a doctor you trust.
Before you gossip…
“Feel free to tell us about your personal life, but know that we’re here for 12 hours with nothing to talk about. So the stuff you tell us will probably get repeated.” —A nurse in St. Petersburg, Florida
Sometimes we give more medication than we’re ordered to
“When a patient is terminally ill, sometimes the doctor won’t order enough pain medication. If the patient is suffering, we’ll sometimes give more than what the doctor said and ask him later to change the order. People will probably howl now that I’ve said it out loud, but you have to take care of your patient.” —A longtime nurse in Texas
A lot of my patients are incontinent
“I’m supposed to just use a wet washcloth to clean them. But if it’s a patient who’s been really nice and appreciative, I’ll go all the way to intensive care to get some of the heated wet wipes, which are a lot more gentle. Somebody who’s constantly yelling at me? I just use the washcloth.” —A nurse in St. Petersburg, Florida
I always remain calm
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“I’ve had people blow out arteries in front of me, where I know the patient could bleed to death within minutes. I’ve had people with brains literally coming out of their head. No matter how worried I am, I’ll say calmly, ‘Hmmm, let me give the doctor a call and have him come look at that.’” —A longtime nurse in Texas. These are the craziest things ER nurses have ever seen.
Yes, you should have come in earlier
“I’d never tell a patient that he was stupid for waiting a week for his stroke symptoms to improve before coming to the hospital. Although I’d like to. Especially if his wife then complains that we’re not doing anything for the guy.” —A longtime nurse who blogs at head-nurse.blogspot.com
Don’t lie about your pain
“If you’re happily texting and laughing with your friends until the second you spot me walking into your room, I’m not going to believe that your pain is a ten out of ten.” —A nurse in New York City. Here are more things doctors and nurses wish patients wouldn’t do.
Your life is in our hands—literally
“We question physicians’ orders more often than you might think. Some of the mistakes I’ve headed off: a physician who forgot to order a medication that the patient was taking at home, a doctor who ordered the incorrect diet for a diabetic, and one who tried to perform a treatment on the wrong patient.” —A nurse from Pennsylvania
People have no idea of the amount of red tape we have to deal with every day
“We spend hours at the computer just clicking boxes. They tell us, ‘If it wasn’t charted, it didn’t happen.’ So I always chart with a jury in the back of my mind.” —An intensive-care nurse in California
Hospitals are full of drug-resistant germs
“Despite nurses’ best efforts, hospitals are still filthy and full of drug-resistant germs. I don’t even bring my shoes into the house when I get home.” —Gina, a longtime nurse
These days, you can’t get admitted unless you’re really sick
“And you’ll probably get sent home before you’re really ready. So we don’t get any easy ones anymore.” —Kathy Stephens Williams, RN, critical care fellowship coordinator at Mercy Hospital South in St. Louis, MO. Here are some doctor-approved tips to shorten your hospital stay.
The sicker you are, the less you complain
“I’ll have a dying patient with horrible chest pain who says nothing, because he doesn’t want to bother me. But the guy with the infected toe—he can’t leave me alone.” —An intensive-care nurse in California
I’ll always come into your room with a smile
“No matter how many times you use your call light, even if it’s every ten minutes, I will come into your room with a smile. However, if you don’t really need help, I will go back to the nurses’ station and complain, and this may affect how the nurses on the next shift take care of you.” —A cardiac nurse in San Jose, CA. Check out these heartwarming stories about nurses who went above and beyond.
Over-the-counter drugs and herbals count as medications you take
“When your provider asks for a list of the medications you’re taking, make sure you include over-the-counter drugs and herbals. People think that if an herb is ‘all natural’ and ‘organic,’ it’s not a medication. But that’s not true. Herbals can interact with other medications and can cause serious complications.” —Kristin Baird, RN, president and CEO of the Baird Group in Fort Atkinson, WI
‘Grey’s Anatomy’? We watch it and laugh
“Ninety percent of the things doctors do on the show are things that nurses do in real life. Plus, there’s no time to sit in patients’ rooms like that.” —Kathy Stephens Williams, RN
This is a hospital, not a hotel
“I’m sorry the food isn’t the best, and no, your boyfriend can’t sleep in the bed with you.” —A nurse in New York City. Learn the secrets hospitals won’t tell you.
Nurses can be mean to each other
“In my first nursing job, some of the more senior nurses on the floor refused to help me when I really needed it, and they corrected my inevitable mistakes loudly and in public. It’s a very stressful job, so we take it out on each other.” —Theresa Brown, RN, an oncology nurse and the author of Critical Care: A New Nurse Faces Death, Life, and Everything in Between
It’s stressful when a physician makes a mistake
“It can be intimidating when you see a physician who is known for being a real ogre make a mistake. Yes, you want to protect your patient, but there’s always a worry: Am I asking for a verbal slap in the face?” —Linda Bell, RN. Learn what happens when doctors make life-threatening mistakes.
A positive note from you can go a long way
iStock/Joshua Hodge Photography
“If you have a really great nurse, a note to her nurse manager that says ‘So-and-so was exceptional for this reason’ will go a long way. Those things come out in her evaluation—it’s huge.” —Linda Bell, RN
I love when you come back and visit
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“If you’ve been a patient in a unit for a long time, come back and visit. We’ll remember you, and we’d love to see you healthy.” —An intensive-care nurse in California
We still believe in miracles
iStock/Abel Mitja Varela
“I once took care of a child who had been in a coma for more than a week. The odds that he would wake up were declining, but I had read that the sense of smell was the last thing to go. So I told his mom, ‘Put your perfume on a diaper and hold it up by his nose to see if it will trigger something.’ The child woke up three hours later. It was probably a coincidence, but it was one of my best moments as a nurse.” —Barb Dehn, RN, NP, a nurse practitioner in Silicon Valley, CA who blogs at nursebarb.com. Read more stories of miraculous recoveries from nurses and doctors.
Nursing is incredibly demanding
“Some jobs are physically demanding. Some are mentally demanding. Some are emotionally demanding. Nursing is all three. If you have a problem with a nurse or with your care, ask to speak to the charge nurse [the one who oversees the shift]. If it isn’t resolved at that level, ask for the hospital supervisor.” —Nancy Brown, RN, a longtime nurse in Seattle, WA
Demand their attention
“Now that medical records are computerized, a lot of nurses or doctors read the screen while you’re trying to talk to them. If you feel like you’re not being heard, say, ‘I need your undivided attention for a moment.’” —Kristin Baird, RN
Nurses shouldn’t miss your vein
“If the person drawing your blood misses your vein the first time, ask for someone else. I’ve seen one person stick someone three times. They need to practice, but it shouldn’t be on you!” —Karon White Gibson, RN, producer-host of Outspoken with Karon, a Chicago cable TV show
Never let your pain get out of control
“Using a scale of zero to ten, with ten being the worst pain you can imagine, start asking for medication when your pain gets to a four. If you let it get really bad, it’s more difficult to get it under control.” —Nancy Beck, RN, a nurse at a Missouri hospital. These are the secrets pain doctors won’t tell you.
Drink lots of water before having your blood drawn
“If you’re going to get blood drawn, drink two or three glasses of water beforehand. If you’re dehydrated, it’s a lot harder for us to find a vein, which means more poking with the needle.” —Mary Pat Aust, RN, executive board relations specialist at American Association of Critical-Care Nurses in Aliso Viejo, CA
Don’t hold your breath before a painful procedure
“Don’t hold your breath when you know we’re about to do something painful, like remove a tube or take the staples out of an incision. Doing that will just make it worse. Take a few deep breaths instead.” —Mary Pat Aust, RN
Try to avoid hospitals in July
“If you have a choice, don’t go into a teaching hospital in July. That’s when the new crop of residents starts, and they’re pretty clueless.” —A nurse supervisor at a New Jersey hospital
Doctors don’t always tell you everything
“They’ll be in the hallway saying, ‘She has a very poor prognosis. There’s nothing we can do.’ Then they don’t say that in the room. Sometimes I try to persuade them to be more up-front, but I don’t always succeed.” —Theresa Brown, RN. Learn what doctors are thinking (but won’t say to your face).
Some doctors seem to have a lack of concern about pain
“I’ve seen physicians perform very painful treatments without giving sedatives or pain medicine in advance, so the patient wakes up in agony. When they do order pain medicine, they’re so concerned about overdosing, they often end up underdosing.” —A nurse supervisor at a New Jersey hospital
Always ask anyone who comes into your room if they’ve washed their hands
“There are staff at every hospital who just don’t think that they need to wash their hands between seeing patients. Others get distracted and forget. So always ask anyone who comes into your room, ‘Have you washed your hands?’” —Kathy Stephens Williams, RN. And make sure you don’t make these hand-washing mistakes yourself, either.
Please give physical affection to dying loved ones
“When you’re with someone who is dying, try to get in bed and snuggle with them. Often they feel very alone and just want to be touched. Many times my patients will tell me, ‘I’m living with cancer but dying from lack of affection.’” —Barb Dehn, RN, NP. Here are some other things you should never do while visiting someone in the hospital.
It’s the little things that make a difference for people who are sick
“One of the best things you can do is wrap them in a warm blanket or towel. Throw the towel in the dryer before they are bathed. If they’re in a hospital, find out where the blanket warmer is.” —Barb Dehn, RN, NP
I may talk to family members to clarify their goals for the patient’s care
“I’ll never tell you to change your code status to Do Not Resuscitate, even though I might cringe at the thought of having to break your ribs during CPR. With certain patients, however, I may talk to family members to clarify their goals for the patient’s care. This sometimes leads to an elderly person being placed on comfort care rather than being continually tortured by us with procedures that aren’t going to help.” —A cardiac nurse in San Jose, CA
We save as many patients as doctors do
“We’re the ones keeping an eye on your electrolytes, your fluids, whether you’re running a fever. We’re often the ones who decide whether you need a feeding tube or a central line for your IV. And we’re the ones who yell and screech when something goes wrong.” —A longtime nurse in Texas
Husbands, listen to your wives if they tell you to go to the hospital
iStock/Joshua Hodge Photography
“Today a man kept fainting but wouldn’t go to the hospital until his wife forced him. He needed not one, not two, but three units of blood—he was bleeding internally. He could have had a cardiac arrest. Another man complained to his wife that he didn’t feel ‘right.’ His wife finally called me to come over to their house. His pulse was 40. He got a pacemaker that evening.” —Barb Dehn, RN, NP. Here are some more mistakes you make that can lead to a misdiagnosis.
If you do not understand what the doctor is telling you, say so!
“I once heard a doctor telling his patient that the tumor was benign, and the patient thought that benign meant that he had cancer. That patient was my dad. It was one of the things that inspired me to become a nurse.” —Theresa Tomeo, RN, a former nurse at the Beth Abraham Center for Nursing and Rehabilitation in Queens, NY. These are the medical facts that doctors and nurses want everyone to know.
At the end of an appointment, ask yourself: Do I know what’s happening next?
“If you had blood drawn, find out who’s calling who with the results, and when. People assume that if they haven’t heard from anyone, nothing is wrong. But I’ve heard horror stories. One positive biopsy sat under a pile of papers for three weeks.” —Kristin Baird, RN
Sometimes you do nothing but run numbers and replenish fluids
“Sometimes you’re also the person who reassures the teenager that ‘everybody’ gets her period on the day of admission, the person who, though 30 years younger than the patient, tells that patient without blushing or stammering that yes, sex is possible even after neck surgery. You’re the person who knows not only the various ways to save somebody else’s life but also how to comfort those left behind.” —A longtime nurse who blogs at head-nurse.blogspot.com
Know when to draw the line
“I had one patient show up repeatedly to see me after he was discharged. Another little old man tried to pull me into bed with him. (He was stronger than he looked.) The general rule is don’t ask us on a date. We’re busy. It’s unethical. And, really, I already know you better than I want to.” —A longtime nurse in Texas
Say thank you
“A simple ‘Thank you’ can really make my day.” —A nurse in New York City
I don’t believe you when you tell me how much you drink
“When you tell me how much you drink or smoke or how often you do drugs, I automatically double or triple it.” —A longtime nurse in Texas. These are the 14 things you should never lie to your doctor about.
Sometimes I have to lie
“When you ask me, ‘Have you ever done this before?’ I’ll always say yes. Even if I haven’t.” —A nurse in New York City
Try this trick
“Ask the nurse to wet your bandage or dressing before removal—it won’t hurt as much.” —Karen White Gibson, RN. Here are some more easy tips from doctors and nurses that will improve your hospital stay.
We can’t talk to everyone
“You might think that all the doctors who see you talk to each other, but they often don’t. That’s a problem because physicians sometimes disagree. The more you can keep track of different doctors’ opinions—and communicate them—the better off you’ll be.” –A nurse in Pennsylvania
Don’t come for lunch
“Don’t show up for a scheduled hospital admission at 12:30 p.m. and expect lunch. We’re not a hotel with room service and we can’t always turn around requests that quickly. Eat before you come, unless the doctor tells you not to.” –Theresa Brown, RN
Know your symptoms
“To get a faster diagnosis, know your symptoms and what makes them worse. If you’re having chest pains, is it worse when you take a deep breath? What about when you press on your chest?” –Nancy Beck, RN, a nurse at a Missouri hospital
Know how to check glucose
“If you’re diabetic and need to check your glucose frequently, don’t buy a glucometer—the gadget that measures your blood sugar. Some manufacturers will give you one for free if you know to ask, because they make more money on the test strips than they do on the machines. Just make sure your insurance plan covers the test strips for the glucometer you choose. If you’re paying out of pocket, check the price of the strips, not just the device.” –Theresa Tomeo, RN
Don’t lie about your pain
“For some reason, when I ask ‘Are you having pain?’ a lot of patients say no, even if they are. But I’ve found that if I say, ‘Are you uncomfortable?’ people are much more likely to say yes. Please tell us if you’re in pain. We have all sorts of medications we can use to help you.”–Mary Pat Aust, RN. Here are some questions you should always ask before you take pain medication.
Say “I love you”
“When someone you love is dying, you can never say ‘I love you’ too much.” –Barbara Dehn, RN
Fresh air works wonders
“I once had a patient who had been in ICU for six months. He was totally withdrawn—wouldn’t look at us, talk to us, or even open his eyes. One day, the doctor said, ‘Why don’t you take him outside?’ We were thinking, ‘Man, that’s a lot of work,’ but of course we said okay. We rolled his bed out the door, thinking what a waste of time it was. Well, the wind was on his face, he could hear the birds, and suddenly he opened his eyes and talked to his wife for the first time in months. That was an incredible day.” –Gina Rybolt, RN, after hours triage RN in the San Francisco Bay area
Prep the day before
“One of the things people hate most about having a colonoscopy is drinking the solution that triggers diarrhea to clean you out. But if you mix the prep the day before and place it in the fridge, it will be a lot easier to get down.” –Theresa Tomeo, RN
Your vitals are important
“We know you hate being woken up, but we have to check your vital signs every four hours. It’s not the Hilton, it’s a hospital. And that’s hospital policy.” –A nurse in St. Petersburg, FL
Some doctors smoke
“Some doctors tell people not to smoke, then sneak a cigarette outside.” –Karon White Gibson, RN. These are the stroke symptoms you should never ignore.
Ask if you can call back
“When someone you care about is in the hospital and you call in for information, sometimes it’s not a good time for me to have a 10-minute conversation. Ask me first if I can call you back. That way, I can talk to you after I’ve collected my thoughts—and when I’m not thinking about another patient who’s throwing up.” –Theresa Brown, RN
Ask the nurse for recommendations
“If the doctor gives you names of three different specialists, ask the nurse which doctor she would choose to take care of her own child.” –Karon White Gibson, RN
Don’t have me call your doctor
“Before you demand that I call your doctor, understand what you’re asking. It’s not like you can just place a pleasant little phone call. You have to call their answering service and get them to call you back. Inevitably, you’re in another room when they call. Then when you finally talk to them, a lot of them are complete jerks, especially if you wake them up.” –A nurse in St. Petersburg, FL
“I don’t know if we’re making more mistakes now or if we’re just tracking them better. It used to be if a patient came in the hospital and developed pneumonia, the attitude was ‘That just happens.’ Now, if they get pneumonia, we ask, ‘How did that happen?’ and we investigate.” –Kathy Stephens Williams, RN
Bother the nurse
“My biggest piece of advice: Bother the nurse. When I come upon patients who are in a lot of pain, I’ll ask, ‘Why didn’t you ask the nurse for your pain medication?’ and they say, ‘She looked so busy. I didn’t want to bother her.’ Please, ‘bother’ your nurse. She can’t help you if she doesn’t know what you need.” –Nurse supervisor at a New Jersey hospital
Ask us to translate
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“If your doctor uses a lot of medical jargon and you don’t understand what it means, ask me to help translate—that’s part of our job.” –Theresa Brown, RN. If you want to figure it out on your own, here are the definitions of the outrageous medical jargon doctors and nurses use.
Tell us about money problems
“If you can’t afford your medication, tell us. Your doctor may have other, less expensive ways to keep you healthy, or we may be able to connect you to resources that can help.” –Nancy Beck, RN, a nurse at a Missouri hospital
Keep comfort in mind
“When it comes to very elderly patients, sometimes family members who are afraid of seeing Mom or Dad go will want us to run a lot of tests or do a major surgery—when, really, the elderly patient just wants to be comfortable. If you’re the older patient, be sure your nurse and your doctors know what you want.” –Nancy Beck, RN, a nurse at a Missouri hospital
Don’t blame us for being late
“Please don’t get mad at me because your scan was supposed to be at noon and you didn’t have it until 3. Unfortunately, I have no control over that.” –Theresa Brown, RN
“Expect to get pain medication about 10 minutes after your request. If I am not there, simply call back.” –Nancy Beck, RN, a nurse at a Missouri hospital. Learn about how a positive attitude can influence your health.
Let us know about your family
“If you think your family member is confused, let us know. That tells us we should move them closer to the nurses’ desk and check in on them more frequently. We’ll also attach an alarm to their gown so we know if they’re getting up without assistance.” –Nancy Beck, RN, a nurse at a Missouri hospital
Don’t bring your medication with you
“I understand why you want to bring your own medication to the hospital: It probably costs $10 in the hospital and 3 cents at the drugstore. But please, don’t do it. Under our regulations, it’s not allowed. We need to know everything that’s going into your system.” –Mary Pat Aust, RN
Tell them to take deep breaths
“In an emergency, the person who needs assistance is usually hyperventilating. So when you jump in to help, the first thing you should do is tell them to look you in the eye and take some slow, deep breaths. You’ll sound and act like an expert, and it will help everyone focus.” –Barba Dehn, RN, NP
Hygiene doesn’t always take priority
“Trust me: I want to give your mother a bath, but sometimes I’m too busy trying to keep people alive. Hygiene is important, but when you have people who aren’t breathing well, that has to take priority.” –Theresa Brown, RN. Next, check out this story of the rarest conditions doctors have ever diagnosed.
- Linda Bell, RN, clinical practice specialist at the American Association of Critical-Care Nurses in Aliso Viejo, CA
- Kathy Stephens Williams, RN, critical care fellowship coordinator at Mercy Hospital South in St. Louis, MO
- Kristin Baird, RN, president and CEO of the Baird Group in Fort Atkinson, WI
- Theresa Brown, RN, an oncology nurse and the author of Critical Care: A New Nurse Faces Death, Life, and Everything in Between
- Barb Dehn, RN, NP, a nurse practitioner in Silicon Valley, CA who blogs at nursebarb.com
- Karon White Gibson, RN, producer-host of Outspoken with Karon, a Chicago cable TV show
- Mary Pat Aust, RN, executive board relations specialist at American Association of Critical-Care Nurses
- Theresa Tomeo, RN, a former nurse at the Beth Abraham Center for Nursing and Rehabilitation in Queens, NY
- Gina Rybolt, RN, after hours triage RN in the San Francisco Bay area