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Louise Asselin
Ontario
Canada

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In your experience, what was the difference between a 'good' nurse or a 'bad' nurse?

As a patient under the care of a nurse, beit for an acute or a chronic issue, what did the nurse do or not do that made you feel he/she was a good or a bad nurse?

How did his/her interaction with you (or lack thereof) change your view on your illness and journey to wellness? Was a therapeutic relationship formed?

Note: By 'bad' I don't mean someone as not having the required credentials. By 'bad', I mean that the nurse did or did not do something that conflicted with your view of a nurse's role.

Related Talks:

Abraham Verghese: A doctor's touch

Topics: care healing health nursing therapeutic relationship

Closing Statement from Louise Asselin

Nursing implications are not limited to practical skills but also involve individualized emotional support. Many feel that the difference between a good nurse and a nurse is the ability to care and be compassionate during the healing process. A good nurse is someone who can be trusted and relied upon during a person's most vulerable state.

Thank you to everyone for sharing your comments, thoughts and personal accounts.

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Dana Devorah
- 0
Oct 28 2011: For me the difference the lies in the fact that good nurses constantly ask 3 questions and acts on them. The questions are: "Is this right?" ; "Is this working?"; "Is this how I would want things for myself?"
Omar Miralles
- +1
Oct 27 2011: As a Nurse no matter how difficult the patient status might be,it is always fundamental that you put your love for life and the human being before anything else, that will lead you a better place and for sure patients recovery will be better even in the worst case situation that normally takes place in our daily duty
vince vernile
- +1
Oct 27 2011: I've been admitted more times than I wish to remember, and the nurses that stand out to me, were those who 'recognised my individuality' as a patient, who spoke TO me, not so much 'about' me, who 'gave the kindness up', without technically 'needing' to do so, in order to perform their functions.
Patricia Larsen
- +1
Oct 27 2011: As a patient, I think the true difference is in the actual CARE, between the nurses (or anyone in the health care profession) who actually do what they enjoy doing and those who are in the biz for other reasons.. I couldn't care less if a nurse poke me 5 times to get the blood out of me, as long as I feel that she/he cares, but if one walks in the room and you can actually tell that she/he can't wait to get out of there, then we have a problem Houston...
If someone reading this is thinking of getting in the health care profession and is not a patient person, nice person, loving and caring, please find something else to do! It will be better for you in the long run, you'll be happier doing something else... :)
Kenji Gerhardt
- 0
Oct 27 2011: A good nurse is the one who listens to the doctor and doesn't try to do more than they are trained to do. Frankly, bedside manner, comforting, and emotional skill are very secondary in my opinion. The nurses who are best at their job are the ones with the best skill sets that don't try to do a doctor's job, not he ones that can convince you they have the best skill sets or make you think that they are equal to doctors in training or expertise.
- Louise Asselin
  - 0
  Oct 27 2011: Thank you for your input Kenji !
  
  I'm a bit confused as to why you are comparing the skill sets of doctors and nurses and how it relates to my question. Are you implying doctors are the only health care providers to give emotional support to a patient? Should you be in a hospital bed you would prefer the nurse to come in, do his/her assessments, not say a word and leave the room without saying a word or attempt to make sure you are comfortble and attended to in every aspect?
  
  Doctors and nurses have their separate roles and both have a professional responsibility to a therapeutic relationship with the patient. It can't be denied that transference can simply take place with a patient and doctor. Nurses have the most patient contact and it is their responsibility to inform the doctor of the patient's condition. At what point does the nurse try to equalify her/himself to the doctor in terms of skill sets?
  
  *Please note I'm genuinely interested and not trying to cause offence. I am curious to know more about your point of view.
Shan Talton
- 0
Oct 27 2011: Know what they are doing, willing to work hard, and albe to negotiate the emotional and interpersonal issue that confront professionals and patients alike while maintaining proper boundaries.
- Louise Asselin
  - 0
  Oct 27 2011: Thank you Shan. Very well put.
Diana Lane
- 0
Oct 26 2011: A good nurse understood how scared I was.
- Louise Asselin
  - 0
  Oct 27 2011: Possibly the shortest comment here and yet one that struck me the most. Thanks for sharing.
Guillaume Regis
- 0
Oct 26 2011: Someone with empathy, patience good communication and hard working. I have met plenty of nurses who I would describe as lazy and more interested in their mobile phones
- Louise Asselin
  - 0
  Oct 27 2011: That is my pet peeve! Thanks for your input Guillaume.
Colleen Steen 500+
- +1
Oct 26 2011: With my physical challenges, and the experiences of spending time with many friends and relatives who were/are facing physical and emotional challenges, my perception of what makes health care providers good, or not so good, is whether s/he genuinely cares....whether or not s/he is simply doing a job, or is genuinely engaged in the process of assisting with healing and supporting the patient in his/her journey through the challenge.
Bilal Saad
- 0
Oct 25 2011: Hi Louise, the opinion of patient. who can decide which is best.
Adam Tobbe
- 0
Oct 25 2011: I read, Louise, that you are a nursing student. That's fantastic. I'm a nurse as well, practicing in a large level-I trauma hospital in the Midwest. While my patient interaction is fairly brief due to the nature of the patients I work with and the short holding times on the trauma stabilization unit, I don't have a chance to get to know my patients, nor do they have any idea who I am. 9 of 10 times they are unconscious during my interaction with them. I believe your question just proves how dedicated you are to the field. A 'bad' nurse would never question the differences between a good and bad nurse, maybe they're afraid of what they'll learn of themselves. Maybe their justification of good or bad is different though. I consider myself to be a good nurse. I'll fight tooth and nail for my patients. I'll go toe-to-toe with any attending or resident that I feel isn't giving the proper treatment to my patients. While my patients won't know me at all, I know that I've done what I can. Remember this; you are here for the patient. You keep them safe. You keep them alive.
Carol A.
- 0
Oct 25 2011: A good nurse is one that wants the best for her patient and will do whatever she is able to ensure that their physical,emotional and spiritual needs are met. If she is unable to meet their specific need herself then she contacts whoever can meet that need.
Bottom line, as simple as it may sound is to treat your patient the way you would want to be treated. Period.
Phillip Beaver 10+
- 0
Oct 25 2011: A good nurse is proficient in the practice, listening to the patient and first attendant, empathetic, and courageous enough to challenge the hospital if needed.
After surgery to remove the lower lobe of my right lung and a carcinoma, a mean nurse kept me waiting for four hours before discharge. I should have reported her.
I visited my friend four times over a week and watched him struggle for oxygen, equipped with a tube to his nose, but unable to close his mouth to inhale. Each time, I asked the nurse to supply him an oxygen mask. The fourth time, I went to the nurse station at 7:30 PM and implored them to supply him a mask. They gave him one at 9:30 PM. At 6:30 the next day, he died. I wonder what might have happened if they had given him a mask the first time I asked (a week earlier).
Thank you for the question.
Phil
- Carol A.
  - 0
  Oct 25 2011: My heart breaks for your friend. As a nurse, even if death is imminent, more than ever, everything to keep the person comfortable should be done. Asking for a mask was such a small thing and the request should of been met .
  - Phillip Beaver 10+
    
    0
    Oct 25 2011: Carol, I agree with you and appreciate your support.
    
    Phil
Gloria Felicia
- 0
TED Translator

Oct 24 2011: Hi there, Louise :-)

Well, a good nurse to me is the one that follow with the inner feeling of the patient so that miracle can become possible or the Placebo effect (in the psychological sight) can help the patient to recover better. The inner feeling I mentioned is actually the demand for needs fulfillment in a current situation. (for example: the patient needs someone to talk to)

I'm sure that you know that human beings do actually recover from disease depending on their perspective or their ways of thinking too. If they keep on receiving negative thinking, how can they heal?
Therefore, the nurse also needs to supply this need since the patient is not 100% made of physical body but psychological beings.

A good nurse does not always mean one that always obeys the doctor.
Instead, a good nurse is the one who is aware of the needs of patients.
- Louise Asselin
  - +1
  Oct 24 2011: Great comment Gloria. I completely agree and believe 100% in patient-centered, holistic care. I too believe that thinking has very much to do with the healing process, in fact it is evidence based in nursing practice. Neuroplasticity is a whole other subject on its own and it certainly has it's place in the recovery process.Thank you for your comment!
  - Gloria Felicia
    
    0
    TED Translator
    
    Oct 25 2011: Oh yes that is a whole different story regarding neuroplasticity. Well, I just watched the link of video you tagged (A Doctor's Touch by Abraham Verghese). I highly suggest that a good nursing is not actually all about filling drugs of a patient, regularly checking but also, interacting & communicating with the patient—who knows the nurse will perhaps find some more additional informations about the disease or family health history that are essentially needed for the record to upgrade the healing treatment. Later the nurse could inform the doctor about the info which is found to be odd but helpful. Touch increases the patients' awareness of his surrounding, especially those with chronic ones. What a very touvhing video. (-:
tishe Hires 10+
- 0
Oct 24 2011: Hello Louise,
I had an crappy experience with a nurse from " One Flew Over, the Cuckoo's Nest!" This woman was, terrible!
There are bad apples in every bunch. (she had the bed side of manner of an enema! ) Nurses are womdermous humans! However, I will never go into a hospital again.
- Louise Asselin
  - +1
  Oct 24 2011: I'm so sorry to hear that! I am trying to avoid that from happening on my part. I don't assume because I think I'm a good person that I will be a good nurse. (Yes, I feel I will be good nurse - I mean to say that those two things aren't necessarily correlated and apply to every nurse.) I don't take anything for granted - I want to hear from anyone and everyone I can regarding patient care.
  
  Thank you for your comment!
  - tishe Hires 10+
    
    0
    Oct 25 2011: Oh please do not get me wrong, Louise! I have the utmost respect for nurses!!! I would think, that "bad" nurses are few and far between! I admire any human that decides to take care of the sick and helpless!! Total respect here!! This one experience, for me, was the worst! I needed help, understanding and compassion! However, I DO know that this was an elite experience? (does that make sense?)
John Bailey
- +1
Oct 23 2011: The best nurses I have experienced expressed compassion and caring in their communication.
lynn eschbach 30+
- 0
Oct 22 2011: When I went in to have a baby, I didn't like my nurse. I thought she was abrupt and not that friendly. While in labor, her abruptness turned into toughness for me. I didn't need a friend then, I needed someone I could professional trust. It's been 30 years and I still remember her help, not her face.
- Louise Asselin
  - 0
  Oct 24 2011: A good example of patient centered care - know what the person needs when they need it.
  Thank you for your comment!
Larry Holmgren
- +1
Oct 22 2011: Louise Asselin, see the movie, Wit (HBO drama, 2001) starring Emma Thompson and directed by Mike Nichols. http://www.imdb.com/title/tt0243664/
It portrays one caring, compassionate nurse amid many cold, uncaring doctors and hospital functionaries.
It is worth seeing twice and worth buying for the pathos, the great acting, and John Donne.
- Louise Asselin
  - +1
  Oct 24 2011: Thanks Larry. I watched it yesterday and was so moved. I believe everyone should see this at least once.
Pontus Westermark
- 0
Oct 22 2011: Being hospitalized was very confusing for me. While the doctors play the waiting-game where the body does its thing and hopefully everything just works out well, I knew nothing about what was going on. It can be very lonely and frustrating to see all the people working at the hospital doing their seemingly structured ritual while half-lying still in the bed just waiting for something and somehow unable to reach out to the surroundings.

What made me feel better was when the person who came into the room was confident, happy and somehow appeared reachable (a simple "Hi" might suffice for that).Some just seemed to be doing what they had to do to earn their wages, I couldn't wait for them to leave so I could get back to my computer. But for the people that had the qualities above, I felt better about the situation.

Also, knowing when or how contact with your doctor will be available and something reassuring like saying "Don't worry, we haven't forgotten about you, but things take time" would always feel nice.
- Louise Asselin
  - 0
  Oct 22 2011: Using the term 'bad nurse' seems like such an oxymoron, but the your story explains exactly what I'm trying to extract from the public through these personal experiences. Seems like common sense to treat your patient the way you explained above, doesn't it?Thank you for your input. It is truly appreciated.
Jonathan Barker
- +1
Oct 22 2011: I appreciate direct honest responses.
Phillip McKay
- +1
Oct 22 2011: It was during a recent vasectomy. ( not that there have been others) As I lay there awake with the surgeon making bad taste jokes and the anaesthetic not quite working, the surgeon abruptly tells the nurse,""No not like that." I have a feeling it was her first vasectomy or worse still the doctor had convinced his neighbour to help out. I hate the thought of being ill and in a hospital and fortunately ( but for a half hour procedure - the vasectomy!) I have never needed to stay in one. A good Nurse for me would be one who made me feel better.
- Louise Asselin
  - 0
  Oct 22 2011: I haven't needed to stay in one as an adult - as a child I don't remember much of it and I'm rarely sick. This is why I'm so curious because I've never truly experienced being the patient in a hospital. Thank you for your story, Phillip.
Steven Dilloway
- 0
Oct 22 2011: not having graduated from a community college
James Turner 10+
- +1
Oct 22 2011: After having survived a heart attack and being left in the hall way of the hospital for over an hour before I was transported to another city for heart surgery, I would say a bad nurse ( I do not know if a person can really be a bad nurse and stay in the job) is one with no people skills or compassion. Maybe technically excellent but no compassion. A good nurse is one with the skills and compassion for the patient even at the end of the shift. Some nurses would just rush in and out of the room and make no human contact. The patient was objectified it may have to do with self defense for the nurse to not be overwhelmed with the illness of the patient or in my case the severity of the heart attack. I always tried to be kind and thankful to the nurses no matter how bad the pain was during the attack but some were just to professional to even laugh a little when I joked about myself. I do not hold any ill will against them. I just wonder if they are in the wrong profession
- Louise Asselin
  - +1
  Oct 22 2011: Thanks for your reply James. As a nursing student, those interpersonal skills are very important for me to develop. It's different forming a therapeutic relationship with a patient than a friendship with someone outside the workplace.
  
  I get easily attached to people I take care of but I realize my boundaries. I think sharing those moments with a patient (like laughing with them in your example) is great and a big part of the healing process for someone.
  - James Turner 10+
    
    0
    Oct 25 2011: You will be a fabulous nurse and have you explored becoming a Physicians Assistant? I think you would be great there also

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