Do you just hand out pills?

A few months ago a nurse I know vented her frustration at a misperception she had received several times, unfortunately.   She recalled a conversation in which someone had asked her in a condescending manner if she does anything else at work besides “handing out pills”. I became visibly irritated at this, not only was this person purposely making disrespectful comments to bring her down, but was also perpetuating her own biased notions to a larger audience.

As anyone who has ever been admitted to a hospital or visited a loved can tell you, it is usually the nurse who is readily available for a patient. When it comes down to the actual amount of time spent with a patient during their hospital stay, it is the nurse, not the doctor, who is in and out of that room tending to the patient’s needs. This is not an oversight on the part of your physician; it is just the nature of the job. In fact, during medical school we take an exam known as the USLME Step 2 CS that grades us during our patient encounters.   You cannot begin residency training without passing this exam. To interview and examine a patient we get 15 minutes. That’s how we are taught, that’s how we pass, and that’s how we practice. On a typical day physicians will see the patient in the morning then discuss the case during rounds, and maybe stop by again in the afternoon to explain a test or results. Throughout the remainder of the day it is the diligent effort of the nurse that remains vital to whether or not a patient improves.

Is the patient eating, moving his bowels, getting out of bed? Did the patient who wasn’t supposed to eat anything sneak a snack in before the test?  When did she pull the IV line out?   Is he getting more confused at night? When did he spike the fever?   How many people are needed to help her get to the bathroom? When did the pain meds kick in? What time are they taking him down for the scan? These answers, and many more, are always with the nurse.

Nurses are stationed in front of patient’s rooms. They are able to look at the monitors, assess breathing status, and are often the first to respond to an emergency. If worried about the patient they then page the physician, who sometimes is not even in the same hospital wing. Imagine this scenario: a patient complains of chest pain so the nurse pages the doctor to come and evaluate the patient. Worried about the heart, the doctor orders cardiac markers and an EKG to rule out a myocardial infarction. Now the doctor is paged to another floor for another patient, but is trusting the nurse will do these things while she runs off to take care of the next patient. What if the nurse decides at that moment that she needs to “hand out pills” to the rest of her patients instead? The doctor comes back and sees nothing has been done. She now has to draw the blood herself, call the tech for the EKG herself, and in the process of staying busy with these things delays the pages she is receiving from the other nurses about critical patients. Ultimately, everyone suffers.

Nurses are a liaison between doctors and patients, they spend time with a patient’s loved ones, they get a better understanding of their needs, and are an integral part of the medical team. They fight for their patients; they feel for their patients. If a nurse were to just “hand out pills” the entire system would fall apart. Without their dedication the hospital would become an unsafe environment. To undermine the work of a nurse is to have no knowledge of the care they provide.