Is mom getting admitted to the hospital frequently? Did your grandma just have a stroke and now your life is half-home and half-hospital? Many families experience this and they are more than willing to do anything to make it easier for everyone involved – they just need to know what to do! I’ve been a nurse since 2010 with experience in both critical care and med surg nursing. Here is some insider info: what your nurse wants you to know.
Insider Info: What Your Nurse Wants You to Know
Below are some of my top tips for those of you who are finding yourself spending a lot more time in the hospital than you anticipated!
Don’t walk around barefoot on the floor
I’m only mentioning this because, well, it happens a lot. Yes, the floor is cleaned appropriately. But, that doesn’t mean it’s a great idea to walk around without shoes or let your infants crawl around on the floor. Many people are in and out of hospitals, and it’s where all the sick people congregate.
Wash you hands frequently, keep your shoes on, and leave kiddos at home (especially during flu season).
Find out when shift change is and don’t call for updates then
Typically, shift change is from 7:00 am – 7:30 am. It’s a really hectic time where the off-going nurse is sharing a lot of information in a short amount of time to the on-coming nurse, all while still caring for patients and answering call lights.
Give the on-coming nurse time to meet your loved one and review their chart. If you call at 7:25 am, they probably just learned their name less than 10 minutes ago and need some time to collect their thoughts, meet the patient, and provide you with a quality update. You can absolutely chat with the off-going nurse, but they’ve been on their feet for 13 hours and are itching to get home and rest. They may have to be back at the bedside in less than 10 hours.
The nurses don’t know when the doctor will be by
Doctors round at random times and we have no idea when that is. They all have different schedules and routines for when they see their patients. Some have to scheduled surgeries and procedures to work around. The nurses working at the bedside typically can’t see their schedule or know when they’re planning on rounding. Depending on the unit, nurses may have as many as 4-9 patients each, and most patients have a few doctors following them… so, it’s not realistic to expect the nurse to know and have access to the personal schedules of anywhere from 8-18 physicians.
If you miss when the physician rounds, let the nurse know and they can always page the physician and you can speak with them on the phone. I think a lot of people assume physicians are in an office near the patient’s room and can pop back in whenever needed. Many times, physicians see patients all over the hospital and are on-the-go most of the day.
Know what being a full code really means
It is vital to know the difference between a full code and a do not resuscitate (DNR) order. A full code means that if you heart stops beating and/or you stop breathing, you want the health care team to do everything in their power to get your heart pumping again or breathing again. The health care team will begin CPR, which looks a lot different than it does in the movies and on TV. It’s much more traumatic. Ribs are broken, a breathing tube is put down the throat, the patient is heavily medicated.
While most people will say yes, do everything you can if that were to happen, not everyone wants that. Some people are living with a terminal illness, some are of advanced age, or have a diagnosis like dementia.
Upon admission to the hospital, the physician who is admitting you should have this conversation with you to ask you if you want to be a “full code” or if you’d like a “do not resuscitate” (or DNR) order. This is done at admission with everyone because if that situation arises in which the patient begins to “code” (heart stops or stops breathing), we can’t have this conversation then.
A DNR communicates to the health care team whether or not to begin CPR *if* the patient begins to code. A DNR does not mean the patient will receive less medical care, fewer treatments or interventions, it simply means that *if* the patient’s heart stops or they stop breathing, that we are to let the patient pass naturally rather than put them through the trauma of CPR.
If you have more questions about this or aren’t sure what the answer is for you, talk about it with the physician who knows you best: your primary care physician.
Make sure next of kin or health care of power of attorney knows your wishes
I cannot tell you how many times a terrible, yet necessary, decision must be made and the next of kin can’t decide to let their loved one pass or not, or they haven’t spoken to them in years so they don’t now what they’d want… or there’s no health care power of attorney.
If all of a sudden you were unable to make your own decisions are incapacitated, who would make decisions for you? In most states, it would be your next of kin (spouse, family, children – it all depends on your unique circumstance). But, not everyone wants their next of kin to be this decision maker. An example would be a married couple who is separated but not legally divorce; they may not want one another to make those decisions but should a tragic accident occur or sudden medical condition, legally it would fall to that person because they are still their spouse.
There is something called a health care power of attorney. This is a person you designate when you are of sound mind that will make medical decisions for you. There are some legal documents you fill out and then you give a copy to your physician and the hospital.
This person can ONLY make medical decisions on your behalf if you are unable to do so. They can’t call the hospital and make decisions on your behalf if you are of sound mind.
Whenever you select this person, make sure they know what you would want at end of life. If you were in a car accident today and the choice was either live in a nursing home for the rest of your days on a breathing tube with a feeding tube, or death – what would you want?
Select someone who knows your wishes, respects them, and will make the right call for you.
Put on your call light and ask to go to the bathroom before it’s an emergency, if you’re able
Emergencies happen, people forget, or there is a crisis, and we can’t get to your room immediately to take you to the bathroom. Sometimes it takes 20 minutes. Please let us know when you have to go and early!
However, we know not everyone get adequate warning of when they have to go to the bathroom. Sometimes when the urge hits, people need to move! If this is you, just let your nurse and nursing assistant know. That’ll let us know that when you put on your call light, we need to high-tail it in there. I’ve had many patients with irritable bowel syndrome or urinary urgency and frequency and they just let me know when I meet them in the morning and I just consider that throughout the day as I see call lights go off and I prioritize my tasks.
If you feel like you don’t see your nurse much, you may be their most stable patient
Emergencies and urgent situations happen a lot, and nurses can’t tell their patients about what’s going on with their other patients. Chances are, if you haven’t seen your nurse much, he or she may be tied up with another patient who is not doing well.
If you don’t know why you’re getting a certain medication, test, procedure, ask! And when you think of questions, write them down so you don’t forget! I love love love it when a family member has a list of questions ready for when the doctor rounds. The nurses do their best to answer your questions, but typically there are questions we can’t answer and the doctor needs to address that with you.
Also, try to write your questions down as you think of them and answers as you receive them. This makes it easier to put the pieces together. Most patients have a lot going on and it can be tough to understand. Keeping notes of what happens or changes can help you get your mind around things.
I’m such a big advocate for this that I wrote a book for patients and loved ones to understand the interworkings of hospitals and including some blank pages with leading questions in the back!
I’ll always say your test results aren’t back, even if they are
It’s not within my scope of practice to interpret or tell you what they are, even if I know. If you just found out you had cancer or an aneurysm or a stroke, you would probably have many questions and your physician needs to answer them.
It’s hard to be on the receiving end of the test, knowing the nurse knows but won’t tell you – which is why many of us simply say the results are not back yet, even if they are.
If you loved me, it’s definitely okay to bring me food
I’ve had multiple patients try to sneak me a monetary tip or a gift card. Alas, legally, we can only accept perishable gifts.
Many families have bought pizza for the staff, or a coffee tote from a nearby Starbucks or Panera. Most nurses love coffee and tea but can’t get away from the unit long enough to grab some, so a 1-3 totes (depending on the size of the unit) is a wonderful surprise. We are typically bombarded with sweet treats, so healthy snacks are a great gift too. Things like protein bars, granola bars, fruit, veggies, hummus, nuts, sparking water, are all great ideas to show your appreciation for your nursing staff.
More from the author
- US News World and Report – 14 Things You Didn’t Know About Nurses
- The TODAY Show – From stethoscopes to tears, 10 things your nurses wish you knew
- US News World and Report – What to expect when your loved one is in the ICU
- The Charlotte Observer – Charlotte nurse: what patients should know, but no one tells them
About the author
Kati Kleber, BSN RN CCRN-K has been a registered nurse since 2010 and has experience in both cardiac med-surg and neurocritical care. Kati is a podcast host, national speaker on nursing topics, and trusted source for various media outlets like US News and World Report, Dr. Oz, CNN, the TODAY show, and more.
Kati is a published author of five titles, including Admit One: What You Must Know When Going to the Hospital, But No One Actually Tells You, the first book published by the American Nurses Association specifically for patients.