They're cold, they smell like disinfectant, and they have dead bodies in the basement. What else do you need to know about hospitals, other than the fact that they're where you end up if shit hits the fan?
A lot, actually. Nurses -- you know, the hard-working professionals who do the dirty work of keeping you alive -- have to put up with tons of literal and metaphorical crap at their job. The least you can do is try to understand the realities of their work environment (and your healing environment!). Here's what five nurses wish more people knew about hospitals.
Hospitals are frigid and bare-bones for a reason
Hospital rooms aren't exactly hotels, but couldn't things be just a little more inviting? Sure, they could… and you could invite a staph infection. "The bare-bones decor of rooms is so it's easier to clean and thereby sterilize," says Jennifer*, a nurse in New Orleans. "It's cold for a reason -- to kill bacteria. It can't survive in cold temperatures."
Don't expect a good night's sleep, either: "You will not get much rest -- inpatients typically have their vital signs checked every four hours," says Nancy Brook, RN, MSN, a nurse practitioner and educator at Stanford Hospital and Clinics.
You can sleep when you're dead, which hopefully won't be anytime soon, because nurses are fantastic in so many ways. However…
Nurses aren't maids
"Nurses are highly educated medical professionals. Do not ask them to fluff your pillow," Brook says. "They do not work for doctors, but are actually part of a healthcare team optimized to give you the best care possible."
Nurses aren't your servers, either, so don't complain about hospital meals to them. "People don't check in for first-class accommodations or gourmet food," Brook adds. They check in because they're in need of medical care. Which brings us to the next point.
Nurses are secretly communicating with each other
"Everything you hear over the intercom (even songs) is a code for nurses," Jennifer says. "On one rotation they'd play 'It's a Beautiful Morning' as a reminder to pause from paperwork and check in on our patients."
What I want to know is whether there's a meaning behind those zany scrubs. How deep does this rabbit hole go?
The ER gets overwhelmed with people who don't have real emergencies
"It shocks me sometimes the things people go to ER for," says Melinda*, an ER nurse in New Orleans. "Basic medication refills, people bringing in elders with dementia who have no change in condition, back and tooth pain, chronic but stable conditions, 'I felt bad and had a sore throat, but I feel better now' -- things urgent care can handle without the outrageous bill."
Because most ERs go by the ESI acuity system to determine who's seen first, Melinda says people with vague symptoms can hold up the process for people who do have ruptured appendixes or a railroad spike through the cortex -- you know, actual emergencies.
The above is annoying, but it's a symptom of a larger healthcare issue
"The reason people go to the ER with vague, non-urgent symptoms is usually because they are uninsured and do not have a primary healthcare provider," says Ricky Lake (not that one), an RN at Parallon Nurses Network. "I'm currently in the ER and, yes, that can be exasperating. But you have to look at the systemic reasons that it's happening.
"One reason: lack of access to care. And we just lost the fight in Louisiana that would have allowed more nurse practitioners to be able to practice without the overly burdening collaborative practice agreements in place with physicians. There is a shortage of primary care providers across the country."
As a result, nurses end up doing the work of several people
"Hospitals are understaffed," Jennifer says. "I have yet to see a hospital that wasn't."
Tensions run high at hospitals, and errors and confrontations happen among the staff
"It can be a charged atmosphere," Lake says. "There's all kinds of juicy nursing controversy. Medical errors, nurse-nurse bullying… You wouldn't believe some of the nasty, immature, and downright dangerous behavior that we witness on the regular. I've been cussed out and hung up on by physicians more times than I can count. I've been belittled by many more, and also by lots and lots of other nurses."
Sometimes things get physical
"My charge nurse warned me about one of the surgeons who actually physically assaulted a nurse once," Lake recalls. "Grabbed her by her scrub top, in front of the patient and family, and dragged her out of the room because he was upset about some replacement potassium being administered through a peripheral line instead of a central line (which is still OK as long as the concentration and rate are adjusted appropriately). They aren't all like that, of course. But I do not socialize much with [people] that I work with."
In spite of that, all hospital staffers are there because they want to help you
"[Hospitals are] not perfect," says Rebecca, a nurse at Emory Healthcare in Atlanta. "We can't fix everything. We can't take all of your problems and make them go away. We're just human beings trying our best to help… but the reality is we can only do so much."
*Some names have been changed
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