Most people don’t know what nurses really do. I think I know why. Patients see the tasks nurses perform and do not realize the critical thinking nurses must do to catch problems early before they become serious, life threatening events. Here is a real life example of what I mean.
Mr. P was recovering from surgery to replace a heart valve. He complained of waking several times a night with shortness of breath when he laid down. Kim, Mr. P’s registered nurse, knew orthopnea (shortness of breath when lying flat) was a symptom commonly experienced by individuals in congestive heart failure. Kim realized that Mr. P’s heart failure was a possible complication after heart valve surgery. Mr. P denied any other symptoms of heart failure like coughing, wheezing or shortness of breath when walking. Kim determined that Mr. P’s heart rate and rhythm, blood pressure, temperature, respiration rate, and oxygen saturation (his vital signs) were normal. Physical signs of heart failure like swelling in his legs or fluid in his lungs were absent when Kim examined Mr. P. Kim discussed these findings with Mr. P’s physician who ordered blood tests and a chest x-ray. Kim made sure Mr. P received these tests right away. When the results came back confirming Mr. P had mild heart failure, Kim recontacted his physician. Mr. P was treated and recovered completely.
But what did Mr. P see? He saw Kim take his temperature and blood pressure. He did not realize the knowledge, skills, critical thinking and judgment his nurse needed to recognize the signs and symptoms of heart failure and convey them to the physician. In Mr. P’s mind it was his physician who diagnosed and treated him. Without the nurse at his bedside picking up the first signs and symptoms of a complication from surgery, Mr. P’s heart failure could have become a serious problem. He may not survived if Kim had not recognized the early symptoms and known what to do.
So what can we as nurses do about this? We are great at educating patients about their health and illnesses. Why not educate them about what we do? While performing our nursing assessments, we can explain what we are doing and why to our patients. Afterward, when we decide what action to take, we can share that plan with our patients. That would allow patients to agree or change this plan and just as importantly educate them about what nurses do. Let’s not keep our knowledge and skills a secret! Let’s be proud of what we do and not be afraid of telling others.