I don’t really like knowing things that my patient doesn’t know.
Think about it: You, the patient, have had weird symptoms over the last few weeks. Maybe some pain, or some bleeding from an orifice that doesn’t usually bleed, etc. So you go see the doctor or come in to the ER and we run some tests.
Sometimes I, the nurse, know what the results of those tests are before you do. It’s very difficult to act like I don’t know. But really, you don’t want me to tell you. Because I’m not the doctor; I don’t have answers to the questions you will suddenly have. I don’t know the exact treatment that you will have a very acute need to know. So I have to keep my mouth shut and my attitude clueless until the doctor has come to discuss these very important topics with you.
The patient I admitted today is middle aged and has had some of those weird symptoms that I described above. She had a test and I found out the results before a doctor had a chance to tell her about them. I kept finding myself imagining what her and her obviously devoted family’s reaction would be to finding out the ominous news. I felt very weird knowing that in a few short hours, her life would never be the same again. She is Unknowing. But isn’t that weird? Just because she doesn’t know exactly what is going on inside her body doesn’t make it not happen anyway. She was happily interacting with her family, eating dinner. She simply didn’t know that her test results were shockingly abnormal. I did. And it was hard. But what could I say? I think if she pressed me for an answer regarding the test, I would have in turn pressed the physician in to coming in earlier. But she didn’t… she seemed blissfully unaware.
It was exceedingly strange knowing how long her blissful ignorance was to last. It’s strange knowing things about my patients that my patients don’t know about themselves. How would I want to be treated if I were the patient? I’d want to know! I’d want my nurse to tell me, whether or not he/she had all the answers, but I know I’d then be frustrated that they had no answers, and I’d become impatient for the doctor to come. During the wait, I’d jump to conclusions and imagine the worst. It would be hell, the wait. But … I’d still want to know as soon as possible. Certainly I wouldn’t want my nurse to know and act like she didn’t. Yet I don’t believe that it’s fair at all that I tell a patient what the results were and not have any answers for their questions.
So I guess ignorance is bliss. If only for a little while.
I have been an Intensive Care nurse for 11 years. This blog is about my experiences as a nurse, and the experiences of others in the healthcare system - patients, nurses, doctors, paramedics. We all have stories!
Comments
As a nurse, I have often pondered upon this situation. Ignorance is bliss, but something most healthcare workers are deprived of. I know if I had the symptoms you described, I would have already been through the top five or so nightmare scenarios, before I stepped into hospital.
Don’t do yourself down though. I know it is standard for important results to be relayed by doctors, but I think that if a patient HAS to know, and know NOW, then an experienced nurse is just as capable. In fact I lost count of the situations where I have been left to provide the information that a shocked patient was too nonplussed or scared, to ask the doctor. As long as you clarify that the information you are providing is from a nursing perspective, it has just as much relevance to their care as the doctors information.
added by vurtuali on 07.02.04 1:37 am | Permalink
Working in the ER, patients often ask for their test results before the doc/NP/PA has a chance to tell them. The situation I always hated the most was when working with docs who would intentionally do exactly the opposite of what you just told the patient, just to make the nurse look bad. In my role as an NP in long term care I am frequently in the position of explaining to patients why we are not going to do specific tests like MRI
added by Azygos on 07.02.04 8:57 pm | Permalink
I wouldn’t want to know, AT ALL (I’m good at denial). But since I have to know, I’d rather know from someone who can tell me all that I want to know…. good intentions, appreciated as they are, don’t satisfy that need for answers. Sorry if that sounds rude — not meant that way.
added by bill reith on 07.04.04 5:39 pm | Permalink
As a nursing student, we have discussed this situation a few times, with a different slant. The discussion regards can we, as nurses, give the patient the test results, since trying to interpret those results is “diagnosing” and not in our scope of practice. I know I would want to know as soon as the reults are in, but if I had no idea what the results meant, and the nurse could not legally “diagnose” me, it would be just as frustrating. The whole issue of “what can we do under our scope” thing really has me stressed
added by azbigjohn on 07.06.04 1:51 am | Permalink
As a nursing student, I was stopped by a woman who had been sitting near the L & D nursing station for an hour, with her chart in her lap, waiting to be wheeled back to the ER at 3am. She pointed to the word “twins” on her chart and asked me if she was having twins.
After checking the name on the chart and that paper and finding they matched her armband, I took the chart to my preceptor–who had a fit! “You are not supposed to discuss the chart with the patient and she is not allowed to read it!” I was in big trouble.
It turned out that she had overheard the resident who had done the sonogram telling someone else that she was going to let the woman’s private OB tell her about the twins, and assumed that nurses were obligated to collaborate in the deception.
Does everyone agreee with that assumption?
added by Shamhat on 07.08.04 4:21 am | Permalink
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