What do nurses really do?

When I went to college to study nursing in 1978, my brother’s friend, a bright engineering student, asked me in all seriousness, “What do nurses do?” Not long ago, someone I was chatting with told me that she had never realized what nurses did until her mother was dying in the hospital. This person was in her early 50s. From 1978 to 2007 is a generation and yet there are still people who don’t know what nurses are do.

I guess it can be expected. People don't usually encounter nurses unless they're in a stressful situation and they only see the obvious, not anything that happens behind the scenes. On TV, nurses receive very little true attention. Either we’re portrayed as bimbo sex objects, doctor hand-maidens, or non-existent (as in the show House).

It’s funny because I do enjoy House very much – it’s a show I don’t like to miss – but in that show, it’s not only nurses who are non-existent, it’s the orderlies, the radiation technologists, and all the other healthcare professionals who help a patient recover while in hospital.

When was the last time, in real life, that doctors in a hospital knew exactly where the medications were and gave them to patients, did all the tests that they do in the show (for example, without any assistance in the cath lab or while the patient is having an MRI), transport patients from place to place, and all the other stuff they’re portrayed as doing on that show? I do recall one scene when one of the doctors told a nurse to do something and she countered with a question; she was told to just do as she was told. Oh boy.

On other shows, nurses are portrayed as women (almost always women) who do only what they’re told, without question. The only exception I recall is the series ER, where nurses, men and women, show that they have a brain.

So, what *do* nurses do? Unfortunately, because of the severe nursing shortage, whatever they are supposed to do, they often don’t have the time to do it all, or to do it as thoroughly as they would like.

The big difference between doctors and nurses is that doctors treat the illness and nurses treat the person. If a person has broken leg, the doctor is concerned, and rightly so, about getting that leg healed. It could be through surgery, casting and traction, casting only, or whatever the orthopedist feels is the correct way. The nurses have other priorities.

Nurses are concerned with the patient’s pain level, the correct placement of the traction as ordered by the doctor, the cast being fit properly and not causing problems with the foot and toes, the immobility causing problems with skin integrity (bedsores), lack of appetite, difficulty going to the bathroom, psychological well-being, and numerous other things. They report back to the doctor the patient's progress and if they notice any problems that they can’t handle or they need medical interventions.

It’s the nurses who observe the patient 24 hours a day, 7 days a week. They keep the records and are able to tell the doctors if there is increased pain, decreased pain, if the patient seems to be getting depressed, if he or she isn’t eating properly, if a foot seems to be getting a bit more swollen every day, and anything that is observed for more than just a few moments.

Nurses don't only care for people, but prevent complications from happening. That is probably the best way I can describe it. When they can, nurses also provide emotional support by being there and listening. They teach and try to help people who have just learned they have diabetes or cancer, or they help someone learn how to cope with a newly dependant parent. Oh yeah, and nurses save lives. Literally. From performing CPR until the crash team arrives to noticing subtle changes in a patient’s status, nurses save lives. Many of them.

A nurse is a person of all trades. When the dietician isn’t around, it’s the nurses who have to convert meals for the patients with diabetes, when the physios aren’t around, it’s the nurses who help the patients with their exercises, when the respiratory techs aren’t around, it’s the nurses who help the post-operative patients do deep breathing and coughing to clear the lungs. There is so much that a nurse does that isn’t seen by the public and probably never will be.

I do admit that there are men and women who shouldn’t be in nursing and give the profession a black eye – just as there are in every profession. The problem is that we’re so visible and out there that if a nurse or nurses give bad care, it gets broadcast quickly. If a nurse does a good job, it often goes unnoticed because everything has gone as smoothly as possible.

So, I guess this is a plea for a bit of understanding. Nurses are not miracle workers but they have been known to perform what could be seen as miracles sometimes.