Patient care, nurse compassion, nurse competence, patient-nurse relationship
I was caring for a patient in rapid Afib. Apparently, this wasn’t the first time he’d experienced the sensation of his heart racing and jumping all over the place. We got his heart rate under control through the magic of Cardizem and although his blood pressure dropped a bit, he was hemodynamically stable.
For the next several hours I had the opportunity to spend time with him and his wife. We talked about his cardiac rhythm issues, his previous surgeries, what he eats, how he exercises, and eventually, we talked about his bowel habits. Initially, our conversations focused on his problems, treatments, and physical care but then over the course of the day, we shifted to lifestyle, family, and hobbies.
When I stopped in his room to say goodbye, he and his wife unanimously shouted, “No! We don’t want you to leave!” Although it made me feel good about my “work” that day, it reinforced some things I’ve learned about patients over my 25 years as a nurse.


1.   Patients EXPECT their nurses to be competent
Patients don’t care if you’ve been a nurse for 1 week, 1 month, 1 year, or 100 years; patients don’t care if you have a diploma, associates, bachelors, masters or even doctoral degree. They expect all of their nurses to be competent.

2.   Patients WANT their nurses to be compassionate
Patients assume that we will provide high quality care, free from mistakes; that they will get the right medications at the right time; but what they WANT from us is compassion. Do we care about them as human beings? Although WE focus on competence, THEY want compassion.

3.   Patients WANT to be involved in their care
We make the false assumption that as soon as we put a gown on a patient he/she becomes stupid. We make decisions about their care on the telephone, in the nurses station and in the hallway yet rarely do we talk about them in front of them. It’s their life and they want to be involved.

4.   Patients NEED to feel safe
Many patients suffer from separation anxiety when their nurse ends his/her shift. They get concerned that the next person might not take good care of them, especially when they hear the negative chatter from the hallway (note: patients hear everything!). Patients need to feel that they are in a safe environment no matter who is caring for them.

5.   Patients NEED to trust us
When patients are in our care, they are vulnerable. We start them on new medications, poke them with needles, send them for test after test, and put them in embarrassing situations (enemas, suppositories and straight caths ring a bell?). They need to trust that we will make decisions based on what’s best for them – not for us. That we won’t make fun of them in the break room, and that their OMG information won’t be shared on the social media superhighway.
When I met my patient and his wife, I told them that I had been a cardiac nurse for more than 23 years; that I still teach basic arrhythmia courses (among others) and have taken care of patients just like him for years. Over the course of the day, it slipped out that I happen to have a doctoral degree. I managed myself up. My patient believed I was competent.
I sat on his bed and held his hand when he talked about his grandkids and how his cardiac issues prevented him from being the grandfather he wanted to be. I reminded him that he has many gifts to offer his grandchildren even with a “broken heart.” He knew I cared about him as a human being – because I did.
When his heart rate started increasing again, I assessed him, told him I was concerned, asked him how he felt (no symptoms) and then collaborated with him and his wife on at what point I needed to call the physician (we created a plan that if started to have any symptoms or if his heart rate consistently stayed above 110, then I would call.) They both felt involved in his care.
When I was leaving, I introduced him to Sarah and said, “Sarah is one of the best nurses here. She is an excellent cardiac nurse and will take good care of you.” I “managed up” my co-worker. You could see my patient and his wife instantly relax a bit. They felt safe.
My patient didn’t question the medications I gave him to slow his heart rate or the fluid bolus I gave to increase his blood pressure or anything else I did for him. He trusted me.
Patients deserve to be care for by competent, caring and compassionate nurses. And, nurses deserve to believe they make a difference – because they do.
Thanks so much for reading. Take care and stay connected.