The pitfalls of being a “nice” patient: A nurse’s perspective

I actually have often heard health care employees in various settings say, “In the event you are nice to the nurses and doctors who look after you, you’ll recuperate care.” As a bedside nurse, I understand this sentiment. No busy health care skilled likes to come across antagonism or pressing demands that don’t seem critically urgent to us.

But when my husband and I each became seriously unwell last 12 months, we learned the clinical pitfalls of being nice patients. I’m wondering how patients might be expected or allowed to advocate for their very own care without worrying that they’ll face disapproval or rejection because they’re perceived as “difficult.”

First warning.

Firstly of 2022, I discovered a small lump under my right breast, which I initially wrote off as a cyst. Surely, I told myself, as a lady in my 40s with no risk aspects for breast cancer, this should be a benign condition. A screening mammogram in May 2022 showed all the things was positive and I moved on.

But in November I knew the tumor had grown. I contacted my PCP to request a diagnostic mammogram, and he emailed me back with a casual reassurance. “I do know you are fearful, but I’m sure it’s only a benign fibroadenoma. I would like you to return see me in person first before we proceed with further examination. The subsequent visit is scheduled for the tip of January 2023.

I felt keenly aware of how I might be seen as a paranoid or hypochondriac woman, or a cocky nurse attempting to play my “Hey, I’m a health care skilled too” card. I hesitated for a day, but my nightly scan again showed me that this lump had definitely grown and was not normal. So I stepped away.

“Dear PCP,” I wrote, “we each know that even after an in-person exam, we are going to need a diagnostic mammogram and possibly an ultrasound and biopsy to seek out out of course, so could you simply organize them? ” My PCP agreed without further resistance. Sure enough, it turned out to be invasive ductal carcinoma, so I started my journey through tumor removal, radiation, and hormone therapy.

“Time is a function”: my husband’s story.

Shortly after starting hormone therapy, my husband Steve underwent outpatient surgery for speech and swallowing problems. Inside two weeks of surgery, the postoperative course modified from the expected sore throat to neurologic deterioration that was ultimately attributed to an epidural abscess that had developed and was severely compressing the spinal cord. He was rushed to emergency surgery after which spent a month in a rehabilitation center. He recovered enough to eventually return to work, but now has some significant deficiencies.

While he was still on edge attributable to an unexplained neurological deterioration, the primary two MRIs of his spine did not capture the slowly growing abscess that may erupt in only a number of days, dangerously close to finish paralysis or death. Doctors scratched their heads on the apparently “clean” MRI results and increased his pain medication.

When he lost his footing, he went to the emergency department, where triage is a significant component in clinical attention and decision-making. In the course of the 32 hours he spent within the ER, my husband’s vital signs were stable. Ever the “nice guy,” he remained calm and quiet, uncomplaining despite the excruciating pain when he moved, and made no mention of the degree to which he felt he was losing using his limbs.

“I actually have a tough time holding my cellphone, even with each hands,” he told me. “I attempted to succeed in for something within the room and fell on the emergency room floor. It took them about 20 minutes. realize that I actually have fallen.

I used to be too overwhelmed attempting to sort out our youngsters’s logistical needs, attempting to make sense of a rapidly changing situation (after barely stabilizing from my very own health crisis) to think clearly about his clinical situation. Fortunately, a physician friend contacted my husband via text and have become concerned when he heard how quickly Steve’s health was deteriorating. This friend advisable on our behalf that the neurosurgeon make a call before we had requested, prompting us to seek the advice of with a neurosurgeon, which resulted in one other statistical MRI, which ultimately identified the abscess that was now visible on the scan. At 2 a.m. my husband was transported to a bigger hospital, where he underwent decompression surgery at 6 a.m.

In these cases, “time is a function”. We now understand that if we had waited even yet another day, my husband would likely have been permanently paralyzed or died.

Let’s put ourselves within the patients’ shoes.

It strikes me how much we desired to be “nice” patients. As a nurse, I used to be sensitive to the necessity for time that each one of those healthcare employees surely felt. I wanted them to know that I understood their stressors and revered all of the work they did. I too was terrified and felt very strongly that my husband and I needed immediate help for the situation, sooner quite than later. I used to be shocked at how difficult it was to navigate these nuances.

I recognize that there are systemic issues at play that make it difficult for health care providers to devote detailed attention to every anxious patient and member of the family. I still don’t need to change into an excessively “squeaky wheel” during future visits for myself or my husband. But I actually have to ask, are we as nurses aware of the pitfalls that await “nice” patients and their families who don’t speak up for themselves after they have concerns? Are we ready and smart enough to maintain them in our sights when vital questions on their clinical status remain unanswered?

(More posts by pediatric ICU nurse Hui-wen Sato might be found here.)