Kristy Rodriguez, BSN, RN, works as a nurse in Florida.
As a mother and a nurse, I have often found myself with the dilemma of whether to inform others in a health care setting that I am a nurse. I say this because it can go either way: some look at it as a blessing that they can easily explain things to you using medical terminology, while other nurses may take it as a threat. And I understand these concerns. As a nurse I have come in contact with both attitudes—the helpful and the threatening—among family members and patients who work in health care. It has been helpful to have a family member or patient who understands at least the basics and is eager to learn. Then, on the other hand, it can be a nightmare with the patient or family member who uses the statement “I’m a nurse” as a kind of threat.
A son’s troubling symptoms.
My story all started about three years ago, a day that my son’s life would forever be changed, and mine with it. It was the spring of 2012 and my son was 12 years old and developing as a normal boy should develop. A stomach virus had recently swept through our house and sickened my son and his sisters. All three children were seen at the clinic for their symptoms. We were told it was viral and the normal treatment was hydration and waiting for the symptoms to resolve. My daughters’ health returned to normal, but my son remained sick. He continued to have episodes of nausea and vomiting over the three weeks that followed.
Seeking an answer, hitting a wall.
The day before he was to return to the clinic for a third visit, he came home from school crying and showed me his finger. He would sometimes bite his nails, and I saw that he had an infection alongside the nail bed on his thumb. His finger was swollen and red. Since he had an appointment in the morning, we placed warm compresses on his finger overnight.
On this third visit, because of his continued vomiting, the nurse practitioner suggested that the acid reflux might have returned and that this was why he wasn’t getting better. The first course of action, she said, should be a GI consult. But while my son had a history of acid reflux that had started when he was a small child, he’d been off his medication for some time now, and his symptoms had resolved with age.
A mother’s persistence.
The visit was on a Thursday preceding the long Memorial Day weekend, and I felt I had to say something. I knew my son and I knew that there was more to this than acid reflux. When I started to explain that I had concerns over my son’s symptoms, the nurse practitioner stopped me mid-sentence and said, “I know that you’re a nurse, and sometimes we tend to overreact and worry because we are nurses.”
I had never mentioned I was a nurse to her, for fear of this reaction, which effectively negates in advance the validity of any concerns that might be expressed. She knew I was a nurse because I work for the same health care system and it is flagged within the system that you are an employee. Although it was upsetting to feel that nothing I had said mattered at all, I renewed my effort to convey my concerns. I told her that he’d been drinking several liters of water a day, despite being a kid who would almost never drink water. He also was voiding large amounts all through the night, I had slept on the couch one night and noticed him getting up several times to go to the bathroom. But what I was most concerned about was that he’d had a 12-pound weight loss over the last few weeks. “I can feel every bump in his spine,” I told her, with tears in my eyes.
“Well,” the nurse practitioner said at last, “we can check his urine for ketones.”
My son gave them a urine sample to test, which immediately revealed high levels of ketones. They then did a spot check of his hemoglobin A1c level and found that it was above 14. I’d been crying through all this. Now the nurse practitioner looked at me and started to cry as well. With regret in her voice, she told me she was sorry she hadn’t listened to me earlier.
To support other nurses, in every situation.
Then she called the doctor into the room and everything happened quickly from this point on. We were rushed off to the hospital and my son was admitted. The education and teaching began for both of us about how to manage the lifelong condition of type 1 diabetes. Although as a mother I have learned a great deal about diabetes and insulin regimes and carb counting, I think my greatest lesson has been as a nurse:
To listen to other nurses when they are patients and family members and recognize that this is what they are at that time, not nurses. To listen to the symptoms they tell you about, not because they are nurses but because they have experienced them or have witnessed their family member’s symptoms. As nurses, we need to support each other in all facets of life.
Dear Ms. Rodriguez,
As a mother and a future nurse, this story really opened my eyes and touched me. This story is a perfect example of how a health care professional shouldn’t act. Parents are the best historians for their children, especially mothers know how their children act (normal versus abnormal). In this story, the mom knew that her son had more than a viral illness, because he continued with nausea and vomiting over the weeks that followed. In this scenario, the nurse practitioner overlooked the mother’s concerns thinking that she was excessively apprehensive because of nursing experience and knowledge. In my opinion, as future health care practioners, we should listen to their concerns and not put our personal assumptions over their complaints. Being a mother to two children I wouldn’t want any doctor or nurse practitioner to negate and invalidate my feelings by implying that I’m overreacting. I wouldn’t want my children seen by health care professionals that don’t therapeutically listen to my concerns and treat me at face value. The nurse practitioner could have saved herself the embarrassment and guilt by treating and seeing the mom as a worried parent instead of a nurse. This article not only is informative but provides insight into a clinical scenario that can take place in our world today.
Many of us have had similar experiences. 18 months ago I took my husband to the hospital for sudden onset of severe dyspnea and irregularly irregular tachycardia; he was found to have a very low SpO2 and RV strain related to many pulmonary emboli from anomalous leg veins. (Thankfully, he has since recovered with few sequelae.) However, it was like pulling teeth to get the hospitalist, half my age, to listen to my concerns; he literally refused to sit down to talk to us when invited to do so and stood over us with his arms crossed over his chest. Eye-rolling was involved. He prescribed an inappropriate medication based on an inaccurate assumption about my husband’s age and activity level, insinuating that this med was correct because the PEs were a result of an hereditary hematological condition. When I asked, “What are the odds that that such would declare itself for the first time in an 8th decade of life?” he glared at me and left the room. A different physician eventually wrote the discharge; subsequent consult with a hematologist confirmed a lack of coagulopathy, hereditary or otherwise. The medication he had prescribed would have been contraindicated and, indeed, would have had very untoward side effects.