I drove past a billboard the other day advertising a hospital in the Knoxville area. The motto read “Experience Mercy 24/7.” This really struck me, and as I drove south through Tennessee and into Georgia and Alabama, I pondered the concept as it applies to nursing. Being a “new grad” and GREEN, it is perhaps premature for me to comment on anything I see at the hospital, especially if those comments might be considered critical in any way. So, those of you who read, please understand that I mean no offense – I’d rather that these thoughts be taken in an motivational way rather than as a criticism.
I looked up mercy at www.thefreedictionary.com and found these definitions: Compassionate treatment, especially of those under one’s power; clemency; A disposition to be kind and forgiving; Something for which to be thankful; Alleviation of distress; relief. Personally, I believe that mercy is a one-sided action – the recipient need do nothing to deserve or receive it. Watching many nurses react to their patients, I am beginning to realize that this quality is sadly lacking in hospitals. Some units are trying Disneyesque methods to monitor attitudes of their healthcare providers – the motto “On Stage” is used on some units, with some success. However, the deeper quality of mercy is just about lost. Patients are labeled as “good” and treated accordingly, or ” a doozy,” “high maintenance,” or ” a handful” and treated either minimally or with poor attitudes. Many nurses would resent the implication that their attitudes show to their patients, but I maintain that it is nearly impossible to be complaining about a patient at the nursing station one minute, and offering caring, merciful nursing care in their room the next. Really, the “good” patients don’t need merciful care. They elicit good care by being appreciative and gracious. It is the high maintenance patients that need merciful care – care that is given not because it is so enjoyable for you as the nurse to be in the room, but because you are in the position of clemency.
Birthplaces are quite possibly unique in that the majority of the patients are actually healthy people. However, often the experience of giving birth is as shocking and overwhelming in every way as a major illness. Although our patients are generally with us only a short time and may not be “sick” per se, we are still called upon to provide merciful care. Sadly, many of our patients have personal lifestyle habits that do not promote respect. It is very difficult for a nurse to feel sympathy in herself for a patient who has taken drugs during her pregnancy and now has a baby with symptoms of withdrawal. Our sympathy towards the helpless infant implies near outrage towards the perpetrator of the suffering – who, incidentally, may have been our patient yesterday, or will be tomorrow. The patient who is so concerned about getting up and out of her room to smoke immediately after delivery that she is indifferent toward the infant is another patient who challenges the attitudes of the nurses. These patients require merciful care – not because they deserve it, but because they are the patient and we are in the position of clemency. Some patients are particularly demanding, making it difficult for the nurse to stay compassionate and not get frustrated. However, patients have the perogative to be demanding. Are we not all somewhat demanding in our own way? Do we not have family members that we know would make demanding patients – yet we still want them treated well? Do we all not expect good customer service in restaurants, hotels, and stores? The hospital is a customer service agency that is intensely more personal. It is in our power to treat the patients with kindness, whatever attentiveness we can allow while not neglecting other patients, and respect. This doesn’t mean that you must feel as though you would want to be that person’s best friend outside the hospital, but we must detach ourselves from our personal judgements about the patient, their family, their habits, and their ignorance and provide mercy 24/7.
We, as nurses, recognize the appalling level of ignorance too often evidenced in our patients. Our region is particularly infamous for poor education, poor nutrition, and a lack of attention to personal well-being. Facts such as these are glaringly apparent in a birthing center. Teaching new mothers is a tremendous responsibility of nursing care. When your patients are in pain, more exhausted than they have ever been, and caught up in the adrenalin rush of giving birth, they are not really receptive to teaching. Still, it is our responsibility to teach to the utmost possible level – if one small lesson makes the difference for one mother-baby dyad, our efforts have not been in vain. Every patient may not be affected by our merciful care, and many will remain unappreciative. Still, when we, as nurses, lay our heads on our pillows to sleep, we will be able to rest easy knowing that we have provided the care that we would want to receive – and treated our patients as we would want our families to be treated.
If you commit yourself to merciful care, the main point to remember is that merciful care is unmerited. The patients who need it are not going to make you want to provide it. That mercy has to come from deep inside you when your personal desire might be to never walk into the room again. It won’t be easy….but it will be worth it.
On the Other Hand.... 