Bedside nursing is deteriorating to the detriment of all of us. Hospitals are often short staffed. Doctors often will answer a question with a short, specific, and often oft-handed answer. They don’t intend to be glib or dismissive, but are in a rush to visit yet another patient. The new graduate nurses I have encountered are very task oriented and are good time managers, but they too seem to lack the time to listen. In many ways, nursing has become more industrial, more factory-like – all about how many patients you document having seen in a given period of time rather than how good – and compassionate –the overall care for each individual patient was. Many nurses want to offer that kind of time-demanding care, but are pressured to just keep moving. In the last decade, many nurses have left the bedside out of frustration. But I’m still here.
What many in the medical profession, nurses especially, are missing is the time to stop and think about the question that’s not being asked. Because I’ve spent so much of my working life listening to patients at their bedside, I’ve developed a keen ear for what is not being said. I have learned how life-changing it can be for both the patient and family to know what to ask and when. A nurse with the time to watch compassionately what is not being said can help bridge that gap between the clinical, technical and the compassionate, human interaction that can make a huge difference in experience and outcome.
I did not master the ability to discern unspoken questions overnight, and I evolve every time I work with both patient and family — every experience is unique to each person and each set of circumstances. During my hospice career, I’ve also done liaison — teaching about hospice to doctors, nurses, hospitals, facilities and organizations. But being at the bedside working directly with patients and families is what I cherish most.
Forty years of bedside nursing has taught me about vulnerability and the human spirit, and about how beneficial listening can be. That understanding comes from being there, and taking the time to focus on each person. It’s a compassionate skill you can’t learn that in textbooks. No matter how technically adept you are, to be the kind of nurse we all want to have when we need him or her, we need that skill. It’s the one that matters most.