30 rules to live by

Nursing, Sep 1998

You can't go wrong if you remember these universal truths about nursing.

Knowing your patient

1. Whatever subject the patient is most comfortable discussing is probably not the real problem.

2. Always sit down when you talk with a patient.

3. When patients are admitted to the hospital, they bring their dignity with them. Don't let anyone steal it.

4. Time is distorted when waiting for a physician or nurse, news of a loved one, the report of an important test, a biopsy result, and pain medication.

5. Don't talk with an angry patient about any other subject until you understand the source of the anger.

6. Never forget that being a patient can be frightening and demeaning. A bed bath may be just a nursing task to you, but to your patient, it's a highly intimate experience.

7. The higher the technology, the greater the need for human touch.

8. Pay careful attention to patients who say they're going to die.

9. Never ask, "How are we doing today?" (You should already know how you're doing.)

10. There are three kinds of patients: those who believe every word you say and do everything you suggest; those who reflect on what you say, ask you questions and then make up their own minds; and those who with everything you say and think that nothing will help them. Learn to deal with all three.

Murphy's law

11. False teeth get lost.

12. Two types of adhesive tape exist-the kind that won't stick and the kind that won't come off.

13. Intravenous stands are at the opposite end of the hall, when you need them most.

14. Nobody ever arrived in the emergency department wearing her best underwear.

15. Bedpans attract visitors, families, and physicians on teaching rounds.

16. After midnight, all cases get clinically strange.

17. As soon as you're gloved and gowned, the itching will begin.

Clinically speaking...

18. Be especially careful with patients who are being treated with a second drug to correct a reaction to a first drug.

19. If routine practice doesn't meet the patient's needs, change the routine.

20. If you cut off an armband, replace it immediately.

21. The call bell is of no use if it's on the floor.

22. Any patient on more than four drugs is beyond medical science. No controlled studies have been done on patients taking more than four drugs, and very few exist on patients ta three.

23. There's no such thing as an organ-specific drug. All drugs work throughout the body.

24. Laughter is a natural tranquilizer. It's also free, nonfattening, sodium-free, and available to everyone. Best of all, it's contagious.

In the hospital

25. The admitting office puts all patients with identical names in the same unit.. .and whenever possible, in the same room.

26. A hospital is a dangerous place. It should be used wisely and as briefly as possible.

27. Jails and hospitals have many similarities: they're institutions take away personal clothing and issue uniforms, re valuables and personal belongings, allow visiting on a limited basis, assign people to rooms with strangers, designate people by numbers, restrict freedom of movement, and serve limited kinds of food. Try to minimize the similarities. You're the patient's nurse, not her warden.

Professionally speaking...

28. Help nurses who float to your unit. Try to keep their heads above water. Don't let them sink.

29. Laughter among nurses attracts managers and directors of nursing.

30. Excellence in nursing is achievable; perfection isn't. Know the difference.

From A Little Book of Nurses' Rules, by Rosalie Hammerschmidt, RN, and Clifton K. Meador, MD. 1993 Hanley and Belfus, Inc. Philadelphia. Excerpted and adapted with permission of the authors.