In the United States alone, there are more than 3 million registered nurses. To put this number in perspective, there are only about 900,000 doctors. That means that nurses outnumber doctors more than 3 to 1. There are only a few of us who cannot connect a nurse to some aspect of our lives -- be it a friend, relative, or acquaintance. Let's be honest -- almost all of us have that one nurse that we can call occasionally with medical questions when we aren't sure whether to believe WebMD.
Still, even with our close proximity to nurses, few people can truly define what a nurse does. To test this theory, I went to the handiest survey tool out there -- Facebook. I surveyed my friends, a healthy mix of both health care providers -- nurses, doctors, and emergency medical personnel - and civilians not involved in the health care field. I asked a simple question: What does a nurse do?
The answers ranged from the comical "they take care of my booboos when I get a big ouchy," to the more serious "almost everything a doctor does, at a quarter of the salary." The overwhelming response though, was that nurses care. And they're right -- nurses do care. But there are other health care workers that care. Doctors care, nursing assistants care, physical therapists care... even those not directly tending to patients care. So what sets nurses apart?
What makes nurses caring different than the caring of every other employee at the hospital? The answer boils down to this: It's not the fact that nurses care that is important, it's what they care about.
A doctor generally specializes in one area and sticks with it. There is an -ologist for just about every human function you can think of. Cardiologists, nephrologists, ophthalmologists, gynecologists. Consider a patient who is admitted to the hospital with congestive heart failure. This patient may have multiple specialists following them: usually a Cardiologist, Nephrologist, Internal Medicine specialist, etc. Each of these doctors (while obviously concerned about the overall patient condition) is focused mainly on their own specialty. The Cardiologist defers to the Nephrologist for kidney issues and the Nephrologist defers to the Cardiologist for heart issues.
As a nursing student at Gwynedd Mercy University, we learn that nurses focus on the entire body. We are taught from the get go that we should be holistic in our care, considering the needs of the patient's mind, body, and spirit.
Regardless of how many specialists are seeing the patient, it is the nurse that is communicating with all of them and coordinating the care that they prescribe to ensure the safety and healing of the patient.
The nurse is responsible for all of the treatments, medications, diagnostics, and therapies ordered. If the Cardiologist orders a drug that interacts with another drug ordered by the Nephrologist, it is the responsibility of the nurse to ensure that they can safely be given together. If the patient is to undergo a procedure, it is the responsibility of the nurse to ensure that they are properly prepped and ready to go. When the patient's lab results are back, it is the responsibility of the nurse to evaluate them and decide if the doctor needs to be notified immediately. If the patient seems unsteady on their feet, it is the responsibility of the nurse to mark the patient as a fall risk to ensure safety. If a nursing assistant notices a patient is suddenly confused and anxious, it is the nurse who will immediately go to the room and assess the patient.
Ultimately, the bulk of the patient's care and safety falls onto the shoulders of the nurse. We are responsible for the majority of the care given by everyone else on the floor -- even the doctors.
Gone are the days of nurses acting as doctors' handmaidens. If a doctor orders a dangerous medication or treatment and the nurse administers it, both the nurse and the doctor are responsible for that treatment and they may both be at risk of losing their licenses.
All of this monitoring and evaluating means nurses must be smart, adaptive, educated, and skilled in critical thinking. We must know the underlying background of our patients' health care problems: what causes them, how they relate to one another, how one can impact another, and what treatments are needed to help heal the patient. We must be skilled in assessing each body system, from the neurological state of our patient all the way down to their bowel function. In an emergency, we have to be able to evaluate a patient with a single glance, taking in their color, breathing pattern, and overall appearance.
There is an old adage that you need a doctor to diagnose you, but a nurse to save your life. This is because nurses are at the bedside with the patient 24 hours a day, 7 days a week. It is the nurse who will take your hand and guide you on your hospital journey, taking time to educate and comfort you along the way. It is the nurse who will worry about your lab values, medications, and assessment findings so that you can focus on healing. It is the nurse who will advocate for you, be it to your doctor, family, or even sometimes yourself. It is the nurse who will spend their entire day focused on you and your health. It is the nurse who will take the time to evaluate how you are doing as a person, not just how your body is handling its illness. It is the nurse who finds your coping and overall well-being to be just as important as your medical diagnosis. After all, we do this job because we care.