Nurses Reveal What Really Goes on in the Doctor's Office

Nurses are amazing. They care when others don't. They work hard, without a break. They bleed so you don't have to. As a result, they've seen it all.

And they're here to reveal it all.

How do they really feel about incompetent doctors? Where did that blood on the floor come from? What smells so…gross? And what are they saying about you. Eat This, Not That! Health spoke the registered nurses we know personally—as well as our network of medical experts—and divulge the answers right here. Read on, and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus.

Before the coronavirus, some hospitals were a little less focused on hygiene. "We know that some surgeons don't really care as much about sterility as about the number of procedures they perform," a nurse with 10 years of experience in NYC operating rooms reveals. "In order to make more surgeries, they try to cut the time between operations. To speed up the process and save time, surgeons sometimes 'help' to clean up the operating room themselves. So occasionally you can find a piece of human fat under the operating table. Unfortunately, hospitals allow that kind of practice. These doctors bring a lot of money!"

"Nurses also (try to) withhold sad emotions from patients," says Catherine Burger, RN, BS, MSOL, NEA-BC, a contributor with Registered Nursing. "It takes everything we have sometimes not to burst into tears along with them when the physician is sharing bad news. We remain supportive and professional, and then break down in the car on the way home!"

It's gross, but true. "Before certain surgeries patients have to go through bowel prep—a process of removing feces from the colon," the NYC nurse says. "Sometimes during positioning a patient, when lifting their legs up, accidents will happen and doctors or nurses could end up with a piece of poop on their clogs. There's no time to clean it before the end of the procedure so we have to keep working—ignoring the mess. We wind up preparing for such situations by rubbing some mastisol liquid on our masks to kill the unpleasant smell."

"Nurses withhold many things from patients, and often our silence should speak volumes," Burger says. "While it's unprofessional to speak poorly about a clinician when patients ask us—especially if we like a physician we know is incompetent—we have to get creative with our response or we simply change the subject. A clue for patients is when nurses 'strongly' encourage a second opinion."

Due to the high stress and hectic pace of their jobs, nurses sometimes skip meal breaks. "Nurses repeatedly are not eating at the right time," says Donna F. Brown, a registered nurse in Arizona with over 30 years of experience. "They go long hours without eating, which causes low blood sugar syndrome. It makes them fatigued, angry, irritable, almost hostile."

"You'd be surprised how dirty some patients' belly buttons could be," E.M., an operating nurse with over eight years of NYC hospital experience, tells Eat This, Not That! Health. "We must clean this area before the laparoscopy procedure, and it's often shocking. We often tell each other that operating nurses have the cleanest belly buttons, knowing what we can find in there."

"Patients don't see the times we almost make a mistake regarding their care," Burger admits. "Referred to as a 'near-miss' in the world of risk-management, we put safety processes in place to avoid errors, but sometimes we come close—and we strive to learn from them!"

"Nurses aren't allowed to diagnose patients, so even if we see something obvious on an ultrasound—officially, we aren't allowed to say anything," says Hilary Erickson, an RN at Pulling Curls. "This includes if we get an ultrasound on a baby who has no heart activity. It's just heartbreaking, and a really hard situation."

"It's really annoying when patients eat before surgery and admit to it right before the surgery starts," says the nurse with 10 years of operating-room experience. "When a patient eats he cannot receive anesthesia, which means surgery needs to be canceled or postponed. It's a waste of expensive supplies, sterile instruments—and our time. The whole team needs to stay longer for when the patient is ready to be operated on. Usually, you shouldn't eat anything six to 12 hours before surgery."

"Patients may want to avoid telling how they feel about something, but we have our ways of dealing with that," says Brown. "When I see a patient acting nervously, like, avoiding eye contact, I try to open the patient up by saying things like, 'You're quite tense today.' And I'll see if the person is afraid of something. This especially happens when patients are anticipating surgery and other medical procedures such as surgery."

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"Hospitals are short staffed," the veteran operating-room nurse admits. "Many times difficult surgeries are stuffed with orientees or nurses who don't work in the service. Neither really knows much—they don't know where to get supplies from or what is the thing that surgeon just asked for. When something bad is happening they don't know how to quickly respond. It's very dangerous to the patient who trusts us completely."

"Nurses work with many doctors and they know better than anyone that some surgeons are not the most talented. Therefore you have to reassure patients that they are in great hands," says the veteran NYC operating-room nurse. "When you work with a surgeon who doesn't have the best reputation you'll make sure a chief resident or a fellow is around to be in charge during the whole time."

"Due to nursing shortages, hospitals are forced to fill the holes by recruiting nurses from temp agencies," Brown says. "Temp nurses don't necessarily lack in skills, but they often aren't familiar with a particular hospital or team they're delegated to work with. They need to be trained on how to follow protocols, know teams, doctors, and patients. It impacts patients' care."

Brown wants to remind people how demanding nursing is. "After a 12-hour work shift, nurses are often being asked to work another shift," she says. "Sometimes they work double shifts and don't have breaks—including bathroom breaks. They need to plan in advance or use the restroom when they can. Plan in advance."

"For the most part, we don't remember your name. And if you visit we most likely won't remember you until we kind of connect the dots and realize which room you were in," says a PACU nurse—that's "post anesthesia care unit"—with 8 years' experience.

They deal with long hours, double shifts, condescending doctors, full bladders—but let's not forget about the most stressful factor of their jobs. "Nurses work in an extreme stress environment—people can't see what they can see," Brown tells us. "Nurses must deal with victims of violence, road accidents, and witness patients as victims of various traumatic situations. They are very stressed out. And they have to hide all the feelings from patients. So they often bring it home."

A 2016 study published in Nursing Research and Practice reported that 92% of nurses report moderate to very high stress levels. According to the study, the stress leads to lack of sleep (72%), eating junk food (70%), lack of exercise (69%), and sometimes binge drinking (22%). However, talking to loved ones (79%), listening to music (46%), watching TV (43%), and praying/meditating (43%) helps them cope with the stress.

"Due to short-staffing, we're often forced to work mandatory overtime," the veteran NYC operating-room nurse says. "It's annoying—we all have families, plans—and we're simply tired after long shifts, but we still have to stay extra hours to help our patients. So next time you visit the hospital and see a tired nurse, please be more understanding."

"My longest shift was 11 a.m. to 3 a.m. in the ambulatory surgery center," the NYC operating room nurse recalls. "You'd think that this was a place where patients would be relatively healthy and ready to go home after the procedure. But not that night. We had a very sick patient who should not have been operated in a place without a charge nurse—she already left for the day. After 8 p.m., there's absolutely no one who can help you (get a crash car to the room). As a nurse, you're completely on your own—without help from your co-workers! It's a very dangerous situation. This is why nurses call out sick for mental recharge after those difficult shifts."

"Not all our superiors are good at their jobs," admits the NYC nurse. "We absolutely hate when our charge nurse becomes so occupied on her phone or private matters that she forgets to relieve us on time. It makes us stuck in the operating room for hours, even though there are people from other shifts available. It's a waste of our time and hospital resources."

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"The beauty of nursing is how much of a team we are," Erickson says. "When we're on the floor we try to have an idea of everything that's happening in our area. In Labor and Delivery, all nurses have their eyes on the monitor. That means if something goes wrong with any patient, many hands rush to the room to help out. It's awesome, and it helps patients stay safe. It's one of my favorite parts of working as a nurse."

"What patients don't see is a complex system of professionals working together behind the scenes to provide the safest and most efficient care we can," adds Nancy Brook, MSN, NP, a Nurse Practitioner Surgical Oncology at Stanford Healthcare.

It's not always about teamwork, Brown admits. "A lot is going on behind the hospital bed curtains," she says. "One thing I observed many times in my long career as a nurse is lack of teamwork. Nurses often don't help each other. It's an every-man-for-himself situation, in which other nurses make excuses rather than help. Often it's caused by too much work—nurses have too much on their own plate to help others—but sometimes it's selfishness. Nurses have to be prepared to deal with everything by themselves."

Oftentimes, for a variety of reasons, nurses try to distract patients. "Patients such as dementia patients are often so anxious about their memory loss that they aren't able to focus on anything else and this increases their anxiety," Brown says. "We try to distract them from memory loss and have the focus on things they actually can do, like knitting, social activities, exercising, or just listening to music. Such techniques help these patients refocus their energies on more positive activities to help empower them and allay their anxiety."

"Nurses are true patient advocates," Brown adds. "We answer a lot of your questions. We give you tips on different breathing techniques, even help you find the best position in bed. We are with the patient most of the day, and we know what is going on with them better than anyone else."

"Stress and long hours are reasons why nurses may not have the time to check if they've given patients the proper doses of medicine," Brown admits. "Nurses are so busy, that when the doctor writes an order for a medication dosage change, the order is sometimes overlooked and therefore can lead to med errors. Nurses are also responsible for checking that doctor orders are correct. (For example. trying to decipher whether a doctor means one medication over another similar sounding medication such as Ativan vs. Atenolol.) Sometimes it could cause big problems."

Many hospitals are affected by a phenomenon is known as "nursing shortage." No other profession is in such demand. According to The American Nurses Association, there will be more nursing positions available through 2022 than any other profession in the United States. The U.S. Bureau of Labor Statistics projects 1.1 million additional nurses will be needed to avoid a further shortage. "Most people want to avoid working long hours, double shifts and other forms of excess stress caused by responsibility and lack of staff. That's why nurses are trying to avoid working in hospitals, making the cycle even worse," Brown says.6254a4d1642c605c54bf1cab17d50f1e

Most nurses have been doing their jobs for years, so when a patient tries to overcomplicate things based on fads, nurses become annoyed. "For example, patients coming to us with their birth plan are dead set on how certain things should go," admits a veteran NYC-based labor and delivery nurse. "If something were to veer off their expected path, the patient might get stubborn and refuse help until the labor naturally follows the birth plan. It might get too late to continue waiting, which is why it can oftentimes end with a C-section. We always try and rationalize with the patient rather gently, as you don't want to intimidate the anxious mother even more."

"Some family members believe that the patient doesn't need any pain management and answer for them," the NYC labor nurse says. "It's bad because sick patients often feel overpowered and won't speak for themselves. I always tell them that it is not [your family members'] pain and they shouldn't answer for you."

"It's natural to a bit overstate your pain level, but when we see a patient expressing his pain as 10 on a 0-10 scale and at the same time updating his Facebook status, it makes us really angry," the NYC nurse warns. "Don't forget that we're taught the basic ranges of the pain scale and how the patient looks and acts when feeling a 2 compared to a 7."

"Many times doctors don't know the names of their nurses/scrub techs, even though they've been working with them for a while," a veteran NYC nurse says. "Often they're simply too busy—they are dealing with life and death in real time after all—but sometimes they could show a bit more respect. It's teamwork—no surgery would be successful if the surgeon worked alone in the operating room."

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"We don't have a crystal ball and we can't predict the future," the NYC delivery nurse admits. "If he could, we would enjoy our lottery-won millions rather than working 12-hour shifts. So don't ask us impossible questions, like the time of birth for your baby. We have no idea. I usually tell them that only the baby only knows that."

Nurses are frustrated when you're not sharing your medical history with them. "Many patients withhold information from the nurse for unknown reasons," the NYC labor nurse says. "Whether it be your number of pregnancies or surgeries—it's all important as it could potentially lead to complications."

"Every woman can successfully breastfeed her baby," the labor nurse says. "It's a huge effort by the mother, but it's worth the effort. If the mother does nothing to build her milk supply she won't have enough milk. We provide constant support for the mothers but they're tired. They babies are constantly crying, so sometimes they give up and ask for the formula, which is still OK."

"Nurses hope that patients never see the organized chaos occurring outside their doors and curtains," Burger says. "From the change of shifts to the supply management to the changing room assignments, nurses hope that patients only see a well-oiled machine and not the never-ending frustration that the nurses are enduring."

"Nurses sometimes withhold to family members the fact that a patient needs to be placed on a 'Do Not Resuscitate' order," Burger, the contributor at Registered Nursing, says. "Families are usually too close to the situation and managing their own grief to fully comprehend how traumatic CPR is for an ill or frail patient."

"Nurses try to be tactful when children are visiting patients and advise parents not to allow the children to sit or crawl on the floor," Burger says. "However, we're withholding our true feelings of disgust as we know what has been on those floors during the past 12 hours."

"Many labor nurses don't like working with doulas—birth coaches or post-birth supporters who can't perform clinical or medical tasks in hospitals," admits a veteran NYC-based labor and delivery nurse. "While most doulas do mean well, they tend to get in the way, especially if something were to go wrong. There's enough people in the room already and it could add stress to the nurses and doctors assisting with the labor."

Burger says nurses "withhold telling patients of the risks and benefits of surgery or treatment." According to the Arizona-based registered nurse, "This information must come from the clinician performing the procedure or ordering the care."

Burger also admits that nurses aren't perfect. "Nurses sometimes withhold from patients that they have made an error, such as giving the wrong medication," she says. "While the expectation for the nurse is to disclose the error to their supervisor and the patient, nurses sometimes fail to follow these rules."

"Patients may notice that we don't always wash our hands," Burger admits. "We're good about using the hand gel or washing our hands when we leave your room, but we could be better about cleaning our hands entering your area." Of course, now that COVID has struck, hand-washing procedures are stricter.

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"Giving meds is frustrating. We don't like doing it. It's time consuming, especially when it's a lot and frequent. Some people think that's all we do—not even close," says the PACU nurse.

"Nurses don't want family members to be present during a procedure," Burger says, and the reasons are logical. "We're usually giving medications to the patient so they feel less pain and don't remember the procedure, but the patient is still 'awake' and talking," she says. "Families can misinterpret that the patient needs to be 'knocked out,' but we know how much to give and talk with the doctor to make sure they are getting only what they need."

"Patients don't know that many nurses work more than one job," Burger says. "Especially for the departments that have 12-hour shifts, nurses are able to work at multiple facilities."

Doctors need support as well, Burger says. "Patients don't see when doctors get worried about a treatment plan and call other doctors and nurses for help," she says. "Many practices hold a weekly case review where physicians discuss the plan of care for complex patients and all team members can offer advice," says a nurse from Iowa.

Nurses understand that some of the vendors who are providing hospitals with sophisticated machines used in the operating room may have more experience than doctors in certain types of procedures—for example, orthopedic. "Vendors are often guiding doctors during the surgery and they tend to be very good at it as they know their machines back and forth," says an NYC operating room nurse.

"Most patients are fantastic and we are always happy to help them, but when patients are Googling symptoms and ignorantly quote it without understanding, it could make our lives difficult," the NYC labor and delivery nurse says.

"We Google things all the time," says the PACU nurse.

"We gossip. Patients have reputation on the unit. You may be termed as a difficult patient based on your acuity or personality," says the PACU nurse.

"We expect independence. If you have at least one hand working you can eat. If you can walk few steps you definitely don't need a bed pan," says the PACU nurse.

"We don't like unnecessary call bells. We are exhausted! We do way more than you think. We do more than giving medications. Patient life is in nurses hands. We are the link between doctors and we call a lot of shots," says the PACU nurse.

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"We may not fulfill your request to call the doctor in the middle of the night (or even day) if we think it's unnecessary or we can answer the question or we know they will round soon," says the PACU nurse.

"If we're sick, we're still at work with stuffy nose blaming it on allergies," one nurse reveals.

"We absolutely hate when you ask what the patient next door is here for," says the PACU nurse. Ask yourself: Would you like them to inquire about you?

"Sometimes patients threaten the nurse that they will leave Against Medical Advice (AMA). They say, 'Well, if you don't admit me to the hospital right now I'm leaving AMA,' or, 'You are not doing anything for me here, so I will leave AMA,'" one nurse says. "Some of the patients just walk out and refuse to sign anything. A nurse honestly doesn't care when you do it and will gladly give the papers."

"We prioritize our patients based on acuity and we may not pay attention to you because you are not as sick," says the PACU nurse.

"We won't tell you if this is our first time doing some procedure," says the PACU nurse.

"Not many people know that we have to help all patients," the delivery nurse says. "I often help to deliver babies of Rikers Prison patients. Some of the mothers could be aggressive, but we have to help them no matter what."

"Nurses withhold from patients when we think they are crazy," Burger says. "We listen to the stories and redirect the conversation where we need it to go, all the while contemplating the need for a psychiatric consultation."

"Often we know what the likely outcome will be—but we always say that we are doing everything possible to help them or help their family member," Erickson, an RN at Pulling Curls says. "The reality is that things may be fine, but in the meantime, we're all working hard to help them—versus having the time to talk everything through. However, we do—for the most part—let families be in the room (if they want to) while we work to save people."

Nurses deal with extreme stress, they hide their emotions, they're annoyed when patients don't listen or when they have to deal with lazy colleagues or doctors touched by the "God complex." But despite all the stresses, nurses still love what they do. "I had the most rewarding career for 48 years and counting," says Valerie Nisewarmer, a pediatric nurse. "I would not change a day!" As for yourself: To get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.