You are fairly new to our Emergency Department, you have done your Emergency Nursing courses and you now have collected a slew of certification initials: ACLS, PALS, TNCC, ENPC. You are confident, and just a little arrogant. Believe it or not, creaking dinosaur I am, I get where you are coming from. You are young, you are working in a job that’s both exciting and has a certain glam cachet, and the world is your oyster. And what I am about to write is not directly a criticism per se of your hard-won nursing skills. I believe, in fact, that in your own way, you are perfectly competent in all the technical skills required of an Emergency Nurse.
This is what is bothering me. I am concerned first, by the casual contempt in which you hold your colleagues, and second, how you transfer contempt to your patients. The two, I think, are not unrelated. When you roll your eyes when a nurse-colleague is giving report, or have your eyes on your Blackberry, and fiddling with something in your purse, or having side-conversations with other nurses passing by, you are clearly signalling what information your nurse-colleague is trying to convey is trivial and unimportant, and consequently, this attitude shows in the patient care you’re about to give. You patronize patients in the way you speak to them, you are dismissive of their valid concerns, and you seem to believe no patient is sick enough to be deserving of your care. Older, more experienced nurses have noticed it, and it has not gone unremarked. Cynicism unrelieved by compassion and empathy is ugly, plain and simple.
Somewhere in you education and socialization as and ED nurse, you have concluded that the best approach and attitude towards patients is disdain and condescension. Whether you’ve been influenced by medical dramas on television (which you surely must recognize as presenting a distorted view of reality as anything else you might name), or by your peers, or have confused for contempt the compassion fatigue in the black humour found in the Emergency Department, I don’t know. But at the end of it, the complete lack of self-awareness and self-reflection, in that you seem incapable of recognizing how any of this adversely affects both you and your patients. I cannot ask you to change, because I am pretty sure you will not see the need. And this might be the worst thing of all.