End of Shift: ‘Insensitive’ nurses teach RN about her role as advocate

By | 2020-04-06T10:52:04-04:00 February 29th, 2016|5 Comments

By Tracy Andriano, BSN, RN, COHN-S

Most nurses have stories of inspiration, leadership and praise from patients and families. I have many stories, but one special experience continues to affect me today.

Early in my nursing career, I had difficulty accepting my new role and how it differed from what I learned in school. Being a nurse didn’t feel the way I thought it would; I did not feel empowered or fulfilled. I started my career on the night shift and soon came to realize that most of the time I was working in autopilot mode. The night shift’s high volume of work came in the form of nonstop admissions and discharges. I liked meeting and educating new patients about their surroundings, but was that it? There had to be more that I could do for them.

Tracy Andriano, RN

Tracy Andriano, RN

I decided to explore other nursing specialties that could give me some direction in my career and eventually began picking up travel nursing assignments. Every new assignment came with the task of proving myself to other nurses and earning their respect, but one day the job demanded much more.

During one travel assignment, one of my patients was a young woman with multiple health issues and a DNR. Angie* was in her 20s, single, did not have regular visitors, and was on dialysis and in renal failure. We were so close in age. We got along well and talked quite a bit that day. As usual, the transporter arrived to bring her to dialysis, which would give me a little time to catch up on paperwork. Angie returned a while later, and as I got her situated in her room and assessed her vitals, she began to cry hysterically and talked about how she wanted to die.

I did not understand what caused the sudden change in her mood, but I had a plan in mind as to how to help. If the routine of the treatments caused her to become upset, I would request a visit from a social worker. If it was an issue with a family member or another patient, I would let her know that she could discuss it with me. She seemed to struggle for a bit with why I would care to help her, before she finally told me what happened.

While receiving dialysis that day, Angie had bowel incontinence. As two nurses cleaned her, Angie shared, they treated her as though she wasn’t cognizant of their conversation. They made comments to one another such as, “Look at her. She’s useless. She can’t do anything for herself.” She was taunted for being young and helpless, and made to feel like she was a burden. These nurses continued to talk over her while cleaning her.

I couldn’t believe what I was hearing. This is my patient; it’s my responsibility to care for her physically and emotionally, and it’s often forgotten how connected the two are. I left the room, attempted to control my anger toward these insensitive, unprofessional nurses and told my manager, who called the assistant director of nursing. The ADN spoke to Angie and then to the nurses in question. After the investigation was completed, the ADN told us the nurses were disciplined and sent home. Later I went back to Angie’s room, and we talked and played cards until it was time for me to give report.

The next day I came to work and immediately felt a different vibe in the air. The other nurses were smiling at me, which made  me wonder what was going on. I walked to the nurses station to get report and there it was on the report sheet for Angie, my young patient — an updated status: DNR rescinded. A nurse on the unit patted me on my back. “Good job,” she said.

I can’t describe the personal satisfaction I felt knowing how I treated her and advocated for her was a factor in her decision to rescind her DNR. From that day forward, I never questioned my career choice. And I no longer call it a career — it is my calling. •

Tracy Andriano, BSN, RN, COHN-S, is a worker’s compensation nurse case manager for the Workforce Safety Department at Northwell Health in Lake Success, N.Y.

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About the Author:

Sallie Jimenez
Sallie Jimenez is content manager for healthcare for Nurse.com from Relias. She develops and edits content for the Nurse.com blog, which covers industry news and trends in the nursing profession and healthcare. She also develops content for the Nurse.com Digital Editions. She has more than 25 years of healthcare journalism, content marketing and editing experience.


  1. Avatar
    stacy March 7, 2016 at 8:59 am - Reply

    that was a very touching story…thank you for sharing

    • Avatar
      Lauren Porter May 29, 2016 at 6:09 pm - Reply

      Yes, nursing is a calling, it always has been for me. Unfortunately, not all nurses consider it as such.
      Early in my career, a wise nurse once said, “people don’t care how much you know until they know
      how much you care”. I have always remembered that. Technological advances have changed nursing
      a lot in the past 20 – 30 years. There may be situations when a patient codes and you feel great about helping to save their life. The patient’s memory of that day is only that they got chicken for dinner when they ordered the beef, and nobody emptied their urinal all day. Sometimes it’s the little things that mean
      so very much to them.

    • Avatar
      Tracy Andriano July 6, 2016 at 2:19 pm - Reply

      You are very welcome.

  2. Avatar
    Chloe May 19, 2016 at 12:19 am - Reply

    As I was reading this article, I felt like I was about to start crying. It’s amazing how your willingness to listen to her and treat her as a person renewed her spirit. It’s like you let her see that people do care about her and that she does have a place here on Earth and isn’t just “useless”. I put myself in your patient’s shoes and I can’t imagine how her life must feel everyday. The rescinded DNR is symbolic, like she was going from dark to light.That really touched me. Thank you for giving this patient life, again.

    • Avatar
      Tracy Andriano July 6, 2016 at 2:18 pm - Reply

      Thank you so much for your comments and thoughts. If you do cry hopefully they are happy tears.
      God bless!

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