The nurse did not address the concerns of the patient, she did not seem to be interested in actually communicating with him but rather she seemed like she was just trying to get him to stop asking questions. Based on the transcription of the conversation, it does not sound like the nurse even stopped what she was doing when the patient was talking. She should have stopped assessing his wound so that she would be able to communicate with him. By not focusing her undivided attention on the patient’s concerns, the nurse did not convey any interest in the situation.

I do not think that the patient took the information that the RN was conveying in, nor do I think that he actually assimilated it to his current understanding. The nurse did not try to help the patient understand why the use of the computer had been so important, so this man could not assimilate this knowledge into his understanding of what a post-surgical hospital stay might be like. I also don’t think that he really registered any of the instructions that the RN was giving, because the patient and the nurse were not conversing about the same topic – the patient was focused on reporting the nurses and the nurse was focused on relaying the discharge information. 

The nurse should have stopped he evaluation of the patient and taken time to address the patient’s concerns with the care he had received. She should have asked him what instances had occurred and how the nurses could have changed or better explained what they were doing so that the patient would not feel neglected the next time. Also, the nurse should have explained to the patient, in a way that made it easy for him to understand, what the nurse was doing on the computer and why it was crucial for them to document so much on the surgical floor. 

Also, when she did answer his questions she was unprofessional and abrasive.

The RN should have been an advocate for her patient, and she should have helped him to understand what was going on when previous nurses were working on the computer. Her role in helping her patient was to help him also understand what he needed to do to prevent himself from further injury or pain after leaving the hospital, as she was the nurse in charge of his discharge. Another role that should have fallen under her is that she should have been able to point the patient in the correct direction of the individual in charge of the nurses and should know how to file a complaint. 4

By stopping and actively listening to the patient and making sure she answered his questions, the nurse would have saved so much time instead of trying to talk over him and just get the job done.

I think that it is appropriate to describe this relationship as insecure. It is evident that the RN was not too worried about acknowledging any of Mr. A's concerns, and that is very out of line and unprofessional. There is not one thing the nurse said or did in the interaction to make me think that she was sincere and or compassionate. 

RN: Hi, Mr. Alonzo, how are you feeling since your surgery today?

Mr. A.: I feel fine. I am more than ready to get out of this place. What do I have to do to make that happen?

RN: We want to make sure than your body is recovering well from the surgery first. I am going to check your vital signs and take a look at your wound to make sure there are no complications. Then I will look at lab results in the computer. If there is nothing of concern, you should be ready for discharge soon.

Mr. A.: Don’t remind me of that computer. I have never been so disappointed in a place in all my life. The nurses paid more attention to the computer than to me.

RN: I apologize for your frustrations. I can assure you that the nurses are trying to do everything they can to help you feel better. May I ask what happened that made you feel as though you were not being paid attention to?

Mr: Anytime I would ask the nurse a question their answer would be delayed because they were too busy typing. And when I would tell them how I was feeling they would still be staring at the computer and just nodding their head, I could tell they weren't listening. 

Mr. A.: Who’s in charge of the nurses around here?

RN: We have a director of nursing and a nursing supervisor. Is there someone you would like me to contact for you?

Mr. A.: No, but who would I talk to in order to register a complaint about the nurses?

RN: I am not certain on that question. I believe the director of nursing or hospital relations would be good resources. Their offices are located on the first floor. If you would like I can get that information for you.

Mr. A.: That would be great. I would like to have a word with someone about the nurses here.

RN: I will ask resources where you can talk to someone and get that information for you.

Mr. A.: That would be great. Finally someone paying attention to me and not a computer screen. 

RN:  Before I go, I have a few instructions from the doctor regarding your surgery. It will take about 6 weeks for your abdominal wall to fully heal. In that time you should refrain from lifting over 5 pounds or participating in any straining activity. The doctor would like to see you back in 2 weeks to check on your progress, and we can set up an appointment here before you leave. While you are healing you should try to get as much rest as you can. It is best if you limit your driving, and do not operate a vehicle if you take the narcotics. I understand your schedule may be busy, but the doctor recommends that you do not go back to work until after your check-up in 2 weeks. If you don’t have any further questions, I will work on your discharge papers and get you the information on who to contact regarding your experiences here. Once again, I apologize for any miscommunication and frustrations.