Secrets of the Trade: Nurses Tell All

They work in Chicago’s emergency rooms, intensive care units, psychiatric wards and beyond. Nurses meet the needs of their patients with compassion and unmatched intuition.

Seven Chicago-area nurses, all members of the Illinois Nurses Association, shared their secrets with NBC 5 about what they see on the job every day and what could drive them to the picket lines.

#1 Their jobs go beyond just providing medical care

While their primary focus is to meet the medical needs of patients in their care, a good nurse wears many hats to cater to sick individuals and their families.

“You need compassion,” said Doris Carroll, a 35-year veteran nurse and Vice President of the Illinois Nurses Association. “You need to have what we call critical thinking skills, so you need that education and be a good listener.”

Nurses said many patients simply need someone to talk to.

“The ER has become a large depository for people with psychiatric issues because of the closing of mental health facilities throughout the city,” said Paul, an ER nurse at a Chicago hospital. “A lot of them want help and they don’t know how to find that help.”

And while doctors make their rounds, it’s the nurses who sit with patients, administer any medications and treatments and explain to patients and their families what’s happening.

#2 The ER: The one department that never stops

Chicago’s emergency rooms are unpredictable.

“We are seeing the most unstable patients. We don’t know what’s coming in on a day-to-day basis,” said Bre, an ER nurse at a Chicago hospital.

That thrill is what draws many ER nurses to the field, but it’s not without challenges.

“You can have a sweet old grandma who’s there because her sugar is high or you can have a drunk who wants to murder you,” said Paul.

Warm summer nights in Chicago are especially difficult with the countless gunshot victims who are rushed to the hospital, nurses said, but festivals like Lollapalooza can be just as busy.

“We’re going to have all these teenagers…they’re all passed out. They’ve taken so many different drugs and alcohol, and we have no idea what they’ve taken,” said Bre. “We have to open up different parts of the hospital just to treat the amount of people from Lollapalooza. Plus we’re taking care of all the strokes, the cardiac arrests, the rape victims that were going to come anyway.”

“We are going room to room, and truth is, a lot of times, we don’t eat!”

#3 Nursing is a violent job

A recent survey by the University of Illinois found 40 percent of nurses experienced violence or abuse at least once over the past year. Seventy-eight percent of the nurses surveyed anticipated violence or abusive events.

The nurses who spoke with NBC 5 were unanimous that workplace violence was part of the job.

“I myself have been punched and kicked, slapped, spit on,” said Paul. “I’ve been threatened with a knife before. I’ve had people say they’re going to wait for me at my car so they could shoot me.”

“It’s been so bad, I’ve had to press charges,” said Bre.

It’s not just in the ER.

“The patient literally pulled the TV out of the wall and threw it in the hallway. The nurses were running for their lives hiding in the nursing station. And the security took 5 minutes to respond,” said Terence Yee, a nurse for 27 years and President of the Illinois Nurses Association.

Some hospitals have recently become crime scenes.

Last November, a gunman killed Dr. Tamara O’Neal, Chicago Police Officer Samuel Jimenez and Pharmacist Dayna Less at Chicago’s Mercy Hospital.

In May 2017, an unshackled inmate took two nurses hostage at Delnor Hospital in Geneva. One nurse was tortured and raped.

“This happened to nurses at their workplace. It shouldn't be this way,” Doris said.

The Delnor incident led to swift changes in Illinois law. All facilities that employ nurses must now have Workplace Violence Prevention Programs to review security issues. The law also provides whistle-blower protections for nurses who file criminal complaints against individuals who attack them. And finally, new safety protocols for the Department of Corrections and the Department of Juvenile Justice were put in place for inmates who need medical care at outside facilities.

#4 Many nurses say they are ‘dangerously overworked’

Threats to physical safety don’t just come from patients but also in their working conditions, the nurses said. Many feel staffing levels are unsafe.

“By half way through the shift, you're going to burn out and then who's going to take care of the patients?” said Terence.

While staffing levels vary by unit and hospital, the ER nurses we spoke to said it was not uncommon to have upwards of five patients at a time.

“If you’re an ICU nurse and you’re taking care of three or four patients, you're not taking care of them. You're just putting out fires, and people are dying,” Doris said. “Not only is it dangerous for patients, it's dangerous for us.”

The Illinois Nurses Association is pushing the Safe Patient Limits bill that would mandate nurse staffing ratios and penalize hospitals that don’t comply. HB 2604 would cap the number of patients per nurse, between one and four, depending on the unit. For example, an ER nurse would care for no more than three patients at a time; an ICU nurse would be assigned no more than two patients.

California is the only state with a nurse staffing ratio law.

The Illinois Health and Hospital Association opposes the legislation, saying a one-size-fits-all approach will not improve quality or outcomes. Instead, the group argues mandatory staffing levels will lead to reduced services, longer wait times and increased bills to the patient. They estimate the mandate could drive up health care costs in Illinois by $2 billion a year.

If the legislation becomes law, hospitals that don’t comply with the mandatory staffing ratios would face fines of $25,000 a day.

“Given the shortage of nurses in Illinois and the significant cost of this mandate, this bill will result in a reduction of healthcare services and therefore jobs. Something will have to give,” A.J. Wilhelmi, President and CEO of the Illinois Health and Hospital Association, said before a House committee in March.

The IHA is instead proposing the state improve the Nurse Staffing by Patient Acuity Law that is already on the books. Enacted in 2008, the law requires each Illinois hospital to have a nursing committee that sets staffing based on patient needs and nursing experience.

Among IHA’s proposals include requiring the committee to meet twice a year instead of once; mandating a way for nurses to report violations from the staffing plan; and prohibiting retaliation for employees who express concerns related to nurse staffing.

The nurses we spoke to say the acuity law does not go far enough to protect them and their patients. They said a staffing ratio law would decrease nurse burnout and turnover. The nurses said they would be willing to strike if something doesn’t change soon.

“We are ready to do that,” Doris said.

#5 “Can’t imagine doing anything else”

Despite the hard work and frustrating aspects of the job, the nurses who spoke with NBC 5 said they wouldn’t choose another profession.

In fact, many told us they became nurses because of personal experiences – both good and bad.

Flowers said one of her first experiences with nurses was when she was in labor as a teen mom.

“The nurse was so mean to me. She treated me like crap,” said Bre. “For my next child, I was much older, and the nurses were amazing! I decided I was going to become a nurse so that I can be a good nurse to everyone.”

Nurses said some of their most rewarding stories are seeing a patient come full circle.

“You see these patients rolling in, having a bad stroke, almost dead,” said Terence. “And a couple of weeks later, they’re walking out and to be part of that one is just amazing.”

#6 Sorry, family and friends. That rash? You’ll live!

Being a nurse means fielding medical questions from family and friends.

“It can be a blessing and a curse,” said Pat, a 30-year veteran nurse. “At church, I’m the church nurse. Things happen, and it’s like Pat! And here I go!”

But given all the serious illnesses they’re exposed to, the nurses said they often dismiss everyday ailments of their loved ones.

“My husband and my kids, I put them on the back burner” Bre said, with a laugh. “My husband was complaining of back pain. He was telling me for months, and I kept saying you’re fine. As a nurse, you think everyone will be fine. Well about three months later, he goes to the hospital and he’s rushed to surgery.”

Her husband did get better after treatment.

“We see people dying, so your headache? You’re going to be fine. Your back pain is going to be fine.”

#7 You can’t separate emotion from the job

There is an emotional toll that comes from seeing people at their lowest and sickest moments.

“We’re human beings. We generally see things that the average human person should never see,” said Paul.

They’ve had moments where they go home after a shift – or outside of a patient’s room – to cry.

“Our professionalism has to trump our emotion though because we have to move on to the next patient,” said Bre.

#8 Amidst the death and sadness they experience, it doesn’t require much to make it a good day

“One genuine thank you makes or breaks my day,” said Paul.

“It means everything when you see a smile. It just brightens your day,” said Pat.

And of course, when you can nurse a patient back to health, there’s nothing better.

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