Advice - I'll need a meal tray too

  1. 14 I'm a newer nurse in ED. I love my job so much. So far I have a high tolerance for BS... however, there's something that really bothers me and I need advice on what to say to the patient without sounding like a jerk... This situation happens at least once a shift, sometimes more... and typically it's with our frequent flyer friends.

    Most recent occurrence that almost made me be a big B-word:
    Pt comes into the ED c/o chest pain

    Me: "What brings you to the ER today?"

    Pt: *walking, speaking full complete sentences, NAD, EKG normal in triage, etc* "I have 10/10 chest pain and it's been going on since like this morning. I'll need 2 warm blankets, the TV channel list because the channels are all messed up here, a cup of water and a separate cup of ice... and might as well get me a meal tray going for me and my boyfriend too because I know these chest pain work-ups take a long time...and it's 5:30 and we've been in the waiting room for about 45 minutes so we missed dinner."

    The warm blankets - no problem... The TV channel list - sure!... The meal tray - NOT IN YOUR LIFE WILL I GET YOU A MEAL TRAY! THIS ISN'T A DAMN RESTAURANT!! AND DON'T EVEN THINK I WILL GET YOUR BOYFRIEND A MEAL TRAY! HE CAN GO GET FOOD FOR HIS GROWN-MAN SELF! THERE'S A CAFE UPSTAIRS! AND DON'T TELL ME HOW YOU TAKE YOUR WATER; 2 SEPARATE CUPS FOR ICE AND WATER! PLEASE!

    I must suffer from some suppressed anger from early childhood about meal trays or something, but when a patients tells me to get them food, I just get so mad. Luckily I still have self-control, so I give the pt the policy about how they can't have anything to eat or drink until everything is resulted, MD approves, etc... But sometimes the patient's can't take that for an answer and they think I'm being a jerk for not ordering them "room service" even though "They always get a meal tray for me and my boyfriend when we come in this place."

    My question is: How do I nicely tell a patient that this isn't a hotel or restaurant when telling me I need to order them food? And how can I stop getting so MAD when people ask me for a meal tray?!! It's so weird how this irks me so bad!
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  3. Visit  LalaJJB profile page

    About LalaJJB

    LalaJJB has '1' year(s) of experience and specializes in 'Emergency'. From 'Flagstaff, Az'; Joined Feb '09; Posts: 95; Likes: 91.

    67 Comments so far...

  4. Visit  BostonTerrierLoverRN profile page
    21
    Wow, Yeah.

    I NEVER FEED AN ED PATIENT UNLESS IT IS AN EXCESSIVE HOLD, DM RELATED, OR I AM IN A FREAKING AWESOME MOOD!!!

    You will soon grow antennas out of your head that are invinsible and pick up on what ED is all about, and what it is not.

    WHAT IT IS.

    a great place to come if you are dying.... OR, . . . If you are near dying. If you are greater than 8/10 pain scale. If you are bleeding uncontrollably. If your chest hurts. If you have a limb missing or traumatic brain injury. If something inside of you that should remain inside of you is now out (NOT INCLUDING TEETH, SNOT, OR HAIR). If you have recently turned a land vehicle into an airborn vehicle. If you are tired to the point of needing a DIRT NAP, thats the only time you should be resting in this ED!!!!!

    WHAT IT IS NOT.
    It is not a Motel or Hotel. It is not a bed and breakfast with dope. It is not a Full Service Restaurant complete with treatment for the after effects, . .heartburn, nausea/vomiting/diarrhea,. . .It is not a clinic for three day old colds, It is not a place to come with the FLU!!! (Actually a joke, I know many Americans actually die with Influenza, But common' if you are 21, and otherwise healthy, chances are in YOUR favor!!!!! It is not a first aid station. It is not a place to ask for clean needles for your dope habit!! It is not a Wendy's or INSERT YOUR FAVORITE FAST FOOD STAND!!!! It is not Family Crisis Therapeutic Facility. It is not a nut house calling for open season. It is not a coffee house, DO NOT ASK ME FOR COFFEE DAMN IT!!!!!!!!! It is not a balloon stand, so quit blowing up and tying our latex gloves. It is not a doctor shopping stop. We are not a refill mill. We are not a crisis pregnancy center, or a place to find out if you are pregnant. We are Not an occupational health clinic!!!!

    And for the poor that don't have the money, there is MEDICAID MEDICARE FREE CLINICS AND STATE UNIVERSITY MED CTRs

    For the illegal immigrants nearly the same.

    For the "We don't have any other access to Medicine,. . ." Patient education is needed, but not by an ED Nurse, they are standing by to save a life, if they arent busy trying to do that now.

    For the but it just got worse tonight, or I finally got tired of it, 4 more hours until the clinic opens will not kill you I promise!!

    I ACTUALLY HAVE A REALLY HIGH TOLERANCE FOR ED PATIENT BS, BUT IT DOES AFFECT YOUR ABILITY TO PUT ALL YOUR ATTENTION WHERE IT NEEDS TO BE WHEN YOU ARE STUCK CARING FOR GROUP 2.
    Zookeeper3, funnyliz, Purple_Scrubs, and 18 others like this.
  5. Visit  Altra profile page
    3
    Incremental behavior modification, done with a smile. It takes some time, but it works.
    Pixie.RN, imintrouble, and Esme12 like this.
  6. Visit  caroladybelle profile page
    24
    "Well, so sorry, but I'm not everyone, and you are NPO, until we rule out a heart attack....... Whereupon, you will be going home where you can cook your boyfriend a delightful meal. "Said with a smile on my face.
  7. Visit  the_london_sky profile page
    7
    "Well, the test that we need to run for your safety require that you not eat or drink. Also, I am sorry but we dont give out meal trays to anyone but the patient because of food allergies."

    I work tele and it really puzzles me why some patients ask if their family can bring in 3 shot espresso frappe drink for them.....
  8. Visit  Ruby Vee profile page
    6
    i really want to know who these "everyone" folks are who give meal trays to r/o mis and their boyfriends, allow visitors to use cell phones in the icu and just general ignore all of the rules in favor of giving folks what they want. i'd like to do some education with "everyone".
    lindarn, wooh, imintrouble, and 3 others like this.
  9. Visit  Klimpys profile page
    12
    I am just a student so I don't have an opinion on your patient except for that does sound over-the-top! However, I do have a comment as mom who had to admit her child to the ER one morning very early. I had not eaten anything and my dh had been up since 5am scraping snow off a parking lot. Ds was in the bed having blood drawn, IV's put in, catheter, etc...as he was in diabetic ketoacidosis. My husband started to pass out (he can't handle the sight of blood being drawn). It was brought up that he was probably hungry because he hadn't eaten. They quickly offered and brought us some food. That was very appreciated. When we were transferred to a childrens hospital in "the big city" I thought it was really nice that they gave me meal vouchers every day to cover my food. I could zip down to their amazing food court style cafeteria and get a meal to take back to my son's room. Sorry, I know I veered off course, but sometimes it is the little things that make a difference.
    sharpeimom, funnyliz, annietart, and 9 others like this.
  10. Visit  GitanoRN profile page
    5
    certainly, i learned from the best regarding the issue of standing your ground and say no with a smile. consequently, during my travel nursing days, i worked in several facilities in atlanta ga, and these nurses have it down pack. let me give you an example: if a person is not attractive they would say " oh! she's not that pretty... but so intelligent, blessed her heart" therefore, if you ended everything with blessed your heart it makes it okay:d having said that, every time i get a pt. with the demands that you are confronting i say "oh! until the md approves you're in npo (then you look at them with a smirk-like smile and say) blessed your heart" and move on the the next pt. soon enough they get the picture. unquestionably, they will grunt, but they won't bother you again.
    willowLA, nursel56, lindarn, and 2 others like this.
  11. Visit  KelRN215 profile page
    6
    Quote from LalaJJB
    I'm a newer nurse in ED. I love my job so much. So far I have a high tolerance for BS... however, there's something that really bothers me and I need advice on what to say to the patient without sounding like a jerk... This situation happens at least once a shift, sometimes more... and typically it's with our frequent flyer friends.

    Most recent occurrence that almost made me be a big B-word:
    Pt comes into the ED c/o chest pain

    Me: "What brings you to the ER today?"

    Pt: *walking, speaking full complete sentences, NAD, EKG normal in triage, etc* "I have 10/10 chest pain and it's been going on since like this morning. I'll need 2 warm blankets, the TV channel list because the channels are all messed up here, a cup of water and a separate cup of ice... and might as well get me a meal tray going for me and my boyfriend too because I know these chest pain work-ups take a long time...and it's 5:30 and we've been in the waiting room for about 45 minutes so we missed dinner."

    The warm blankets - no problem... The TV channel list - sure!... The meal tray - NOT IN YOUR LIFE WILL I GET YOU A MEAL TRAY! THIS ISN'T A DAMN RESTAURANT!! AND DON'T EVEN THINK I WILL GET YOUR BOYFRIEND A MEAL TRAY! HE CAN GO GET FOOD FOR HIS GROWN-MAN SELF! THERE'S A CAFE UPSTAIRS! AND DON'T TELL ME HOW YOU TAKE YOUR WATER; 2 SEPARATE CUPS FOR ICE AND WATER! PLEASE!

    I must suffer from some suppressed anger from early childhood about meal trays or something, but when a patients tells me to get them food, I just get so mad. Luckily I still have self-control, so I give the pt the policy about how they can't have anything to eat or drink until everything is resulted, MD approves, etc... But sometimes the patient's can't take that for an answer and they think I'm being a jerk for not ordering them "room service" even though "They always get a meal tray for me and my boyfriend when we come in this place."

    My question is: How do I nicely tell a patient that this isn't a hotel or restaurant when telling me I need to order them food? And how can I stop getting so MAD when people ask me for a meal tray?!! It's so weird how this irks me so bad!

    This really made me think of this:
    Things ER Patients say - YouTube

    Hopefully some comic relief for you.
    ybq2008, rnin0513, RH-CC2011, and 3 others like this.
  12. Visit  Klimpys profile page
    6
    "if you ended everything with blessed your heart it makes it okay
    :d" so true!!!!! i was raised in the midwest but have lived in nc for 20 years. my husband and i have discussed how people think it is ok to gossip about others as long as you throw on "bless your/his/her heart" on the end of the sentence!
    Hygiene Queen, willowLA, canchaser, and 3 others like this.
  13. Visit  Ashley, PICU RN profile page
    8
    I know what you mean. I work in pediatric intensive care and you wouldn't believe the number of parents, family members and friends of the family who think it's out job to supply them with food, drinks, toiletries, the works.

    Our dietary services bring up bagels, pastries and fruit for the families in the mornings and sandwiches at lunch time. We also have some sodas and juice in the fridge and tv dinners in the freezer. You think that would satisfy most people, but nope. I've had so many families say, "Aren't me and her dad going to get a meal tray too?" "When are they going to bring more soda?" (This is after each family member has already taken two.) "Is this all they are bringing for lunch?" "I'm hungry, can you order X and Y from the cafeteria for me?" "Hey, can I get a toothbrush, and toothpaste, and a comb, and soap, and shampoo, and lotion, and chap stick too? And can you bring one for my boyfriend?"

    I even explained to one family (who nearly cleaned us out of soda, juice and pastrys in a a couple of hours) that the food that was brought to the floor was to share with all the patients and family members on the unit and to please be respectful of that. Yep... don't think I'm getting any customer service points for that one. Sometimes we even have to move soda and juice into our staff room fridge just so we will have some for when our patients ask for it.

    When a family member was asking me for chips, snacks, soda, etc I directed her toward the vending machine. She said, "I don't have no money for a vending machine!" Since I don't always carry cash myself, I explained our cafeteria where she could purchase food with a credit/debit card or use the ATM. She insisted she didn't have money for any of those either. So my next response was, "Then I suggest you do what you would do if you were home and not in the hospital. Because we are here to take care of your child, and we don't supply meals for families."

    Don't even get me started on the families who stockpile diapers, wipes, formula and bottles before they leave. There have been several times when I have gone through the closets when the family steps out of the room and removed 5-6 packages of daipers and wipes, and 10-20 bottle of our ready to feed formula that the families were hiding away for when they left.
    canoehead, Cessna172, Altra, and 5 others like this.
  14. Visit  WildOne profile page
    4
    I loved this post it made me laugh and laugh ... I hate when people think their nurse is their personal slave seriously. I think hospitals should attach a laminated brochure about a nurses role to their bedside
  15. Visit  hiddencatRN profile page
    2
    Quote from ruby vee
    i really want to know who these "everyone" folks are who give meal trays to r/o mis and their boyfriends, allow visitors to use cell phones in the icu and just general ignore all of the rules in favor of giving folks what they want. i'd like to do some education with "everyone".
    i think these people don't actually exist. we have parents who like to insist that they always get a cab voucher from us.


    i tell the patient that right now we're going to focus on their medical concern that brought them in, and that while i understand that it's uncomfortable to feel hungry, right now the priority is taking care of the source of their chest pain/abdominal pain/vomiting/breathing problem/etc. and for the family i tell them that there are vending machines in the waiting room. for family members that want the food we have, i tell them that the food and drinks we have on hand are for therapeutic purposes for our patients.

    i had a patient's family ask me for ketchup the other day. i wanted to tell them that the doctor hadn't ordered ketchup for the patient, or that pharmacy hadn't restocked the ketchup in our pyxis but i think the irony would have been lost on them so instead just said "we don't have ketchup" and walked away.
    sharpeimom and imintrouble like this.


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