Venting on another thread got me thinking about this. In our ED, all the rooms including the trauma bays are private, with both curtains and doors that close. Because of this, it's very easy for the patients, in their private rooms with curtains drawn and doors closed, to be completely unaware of the chaos that is unfolding around them.
Most people are pretty nice, and are very understanding, when asking what's taking the doctor/scan results/blood work so long, when you explain politely that there are a lot of sick people here today, and your doctor is taking care of the sickest first, the sickest people go to the scanner first, the lab is backed up because we've had a lot of really sick people, etc.
But some people just don't get that. How honest are you when communicating with such an individual?
Normally, I just give my standard response about the sickest taking priority, and they either get it or they don't. Only once have I been more blunt than that.
It was a well dressed middle aged woman in for a medication request; very low acuity. She didn't want to wait until her PCP could see her and adjust her meds, so she had come to the ED. She kept complaining and complaining about how long it was taking for the doctor to come back, how rude the doctor had been by taking a phone call and then leaving the room (the phone call was the charge nurse letting the doctor know that her pediatric patient had gone into respiratory failure).
After my standard response failed repeatedly to appease her, I finally told her that the doctor was with a very sick child. She said "Oh, my grandson was really sick once. He had a really bad cold. We took him to the doctor and got him some cold medicine.", then went right back to complaining.
I just walked out of the room and implemented the BNPOC- Benign Neglect Plan of Care.
Now, I realize it's not all about me, it is about the patient. I totally get that. And each patient is in a different place. Some are actively trying to die, some are nowhere near dying, and some are somewhere in between, and they all have individual emotional responses to where they are.
I question how much value it really has to be completely open with the less/not sick about why things are taking longer than they would like.
Have any of you Emergency Nurses been completely candid with a not-sick patient about this? Have you ever told them that the reason they are waiting is that everyone is in with a teenager who is bleeding out internally from a car accident, or a father/husband/grandfather who slumped over at the dinner table from a massive MI, or that their doctor is intubating a child?
Do you think there is any therapeutic value in communication this direct? Do you think there are some people that need to hear this, so they can put their own situation into perspective, or do you think it is more of a self serving move on the part of the nurse?
I have been very lucky (but then again, I have not had too many years experience yet) because most of my patients are very understanding and willing to deal w/a little wait time since when their turn comes I will strive to give them as much attention as I give the other patients.
One time I had a patient start crashing and we took an hour to stabilize him...we finally managed it. I turn to see a family member of a patient across the way at the door hesitating. I moved toward her and asked what was wrong. She stated, "something is not right with mom...she just lays there and has stopped talking." This was an acute CVA we had admitted earlier.
Well, my patient was now stable and good to go, so I let the charge nurse know I was going to check on my other lady. I walk into the room, lady turns to look at me...and proceeds to seize. Later on it was determined she had also had another stroke! Daughter was right to come get me, but when I first saw her at the door, for a split second I was annoyed...lol. I am so glad it only lasted for that split second. Thankfully, Rapid response was still across the way.
Oh, and I forgot to mention: the daughter was very grateful and kept apologizing for coming to get me.
Last edit by maelstrom143 on Nov 6, '11