Dear nurse, I really don't want to bother you

[JeanettePNP]

I saw this on an ER thread and I feel it needs to be discussed. Before anyone flames me, this post is not intended to attack nurses, especially ER nurses. I feel that I do need some clarification about what nurses consider to be a "bother."

Originally Posted by RunnerRN

14) Just because you or your family member says "I know you're busy" or "I'm sorry to bother you" before making another dumb request (another blanket, when will my room be ready, etc) does not make me less busy or you less of a bother.

OK, not to be another scolding student, but this one did bother me. It is natural to want to make your family member comfortable during their stay in the ER, even if their need perhaps isn't as urgent as the dying patient down the hall. The family member is at least showing some politeness and sensitivity for the nurse. They are not trying to be a bother. It's just that their family member is sick (even if there are other people there who are sicker) and they are trying to get their needs met.

Trust me, if I knew where the blanket/clean sheet/washcloth/emesis basin was, and I was allowed access to the supply closet, I'd get it myself and not bother you. But I'm a "guest" in the ER, so I have no choice but to bother the nurse or leave my family member cold/wet/dirty/thirsty etc. So to all you hardworking ER nurses, I'm sorry to bother you, I know you're busy, but I will advocate for my family member when I accompany them to the ER.

Point is, from a patient's perspective it's hard to know what will be considered unreasonable. I don't think it's unreasonable to want to be comfortable if you're really not feeling well. I'm not talking about patients who have no reason to be in the ER. I'm talking about patients who truly are sick, but are stable and not about to die. Should their need for comfort be ignored because there are patients who are so much sicker? As a family member, I hate to bother the nurse because I know how much she has to do--but as I said, I'm a guest in their facility and I really don't know where things are. If I could take care of it myself, I would.

It's not just in the ER that this is an issue. I'm one of the least demanding people you'll ever meet, yet I have been in hospital situations where I was made to feel like a "bother." That's one reason I chose to have my babies at home. The OB nurses during my first birth were great, but the postpartum nurses acted like I was a big pain. When I have my babies at home I'm on my own turf and can look after my own comfort, and the midwife is there to assist me. I am not a bother to anyone.

I don't really know what the resolution to the problem is. I know nurses are overworked as it is and can't be all things to all people at all times. I also know that there are whiners and unreasonable people out there who demand all sorts of things that are not their right at all. But should a patient with a legitimate (although not desperate) need be ignored simply because other people have bigger needs? Maybe hospitals can have the most necessary supplies readily available so family members can provide the comfort care when nurses are too busy to do so? I really don't want to bother the nurse, but it's frustrating to be so dependent on people who have much more important things to do than tend to you.

[TXstudentRN]

Another idea is to ask any volunteer that you see. There is nothing wrong with them getting pillows and sheets, dont need nursing input for that.

This is what I was going to say-- volunteers are great for this stuff! And yes, you can volunteer in the ER- we always have them. It won't be anything medical (obviously) but they are VERY useful. Unfortunately I've seen it from the patient side, but at my ER there is always a volunteer down there literally coming TO me to ask if I want a warm blanket, not the other way around. I think volunteers are the perfect answer to this predicament, and every ER should have (at least) one to take care of these requests that, while are important to the patient, certainly don't rank high on the acuity scale. Best wishes and thanks to all the ER nurses for everything you do!

[Spidey's mom, ADN, BSN, RN]

I think this is the crux of the whole thread.

cheers,

Roy - there really isn't a role for family members to go get a blanket or water or food or a box of tissues. For one thing, as others have mentioned, the family may not have (usually does not have) any idea regarding the care of the patient and so if grandma is shivering on the gurney they think she needs a blanket but I know she has a temp of 104.5 and has pneumonia and a blanket is not a good idea. Plus, the family member would have to walk across the ER to the blanket warmer (first they would have to know where it is) and they might just get in the way of a code or a trauma. I don't think it is a good idea to have people roaming around the ER.

The family member's role is to sit by the patient and comfort them and hold their hand. You can certainly advocate for them with the physician and nurses - but you have to understand, as others have mentioned, this is an emergency room and there is a triaged order to things.

Having said that, I have been on the other side when my #2 son was laying on a gurney in pain with a bad ear infection (that I'd ignored for days) and the eardrum burst and he had 10/10 pain and was actually crying (at 17 he never ever cried). The nurses and doc were standing at the nurse's station talking and it bugged me to no end . . . just get some pain meds for my son. I understand the reaction when you are on the other side . . really.

steph

p.s. We don't have volunteers in the ER. And our "techs" are EMT II's or Paramedics and are usually doing the EKG's and starting IV's - when we are busy we are all busy.

[mauxtav8r]

All I'm going to say about this is, when you become a nurse you will understand what the OP was trying to convey by that statement.

As a nursing student, I'd like to know what I need to know to be a nurse BEFORE I'm a nurse. Learning about both sides of the issue is why I'm in school and why I work at a hospital now (while I'm in school).

I read the ER thread and it's hilarious, educational, thoughtful, but this comment was condescending and offensive. :trout:

[piperknitsRN]

I am always pleased when a family member takes a genuine interest in helping their loved one in a hospital setting, and under normal circumstances, I most likely have the time to direct them to the supplies or people who can help them, and do so willingly.

Unfortunately, staff does not always have the luxury of choosing our priorities in patient care, and I am not sure how the system could address the OPs concern regarding how nurses can better facilitate family members who wish to help their family members in the situations she describes. Like it or not, we carry a larger burden of responsibility in patient care because we are highly visible to patients and family members, and so these situations arise, and are difficult for everybody.

While I think hospital's latest drive for "customer service" is bloated and wrong headed on several accounts, I don't think the OPs issue needs to be framed as such. Hospitals have a way of using buzz words that quickly become as elastic and devoid of real meaning as passing a law requiring the phrase "Have a nice day!" must be used after every business transaction.

Forget "customer service" as espoused by hospital administration; we simply need to find ways to make the hospitalization process more "user-friendly," not "customer service" driven. I do think volunteers who could do simple things like bring blankets, guide lost people to the right floors, and such, would be wonderful. Many schools now require their students to do community service, and it would be a great way for hospitals and schools to forge important ties as well as decrease some of the burden on paid staff.

I don't have an answer for the OP, ultimately, but I do sympathize with her concerns, and wish we had better solutions to offer.

[TazziRN, RN]

no, they shouldn't be ignored, or feel that they shouldn't ask. however, they need to understand that i might not be able to get that blanket (or whatever) right then and there. even if we don't look busy. 'cause i don't look very busy when i'm on hold with the lab trying to get the result of that critical lab value, but i can't stop what i am doing.

and that, my friend, is the problem. when you or your loved one is sick, the whole world begins to revolve around you and your loved one. it is difficult to think of that other patient. all you can think of is that your mom is cold, hungry, and in pain. and this is a reasonable perspective, it really is. but, that is not the average nurse's perspective. nurses in general (especially er nurses) are constantly trying to prioritize. and unfortunatly, unless the patient is hypoglycemic and hypothermic, food and warm blanket isn't my top priority.

so, it is ok to ask for the meal tray/blanket/glass of water, as long as you promise to forgive us (and not write nasty comments on the press-gainey survey) if you have to ask again.

as to having a supply of comfort-type stuff for family to have access to, there is a reason why we keep tight control of that stuff:

1. food. not everyone can have it. we only want to feed the patients. family only gets food in very special circumstances. some patients can't have it, either.

2. warm blankets. one tends to shiver/feel cold when one has a fever. depending on how high that fever is, you may not get even a sheet from me, much less a warm blanket. in fact, if the fever is high enough, be glad i'm not taking more drastic (and very uncomfortable) measures to cool you down!

3. everything else. you would be surprised at how many people consider the er to be their own personal drug store/linen store/wound care supply store..... you would be amazed at the stuff that comes up missing. in fact, there is a fairly old thread on the very subject. i, personally, have seen gowns, pillows (at $90 a pop), blankets, sheets, ky jelly, the stirrups from the ob stretcher , dopplers, and countless bandage supplies disappear, to name just a few. people seem to have the notion that hospitals are rich, and they will take what they can walk out with. no, thank you, we will keep the stuff hidden!

:yeahthat: :yeahthat: :yeahthat: we have a new blanket warmer in our trauma room. the door is glass so pts know what's in there. i have walked into a pt's cubicle to find several blankets piled on the pt, courtesy of the family member who decided to help herself because she'd had to ask several times for a blanket but no one had listened to her. unfortunately, even though the tech did pass on the request to me, i was too busy to go in there and explain why her mother couldn't have anything more than the sheet i had covered her with.

chaya, i know you mean well, but this goes back to that old argument: don't assume that you know why we do what we do until you have worked there. could that poster have worded it differently so that you weren't offended? maybe. however, all the er nurses knew what was being said because we work there.

[TazziRN, RN]

As a nursing student, I'd like to know what I need to know to be a nurse BEFORE I'm a nurse. Learning about both sides of the issue is why I'm in school and why I work at a hospital now (while I'm in school).

I read the ER thread and it's hilarious, educational, thoughtful, but this comment was condescending and offensive. :trout:

No, it wasn't. There are things that just can't be taught, they have to be experienced. And having a relative prefacing a statement with "I don't want to bother you but..." when you're running to get the RSI kit is one of them.

[Roy Fokker, BSN, RN]

Roy - there really isn't a role for family members to go get a blanket or water or food or a box of tissues. For one thing, as others have mentioned, the family may not have (usually does not have) any idea regarding the care of the patient and so if grandma is shivering on the gurney they think she needs a blanket but I know she has a temp of 104.5 and has pneumonia and a blanket is not a good idea. Plus, the family member would have to walk across the ER to the blanket warmer (first they would have to know where it is) and they might just get in the way of a code or a trauma. I don't think it is a good idea to have people roaming around the ER.

Hi Steph,

Yes, I know that. I know family has no business wandering the ER and doing stuff. I've "done my time" in the ER too :) (admitedly, not for long. Hence why I refrain from comment in most ER threads).

THAT being said, I really think she wanted to know what "else" could be done given that nurses are super busy in the ER and that family might be around to help.

Therefore your post - especially:

The family member's role is to sit by the patient and comfort them and hold their hand. You can certainly advocate for them with the physician and nurses - but you have to understand, as others have mentioned, this is an emergency room and there is a triaged order to things.

was useful because I think it really answered her question (or atleast the part I highlighted with my initial post in this thread). See because I think OP (Chaya) knows/recognizes that ER nurses are super busy and was just wondering if there was anything she/anyone-else could do to help in the meantime....

Could she have worded her OP (start of this thread) differently - yes. But I don't think her initial post/question was more of a "complaint" about how ER staff handle affairs as opposed to a "question" about if other/alternate methods are practical/applicable.

cheers,

[Spidey's mom, ADN, BSN, RN]

Hi Steph,

Yes, I know that. I know family has no business wandering the ER and doing stuff. I've "done my time" in the ER too :) (admitedly, not for long. Hence why I refrain from comment in most ER threads).

THAT being said, I really think she wanted to know what "else" could be done given that nurses are super busy in the ER and that family might be around to help.

Therefore your post - especially:

was useful because I think it really answered her question (or atleast the part I highlighted with my initial post in this thread). See because I think OP (Chaya) knows/recognizes that ER nurses are super busy and was just wondering if there was anything she/anyone-else could do to help in the meantime....

Could she have worded her OP (start of this thread) differently - yes. But I don't think her initial post/question was more of a "complaint" about how ER staff handle affairs as opposed to a "question" about if other/alternate methods are practical/applicable.

cheers,

Because of the nature of a busy ER, I just don't know if there is a consistent role for the family to help out a busy nurse.

On the acute floor, I have had family members ask to bath their family member or brush their teeth or help them to the bathroom. And this is do-able . . .but in the ER? I just don't see how.

steph

[JeanettePNP, MSN, RN, NP]

Problem is that in some places, you might be spending up to 36 hours in an ER waiting to be admitted.

[Roy Fokker, BSN, RN]

Because of the nature of a busy ER, I just don't know if there is a consistent role for the family to help out a busy nurse.

Hi Steph,

I understand and agree with this as well.

cheers,

[Spidey's mom, ADN, BSN, RN]

Hi back at ya Roy!

We have a three bed ER - with one gyne room. The triage room is about 5 steps from the ER door. We have curtains around each of the 3 beds - not much privacy.

We have begun to limit family to ONE member at bedside - it is just too small for more.

steph

[Roy Fokker, BSN, RN]

I think you are right when you talk about a "consistent" role for family members.

The ER I was at - it was NOT ok for family to be very participative in patient care.

The hospital I work at NOW - very involved. Heck, you can be in the room when a code is going on etc.

As such - given the wide ranges and disparities, it is difficult to come up with a consistent, single minded policy as regards patient family intervention.

cheers,