I have told pts before stuff like, "I'm sorry you had to wait. I didn't forget about you, but I was with someone who wasn't doing very well", and usually they are okay with it, even if they aren't happy about it. I think they get that whole, "yikes, what if I wasn't doing well...would I want her to leave me to go give meds to someone else?" thing in their head. I rarely do that, but I have before when pts start going off about how their meds are 10 minutes late. Gimme a BREAK! If we didn't have the "hour-before-and-hour-after" policy, NOTHING would be "on time"!
As far as Press Ganey goes, just what do they expect us to do, anyway? If nursing is in the 99th percentile, it doesn't seem to me that our floor should be at the 25th just because people don't like some of the docs (we have one group with a pretty poor bedside manner in general, so that's where the 1st percentile came from...our heme/onc guys are great) or they don't like waiting for tests! I mean, what am I supposed to do, take my pt down and run the machines myself?? Give me a BREAK!
I liked hearing about CA having the 5:1 ratio, but if you don't have techs, I am very sorry for you! I'd rather have 6 or 7 pts and a tech than 5 pts and no tech. I mean, sometimes you get 5 pts and they are fantastic, and you have everything under control. But then there's the other times where it's, let's see, what's a good word for it...impossible? Unsafe, even? That's the thing I hate trying to explain. Yes, I like there to be a solid number, so you know you will not have to take more pts than that, but I still maintain that assignments should be made based on acuity!!! I've had 5 pts before with 2 getting chemo (one was on frequent VS), and 2 people getting blood (of course, more frequent VS), and #5 was very confused and kept getting ut of bed...but she was a little houdini and would slide out of the posey vest and leave it TIED AND ZIPPED on the bed! It was working fine when we had her in a chair in the hall folding washcloths...until her son came in and said he wanted her back in bed. We didn't have any sitters available and we only had 2 techs for 30 pts, so we didn't have anyone on the floor to sit with her either. That's why we wanted her where we could see her. She was so sweet, too. She was afraid of being in the room alone, that's why she kept getting up. She said that she was going to die if she was alone. how can you tell her she has to stay in her room when she's so scared to be in there??? I guess I'm getting a little off topic, but I had to vent a little. :wink2: