Patients who don't use their call light....

[Virgo_RN]

....but instead "save up" their requests until you go in there to do something, are just as annoying as patients who are on their call light all the time, IMO.

I *hate* it when I'm just going in to get some vitals or pass a pill, and the patient has saved up all of their requests. They need more water, another blanket, some jello, to go for a walk, to take a shower, and on and on.

Last night, one of my patients' tele said he was in V Tach. Well, since monitors do lie, and I knew the patient well, in my heart of hearts I knew he was probably just scratching his belly or something. But, as a good nurse, I could not ignore it, and got up from where I had logged in on the computer and had all my charts piled around me, trying to catch up on documentation before doing my last rounds, and went in there to make sure the guy was still alive. Sure enough, he was sitting on the side of his bed, just fine and dandy. One of his leads had come off while he was moving around, so I fixed it, and as I'm trying to get out the door to go back and finish what had been interrupted, he says he wants his pills, some new bedding, a snack, more water, etc. I told him I had something to finish up and that I'd be back in a while, and left (I'm learning to prioritize my work; as a former CNA, it's hard for me to not respond to patient requests like this immediately).

So, I went back, logged out of the computer, then went and took care of my two elderly "turn Q2" and incontinent patients, made sure they were clean, dry, and pain free, then went and took care of my isolation patient, since he had only one med pass left for the night and I hadn't checked on him for a while, and saved this guy for last so I could give him the attention he was seeking.

Of course, he complained that I had kept him up "past his bed time". Then he took my hand, and would not let go, while he apologized for being such a difficult patient and thanked me for my hard work, and went ON AND ON, all the while holding onto my hand, which I kept trying to pull away, all about how when you die is when people say all the nice stuff about you, and how you should say nice stuff to people while they're still alive, and on and on and on ad nauseum. I mean, I agreed with what he was saying and appreciated being thanked, but it felt really disengenious, and the way he wouldn't let go of my hand made me really uncomfortable.

[MedicalLPN, LPN]

I can handle them saving their requests, that's not irritating to me, I do however HATE for the family to run around and seek me out for little things, I had a family member come in another patient's room that I was in and demand a blanket, I told her point blank "I'm with another patient, you need to leave the room, when I'm done I'll be with you."

This story takes the cake though, I had a patient who rang out for a her water pitcher to be filled, about 30 seconds later I hear on the intercom "Code Blue", the patient had pulled the code blue switch!! Needless to say all of us on the unit rush in, code team comes, physician and RT is there, when asked why she pulled it, she said "Oh I just knew you'd get here faster" She was discharged the next day hehe

[banditrn]

Nancy Nurse--I can appreciate the need for venting...I couldnt agree with you more, yes I have had countless patients and families make requests and I think "oh ok--after I am done getting the pt with a 45 blood sugar some juice and sugar- I will be right there to scratch your left toe"

My biggest--and I mean BIGGEST..is the morbidly obese who want you to wipe for them. Now I will wipe them, but I must think to myself, OK how do you do this at home???

One time after wiping a 30 something year old womans front about 15x one night I did finally ask, "How do you do this at home?"

Answer---she has a cloth toilet seat cover that she sits on and rocks back and forth and she just washes it every night.

ewwwaaaaa----hint--when your arms no longer reach below your belt, it is time to take action.

Oh, geez, that's nasty!! :bugeyes:

[madwife2002, BSN, RN]

I just love it when I am running up the corridor with my hands full of either drugs or fluids or something and a relative comes up to me to ask for more chairs for them to sit on I want to reply 'just hand me a brush and I'll sweep the floor as well'

There is already enough chairs in the room but some families are enormous

[Nate'sMum]

I am a pre nursing student. I have also just had a baby by emergency c-section. Two weeks later I was in the hospital for mastitis w/104 degree temp. Now, I understand that there are priority patients, but when the abx that are coming into my arm via IV are burning like hell...I would like a sensitive person to respond promptly w/ some freakin' ice or something.

I hated using that call button b/c I didn't want to be a nuisance. Please consider this when patients are trying not to be bothersome. As a patient and a future nurse I understand that the work load is extreme for nurses at times.

Please be patient with patients.

[Virgo_RN, BSN, RN]

I am a pre nursing student. I have also just had a baby by emergency c-section. Two weeks later I was in the hospital for mastitis w/104 degree temp. Now, I understand that there are priority patients, but when the abx that are coming into my arm via IV are burning like hell...I would like a sensitive person to respond promptly w/ some freakin' ice or something.

I hated using that call button b/c I didn't want to be a nuisance. Please consider this when patients are trying not to be bothersome. As a patient and a future nurse I understand that the work load is extreme for nurses at times.

Please be patient with patients.

No need to lay there like a martyr waiting for the nurse to come. Just use the call bell. That's what it's for. Believe me, it's more of a nuisance to go in for last rounds to do a quick safety check and find out the patient's been uncomfortable this whole time and didn't ask for any help. Just as the nurse has a responsibility to be responsive to the patient's needs, the patient has a responsibility to make their needs known.

[kimmie sue]

As a nursing student, dealing with "needy" pts. was hard to learn. With great preceptors I have learned to prioritize, and to not be afraid to tell those with a fast call light finger- I am going to be busy with other pt. for the next 45 min, hr. ect , is there anything else you need before I go? If you call me I will try to get to you when I can. Dealing with controlling pts has helped me get what I need done in my clinical shifts.

[Dolce, RN]

I'd prefer for them to ask for everything at once. Sometimes the rapid-fire requests are the worst though!!

I had a patient the other night that said, "Hey I drank this whole cup of water you gave me 2 hours ago! I've been thirsty!" So I walked to the kitchen, got him a new cup of water.

When I returned he said, "Is there any way I can get a cup of ice cream?" I think, "sure, why not, he's a diabetic and got a bunch of insulin earlier it can't hurt." Walk to the kitchen, get him some ice cream."

When I returned he said, "LOL I accidentally spilled my urinal on my bed I need new sheets. Just call me Mr. Butterfingers." I say, "hang on a minute I'll be right back. Can I get anything else for ya?" Pt-"nope" Walk to the clean utility, get new sheets. Walked back and changed the bed.

Pt-"Boy all that rolling around in bed made me sore...can I get a pain med?" Me-"yes! Anything else while I'm out there?" Pt-"Nope." I went to ge tthe pain med...returned, handed him the meds.

Pt-"These pain meds can be hard on my stomach, Can I get some graham or soda crackers to eat with it?" Me-"Okay sure. Do you need anything else?" Pt-"Nope" Walk back to the kitchen AGAIN. Return smiling, "here's your crackers sir."

I notice he had dropped ice cream all over himself..

Pt-"Can I get a new..."

Me-"Gown! Yes a gown!! Anything else?" Pt-"Nope."

Make the triangle from the dirty utility to clean utility to pt room.

Pt-"I'm still kinda hungry do you guys have sandwiches up here?"

Me-"Sure do you like ham or turkey? Mayo or mustard?"

Pt-"Ham with mayo please!"

Me-"okay! Is there anything else I can get while I'm out there?" pt-"Nope"

Run back to the kitchen AGAIN. Return to the pt's room.

pt-"Do you guys have milk up here?"

me-"Yes do you like 2%, whole or skim?"

pt-"2% sounds great."

me-"Anything else?"

pt-"nope" Run to the kitchen and back

pt-"hey thanks for the milk, can I get @#$>@#%........"

repeat this ad nauseam for an entire hour. I wasn't otherwise busy or else I would have had to cut it shorter.

I mean, obviously if he had just asked, "I need my bed changed, my urinal's kind of full, and I'm sore and hungry" I would have just done all that in the first place...

Oh I love this description. After about 5 times of this I usually emphasize my words when I say, "Is there anything else I can get you?" Even that doesn't work. I think these patients are absolutely clueless. I also think that family members are clueless when they follow me around asking for things for the patient while I am clearly busy taking care of another patient. It annoys me no end when a patient or family interrupts me in the middle of taking care of another patient something like, "I have a question for the doctor" or "he's really, really hungry. Can he have a sandwich?"

Most of the time I find that I spend all night running for patients that don't really need the help while my sickest patients lie quietly in bed, not asking for a thing.

[canoehead, BSN, RN]

This story takes the cake though, I had a patient who rang out for a her water pitcher to be filled, about 30 seconds later I hear on the intercom "Code Blue", the patient had pulled the code blue switch!! Needless to say all of us on the unit rush in, code team comes, physician and RT is there, when asked why she pulled it, she said "Oh I just knew you'd get here faster" She was discharged the next day hehe

Filled with warm water I hope...

If you are inundated with one at a time requests of course you can say "anything else?" each time. As you realize this is becoming a pattern add "are you sure??" with a smile. Then be up front about it. Tell them you need to get back to what you were doing so you can make a last trip but that's it, and you'll be around later, and call if there's a problem they need you for. Most people get the hint that by problem you mean physical pain etc. Then in about 30 min stop by the door and say "how ya doing?" so they know you are still available. Repeat as needed, and if you have a patient for a few days you can anticipate a lot of what they will ask for. Get it all at once and they will think you are the most attentive nurse ever.

For visitors that come to the desk nicely say you will finish what you are doing and you will be along. Remember to show up within 15 minutes or so. If the request is manageable by the CNA ask them if they would mind putting on their call bell next time, as "Betsy, the CNA" is out making her rounds and will usually be able to respond faster than those at the desk. "She has her system with linens and drinks you know. When the RN's start doing things we lose track of things, like intake and outputs, or who needs to get up. "

For frequent callers watch out for loneliness, fear or confusion. Take a few minutes and sit to exchange some words with them so they feel cared for, for a moment. Ask why they hit the light so often, are we missing something? is something wrong? Some people will out and out say they want to know how long it takes to respond, or if the call bell is working. Someone from a nursing home may be used to seeing a light go on over the door, and if it's not visible in the hospital they panic.

When all else fails just say "I need to finish what I'm doing and then I will be right there." Most people understand needing to complete one task before starting another.

In most cases where someone expresses a need I recommend walking by the door and making eye contact within 30min so they know you didn't ignore them. Try to educate about who does what and when if appropriate, and tell them what they are welcome to do themselves- like visitors getting drinks for the patient, or where they can get what they need. It takes guts to tell a visitor that we don't supply diapers for her baby, but if you tell her where she can buy some you set limits and don't feel like a total turd.

[Butterfliesnroses]

Wow. When I was in the hospital I tried to be that non-irritating patient. I did exactly as the OP described. I "saved" up all my requests so I was not a bother to the nursing staff. Because as an aide in LTC I find it frustrating when I was just in someones room and they call 2 minutes later because they want something they could have asked me to do 2 minutes ago. In fact, I will answer those residents lights that are on their light less, first. Because I usually have to prioritize due to having so many lights on at once. Nursing staff was very wonderful during my stay, I must say! I had a few rude aides but I just figured they were having a bad day or really busy.