What kind of nurse are you?

Nurses General Nursing

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I work in a busy ED. Most of the time the patients who come in are scared because they are having CP, have broken something, afraid they're having a stroke, etc...I introduce myself, explain what I'm doing. I talk to them and explain things while I am starting the IV, pushing meds, etc...I don't like just sit and talk to them. I am always thanked for being kind and for explaining things. I've never had patients complain that they have to wait too long for pain meds, etc...waiting on the doctor or on test results yes.

I had my yearly evaluation last week and my manager had written down that I am not as productive as the other nurses. He said I talk to the patients too much. Isn't that a part of nursing? I'm not chit-chatting, I'm explaining things and I don't doddle. I didn't know how to reply but I didn't sign the evaluation because I said I had to think about it.

Specializes in Family Nurse Practitioner.
I really won't know until I pass my Nclez in the spring, pray for me!

Good Luck on the NCLEZ

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Specializes in ER/EHR Trainer.

Geez Patrick, have you worked ER? The minute it becomes a factory paced meat market is when people are in danger of dying and nurses lose their licenses. You can be speedy and communicate at the same time. Those few extra minutes spent explaining what is going on to a patient are definately saved later on the callbell not going off! The OP is my kind of nurse, you can operate efficiently and still be a "human". Obviously a fact that your manager has forgotten. It's funny, all of the great ideas come from people who don't actually have to do the work!

Maisy

Blatant sarcasm is a truly unattactive trait in a human being, spelling is no longer taught by rote and memorization. Children are encouraged to free write and don't learn like they used to. That being said, the worst spellers I have come across throughout my life were the entreprenaurs, managers and most educated. It isn't nice to point out ones inadequacies, that finger can always be pointed back in the other direction.

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Perhaps they feel inadequate next to me because they know they are not giving everything that they should to these patients who are scared and need compassion and education. I am not going to change the nurse I am.

bingo, broadway!

i think you've nailed the problem, as stated above.

let's hope your colleagues don't start playing dirtier.

regardless, keep up the excellent standards you strive for.

you are my kind of nurse.:redpinkhe

leslie

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Specializes in M/S, Travel Nursing, Pulmonary.
I had a patient once (LOL w/anxiety) who was convinced she was going to die due to the fact that she couldn't breath. I found out about this when her CNA came to me in a panic. I brought her a breathing treatment, and then sat by her side for 10 minutes just talking to her. I asked about her family, her occupation before retirement, cooking, baking, pets, anything to take her mind off her breathing. She responded very well to this, forgetting she couldn't breath and relaxing. As we left the room the CNA asked how I did that. CNA said she never saw pt respond so quickly. I explained that anxiety attacks can be stopped if you can get the pt to think of anything else, and how to do it. The CNA passed that information along to other CNA's and they now have a happier, less anxious pt. Sometimes you really do have to talk to pts, I wish management would realize that fact.

Great story. Just want to ask you one thing.

I was taught not to give people who complain of SOB breathing treatments. I actually learned this from another nurse whom I respect a lot, not something told to me by a doctor or learned in school. Many of the common breathing treatments increase anxiety.

Has anyone else heard of this? Or, do I not know the whole story and its not really an issue. I'm just curious if experienced nurses follow this rule or not. Wonder if it should be a part of my practice or not.

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Sometimes managers have a form they have to fill out and must list positives AND negatives with every employee, so maybe he was just grasping at straw to find something negative about you, so he said you arent as productive. It isn't the worst thing in the world to be called. I'd rather have someone say I talk to the patient too much than to say the patients don't think I care.

Good for you for remembering that they are people, not bed 1 , bed 2, etc.

:yeah:

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Specializes in CRNA.
Sometimes managers have a form they have to fill out and must list positives AND negatives with every employee, so maybe he was just grasping at straw to find something negative about you, so he said you arent as productive. It isn't the worst thing in the world to be called. I'd rather have someone say I talk to the patient too much than to say the patients don't think I care.

Good for you for remembering that they are people, not bed 1 , bed 2, etc.

:yeah:

That sounds all happy and cute, but there are two sides to every story. In politics there are three sides, but I digress. Spending lots of time talking to Old Man Rivers with the "damn hemorrhoids" in bed 1 is great. What about Rick James, the 40 y/o crack addict who just got placed in bed 2 c/o dizziness and hypertension with the undiagnosed 8cm dissecting DeBakey Type I aneurysm. The productive nurse who bounces in and out of rooms will see this dude, throw in a fat 14 gauge with some LR and tell the attending about the sick degenerate in bed 2 who needs some tests run quick and possibly a surgical consult. This poor bastard doesn't have much longer to live and potentially could be deader than fried chicken by the time Chatty Cathy made it into the room to say hello. Personally if your statement applies DA314, I would rather have patients think I don't care, than walk into bed 2 and find a corpse that could have lived another day livin' it up with the crack rock.:nurse:

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Specializes in M/S, Travel Nursing, Pulmonary.
That sounds all happy and cute, but there are two sides to every story. In politics there are three sides, but I digress. Spending lots of time talking to Old Man Rivers with the "damn hemorrhoids" in bed 1 is great. What about Rick James, the 40 y/o crack addict who just got placed in bed 2 c/o dizziness and hypertension with the undiagnosed 8cm dissecting DeBakey Type I aneurysm. The productive nurse who bounces in and out of rooms will see this dude, throw in a fat 14 gauge with some LR and tell the attending about the sick degenerate in bed 2 who needs some tests run quick and possibly a surgical consult. This poor bastard doesn't have much longer to live and potentially could be deader than fried chicken by the time Chatty Cathy made it into the room to say hello. Personally if your statement applies DA314, I would rather have patients think I don't care, than walk into bed 2 and find a corpse that could have lived another day livin' it up with the crack rock.:nurse:

:icon_roll I guess I missed that part of class. I just dont get that whole post. Its like, you were half way to making a point and then your doorbell rang or something.

Dont get me wrong, I understand the whole point about not socializing with pts to the point where some get good care and some dont. I've known people who did this. I've caught myself doing it. Its human nature, we are drawn to spend time with the pts we find agreeable and easy going. As nurses, we have to see the whole picture and offer a "theraputic, professional relationship", not a good social environment. I get that, I really do.

:confused:I dont get the "livin' it up with the crack rock" stuff. Wouldnt you have also gotten a social services consult and offered your time to "Rick James the 40 y/o crack addict" so if he could talk about quitting the habbit if he so desired?

IDK, I guess thats why you and topic poster dont see eye to eye. It seems to me she would have completed the care and done those parts too. I didnt see anything in her post that made me think she neglected some for others. It takes time and genuine compassion to give holistic care. Your approach would have kept him alive, and yes, more than likely he would have "lived it up another day with the rock". With no support available to him for his problem (like you said, you prefer to be the procuctive one that bounces in and out of rooms, would rather pts think you dont care) that more than likely is the path he will choose. Even if he wanted to try to deal with the habbit, if his nurse acted like you described, he wouldnt have the opportunity.

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Redcell - the key is finding balance. No, you don't want to spend 45 minutes chatting with your pt when there is someone else who needs you asap. But you also don't want to alienate the pt. There is a lot to learn from talking to your pt. and if your pt. feels comfortable with you, they are more likely to tell you exactly what is going on. A person who feels like you don't care may not tell you that they are having an affair and might have an STD, or that they sometimes think about killing themselves.

ERs are not always the hectic place you described. More typically, it seems to be an acute care clinic for the uninsured, with a few actual emergencies thrown in from time to time.

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