Stopping patient care for another patient Stopping patient care for another patient - pg.3 | allnurses

Stopping patient care for another patient - page 3

Ok I have a question.... Here's the scenario ... I was in the middle of patient care with one patient who was requesting pain medication. It was time for her scheduled meds so I was doing the... Read More

  1. Visit  Been there,done that profile page
    0
    Quote from redhead_NURSE98!
    Sorry? BREATHING is my number one nursing priority.
    Yes, believe it or not I still remember Maslow's hierarchy. However pain control was number one with family and patient at that time.
    I tend to jump on pain control because I watched my father suffer for years from nurse's and doctor's that did not give a rat's patooty.
    The bottom line is the patient's family wanted to move the patient from the facility! That is because the very basic need of pain control WAS NOT ADDRESSED. No wonder they wanted him moved.

    I am surprised at the number of responses that feel it is an interruption of the NURSE'S routine to administer pain relief . We are not "running back and forth like a servant" when we are trying to comfort someone in pain.
  2. Visit  Caffeine_IV profile page
    0
    So the patient's family was not pleased but we do not know how the patient felt. What was their pain rating? Is is chronic pain? Was their pain relieved? Did they request pain med again and have to wait long time on more occasions?

    Pain control is important and I make it a priority to administer requested meds in a very timely fashion. That said every time someone requests pain meds it does not mean they are in excruciating pain and I use my nursing judgment and knowledge of the patient in that area.
  3. Visit  LPN2RNn2011 profile page
    0
    that is what scares me! it's all about the dollar n less about the person n their health! it's bs...jmho!

    in response to; jeweles26
    Last edit by LPN2RNn2011 on Aug 1, '12 : Reason: Didn't know my post wld go 2 the very end LOL
  4. Visit  Anna Flaxis profile page
    3
    No, I do not think you were wrong to finish up what you were already in the middle of.

    It is well documented that interruptions during medication preparation and administration contribute to a greater incidence of medication errors. Unless the interruption is a real, life threatening emergency, it can wait a few minutes.

    What I would have done would have been to instruct the tech to return to Patient B's room and inform the family that the nurse has been made aware of the request, and will be there to address it as soon as she is finished with Patient A. Then, as soon as I finished up with Patient A, I would have gone directly to Patient B's room to do a pain assessment and let the patient and family know that I was addressing the request.

    Then, they might not have had to come out into the hallway to find you, and they might have felt like the request was being taken more seriously, and hence, not have felt the need to complain.

    Granted, it is much more efficient to just go to the cart and start pulling the meds than it is to go to the room, do the pain assessment, communicate with the family, then go back to the cart to get the meds. But perception is everything. As far as the family is concerned, they are in that room, that room is their universe, and they have no idea what you are doing, with whom, or why. All they know is that you are not in that room, and every minute seems an eternity.

    The sooner you come into the room and communicate, the more likely the family's perception that you are actually doing something is to be. The more effectively you are able to communicate, the more likely they are to be satisfied with your care.

    One thing I've learned in my brief time as a nurse is that what might be most efficient and make the most sense to you is totally irrelevant to the vast majority of patients and their loved ones. Much of what they perceive is based upon the face to face time with you; not the clock, not your reality, not anything else outside the four walls of that room. Communication really is key.
    Last edit by Anna Flaxis on Aug 1, '12
  5. Visit  dudette10 profile page
    0
    Quote from Jeweles26
    Can I ask why you wouldn't be allowed to say you were with someone else? Seems to me there is nothing wrong with that! You aren't disclosing personal information, you aren't saying 'I was with Mr. So-and-So.'
    I hate what health care is becoming...when did it become more important to kiss everyone's butt than to actually make people better? Just a scary thought for the future of nursing, more about customer service than health care... Ugh...
    It's considered "blaming someone else" for the delay. I know...I don't get it either, which is the reason why I've ignored that particular edict.
  6. Visit  JZ_RN profile page
    5
    Quote from Been there,done that
    Yes, believe it or not I still remember Maslow's hierarchy. However pain control was number one with family and patient at that time.
    I tend to jump on pain control because I watched my father suffer for years from nurse's and doctor's that did not give a rat's patooty.
    The bottom line is the patient's family wanted to move the patient from the facility! That is because the very basic need of pain control WAS NOT ADDRESSED. No wonder they wanted him moved.

    I am surprised at the number of responses that feel it is an interruption of the NURSE'S routine to administer pain relief . We are not "running back and forth like a servant" when we are trying to comfort someone in pain.

    I stay on top of my prns, so my patients aren't in pain, and yes, going from a room where you're doing a pain med to go do another pain med before you complete the care you've prepared to do on another patient because they are not willing to wait a few minutes and want their pain med NOW is running back and forth, and if they want a private duty nurse to jump at each request and to not have to wait a few minutes, they need to hire one. I am not their servant, I am there to help ALL the patients. And maybe this patient she was turning needed turned badly, and who knows what could have happened had she not turned the patient? Sometimes people request PRNs but I know when I go in there they will have 30 other requests and take up an extreme amount of time, I am not making everyone else wait for them. You don't know the patient, nor the situation, nor how that nurse handles her assignments, so no, she's not expected to jump like a circus monkey and respond to a PRN request at the drop of a hat when she is already doing that. If I had done that at the SNF or the LTC facility, I literally never would have been able to finish dressing changes, treatments, or med pass, and never finished a chart. I am not saying that you should ignore pain and prn requests or make them wait a long time, but you cannot just jump jump jump for everyone about them either. Makes me curious, have you ever actually worked in LTC or SNF or ARF? My guess is no if you think that you should respond to every request for a prn pain med like it's 911 emergency and drop everything else like you don't have other priorities or a heavy workload to manage. And if I had a penny for every time a patient's family wanted to move them from the facility... I'd just be like, listen, you can move them, but no nurse worth her salt who gets her work done and has been in ltc or snf for longer than 5 minutes is gonna jump for everyone's prn requests, sometimes you have to wait a few extra minutes. I encourage my patients to ask for prns before the pain is out of control anyways, that way we can stay on top of it. And a 5-10 minute wait will not kill you if you are already in pain.
  7. Visit  JZ_RN profile page
    1
    And as others have stated, short of a code or someone bleeding or something, med pass does not get interrupted and I don't go back and forth. I am not making an error and I am not making 12 trips down the hall for something that can wait 5 minutes.
    MahzieLPN likes this.
  8. Visit  applewhitern profile page
    2
    I make every effort to stay on top of my patient's pain control needs. I have and will stop what I am doing to give pain medication, because I have learned that is one of the things they will complain about the most. What gets me, though, is when you ask the patient if they are hurting, do they need pain medication, and they say "no, I'm fine." Then here comes a family member, takes one look at the patient, and says "he/she needs something for pain!" When the patient has refused pain medication all day, but the family member just assumes you haven't bothered to offer any. Another problem that bothers me is when we get a patient from the emergency room, and the very first words out of their mouth is "I need something for pain." (You have just been in the ER for hours, but suddenly you come to the floor and are writhing in severe pain?) I resent that they complain about not getting pain medication fast enough, when I just got the patient and haven't even got to assess them or their vitals yet. And no, we are not allowed to say we have other patients, either. We are supposed to act like we only have one patient in the entire hospital.
    DizzyLizzyNurse and Anna Flaxis like this.
  9. Visit  Been there,done that profile page
    0
    Quote from JZ_RN
    I stay on top of my prns, so my patients aren't in pain, and yes, going from a room where you're doing a pain med to go do another pain med before you complete the care you've prepared to do on another patient because they are not willing to wait a few minutes and want their pain med NOW is running back and forth, and if they want a private duty nurse to jump at each request and to not have to wait a few minutes, they need to hire one. I am not their servant, I am there to help ALL the patients. And maybe this patient she was turning needed turned badly, and who knows what could have happened had she not turned the patient? Sometimes people request PRNs but I know when I go in there they will have 30 other requests and take up an extreme amount of time, I am not making everyone else wait for them. You don't know the patient, nor the situation, nor how that nurse handles her assignments, so no, she's not expected to jump like a circus monkey and respond to a PRN request at the drop of a hat when she is already doing that. If I had done that at the SNF or the LTC facility, I literally never would have been able to finish dressing changes, treatments, or med pass, and never finished a chart. I am not saying that you should ignore pain and prn requests or make them wait a long time, but you cannot just jump jump jump for everyone about them either. Makes me curious, have you ever actually worked in LTC or SNF or ARF? My guess is no if you think that you should respond to every request for a prn pain med like it's 911 emergency and drop everything else like you don't have other priorities or a heavy workload to manage. And if I had a penny for every time a patient's family wanted to move them from the facility... I'd just be like, listen, you can move them, but no nurse worth her salt who gets her work done and has been in ltc or snf for longer than 5 minutes is gonna jump for everyone's prn requests, sometimes you have to wait a few extra minutes. I encourage my patients to ask for prns before the pain is out of control anyways, that way we can stay on top of it. And a 5-10 minute wait will not kill you if you are already in pain.
    You have been a nurse (?) for a whole year now." I'd just be like, listen, you can move them, but no nurse worth her salt who gets her work done and has been in ltc or snf for longer than 5 minutes is gonna jump for everyone's prn requests"
    I have worked in all areas . Your attitude of "My work flow is more important than responding to your request for pain control.. simply boggles my mind.

    "Like.. ya know." take the bubble gum out of your mouth.. pain is whatever the patient says it is .
  10. Visit  not.done.yet profile page
    10
    Expecting a nurse to drop what she is doing to make one patient a priority over another without a medical emergency is not reasonable. Pain is a high priority but not a medical emergency. Pulling pain meds for more than one patient at a time is not permissible. Interrupting a med pass is irresponsible.

    BTDT, I am so sorry you had trouble with a facility ignoring your father's pain. I can only imagine how awful that was for all of you to go through. Ignoring a patient's pain is heinous and unforgivable.

    That being said, a patient having to wait their turn is not the same as ignoring them. Should we all be on top of pain control? Yes, of course. Does that not always happen ideally? Yes, of course. I think your emotions for your father's suffering is affecting your ability to reasonably argue this one, which is understandable. But your situation is not the same as the one outlined above. Ignoring is one thing, putting a patient next in line is totally different. Five to ten minutes is a long time to suffer pain, yes. That doesn't make the reality of it change. Sometimes that is going to happen and all we can do either break safe practice or apologize. I will choose to apologize for being later than the patient would have liked for a pain med any day over having to apologize for a med error to the patient, their family, my manager and/or the BON. That which is more likely to affect my license is going to dictate my care priorities. I won't ever lose my license for being 10 minutes later than a family wanted for pain control. I sure as shinola could, though, for making a med error such as giving the wrong drug to the wrong patient or making errors in patient care due to rushing off to address another patient's pain.
    Last edit by not.done.yet on Aug 2, '12 : Reason: clarification
  11. Visit  uRNmyway profile page
    6
    Quote from been there,done that
    you have been a nurse (?) for a whole year now." i'd just be like, listen, you can move them, but no nurse worth her salt who gets her work done and has been in ltc or snf for longer than 5 minutes is gonna jump for everyone's prn requests"
    i have worked in all areas . your attitude of "my work flow is more important than responding to your request for pain control.. simply boggles my mind.

    look, i realize your response is largely influenced by your personal experience with your father/mother (whoever it was). but as others have said over and over, walking away from someone who you are already doing an evaluation on is just begging for errors, medication and otherwise. its not like she said anything about finishing all of her morning rounds or anything like that. she said she would finish what she was doing with that patient. geez, if i dropped everything and ran anytime a patient complained of pain, no matter what department or setting its on, i would never get anything done! and with me not getting anything done, its not about "my work flow being more important". its about "my patients are not getting care that they need and was ordered for them in a timely manner".

    "like.. ya know." take the bubble gum out of your mouth.. pain is whatever the patient says it is .
    wow, get off your soap box and quit being judgmental. you have no idea who she is or anything about her. she uses a few words and you assume she is a bubble-gum chewing air-head? unless i missed something, this pain is not what the patient said it is. it is what the family members said it was. and check out other threads, that is another controversial issue in itself. personally, if a family member tells me their mother/father/child/whatever is in pain, i want to assess said pain for myself, not just take their word for it and rush with pain meds. and to be able to focus on them and assess this pain properly, i cant be thinking about the patient i just left behind with unfinished care.
  12. Visit  nrsang97 profile page
    0
    Quote from not.done.yet
    Expecting a nurse to drop what she is doing to make one patient a priority over another without a medical emergency is not reasonable. Pain is a high priority but not a medical emergency. Pulling pain meds for more than one patient at a time is not permissible. Interrupting a med pass is irresponsible.

    BTDT, I am so sorry you had trouble with a facility ignoring your father's pain. I can only imagine how awful that was for all of you to go through. That being said, a patient having to wait their turn is not the same as ignoring them. Should we all be on top of pain control? Yes, of course. Does that not always happen ideally? Yes, of course. I think your emotions to your father's suffering is affecting your ability to reasonably argue this one. Five to ten minutes is a long time to suffer pain, yes. That doesn't make the reality of it change. Sometimes that is going to happen and all we can do either break safe practice rules or apologize. I will choose to apologize for being later than the patient would have liked for a pain med any day over having to apologize for a med error.
    I totally agree with this.
  13. Visit  Butterfly E. Phect profile page
    5
    I have a feeling that this family is going to be moving this patient from one health care facility to another one A LOT. They are going to be just as unhappy in their next hospital. About the 4th or 5th hospital, they'll probably adjust their expectations to realistic ones.

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