Stopping patient care for another patient - page 4

by sAssy_NurSe 6,645 Views | 68 Comments

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 whole nine. Checking her vitals,... Read More


  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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 .
  6. 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
  7. 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.
  8. 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.
  9. 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.
  10. 3
    Quote from dudette10
    One thing that I do that seems to work for reasonable patients, although we aren't allowed by management to do it: I say, "I'm sorry for the delay. I was with another patient at the time I was told of your request, but I'm here now! Here's your pain pill! Anything else you need?"

    Most seem to respond positively to that. If the family or patient is impossible to please, nothing you could say or do would make it better.
    I do this pretty much anytime I can't answer a call right away... "Sorry it took me so long to get here, I was with another patient/on the phone with a doctor, etc". Or, I might stick my head in the door to acknowledge that the CNA passed on the request and that they are next on my list. Seems to work well for me.

    I've heard before about how some places don't want staff to say that they were busy with someone else, etc. My employer has not stated that, but I am sure I would ignore it (as I do with most scripting). My patients are perfectly aware that I have several people to look after, and every now and again they ask how many I have. I tell them.
    DizzyLizzyNurse, JZ_RN, and nrsang97 like this.


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