Stopping patient care for another patient

Nurses Relations

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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, re-positioning, etc.

When I stepped out to grab something off my cart one of the techs on my other hall told me that a patient's family said that she wanted something for pain. I said I will come as soon as I finish.

When I finish I went to my other cart to prepare her meds when her family came up the hall and stated she needed more water so I said I will get it. I got some water then finished pulling her meds and walked with the family down to her room. Administered her meds and made sure she was comfy before I headed back down the hall.

2 days later my DON calls me and asked me to explain what happened because the family said she waited 45 mins(bogus) and they wanted to move her to a new facility. Now was I wrong for not interrupting my current patient care to go to another?

If I was then I will accept that for future reference. But I look at it as unfair to patients to put them on hold for another unless absolutely necessary. I took all of 10 mins at the most. I feel bad. Do you cut patient care short when someone requests something i.e. pain med, tx, water, snacks??

In the LTC where I worked, AO3 patients and those with demanding families got the priority because they COULD say bad things, file complaints, et. al. It was a sad state of affairs.

In my humbleness, I will state that I no longer allow anything short of a code to interrupt a current med administration (I now work in acute care).....the reason why is that I allowed my precepter to interrupt me in the middle of a task (I had pulled meds but had not gone to the patient's room yet). Crux of it....I made a med error. I had to go to the ANM, risk management, the MD and the patient to 'confess' what happened. Ultimately, no harm. Thank God. It is a lesson I will never forget and never repeat.

Specializes in Emergency, Med-Surg, Progressive Care.
How much "sweetness"does it take after you've been laying in pain?

Pain control is NUMBER ONE of all nursing priorities.

If you took the NCLEX today, you would fail miserably. Pain is the absolute last priority according to that exam with a few exceptions (chest pain, unexplained/unexpected pain, and I think kidney stones). If there are no pressing ABC-type needs, then pain can be a priority. If two people are in pain, it should be 'first come, first served' rules. The reality of health care facilities is that there are only so many nurses, and it is up to us to prioritize as we see fit. The original poster may not be comfortable carrying medications for two patients at the same time...that practice is frowned upon where I work. Just because you feel comfortable doing something doesn't mean that others would. None of us wants our patients to be in pain, but the unfortunate truth is that we sometimes have to make them wait while we finish another task.

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 think you are letting your emotions about your father get in the way of seeing this in a rational way. Someone having to wait a few minutes for their pain meds is not the same as ignoring them and not addressing the problem.

Pain control is not number one. I'm more concerned about that whole breathing thing that people need to be doing.

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 .

Wow. That's rude.

Yeah, pain is what the patient says it is, but no one is saying that the patient wasn't in pain, so that's not the issue here. The issue is that patients/families think you should stop what you're doing to bring them/their loved one pain meds right now, and that's unrealistic. I can't stop what I'm doing every time someone says they want pain meds. I did that during one of the very first shifts I ever worked. I would leave someone's room, and they'd be on the call bell less than 3 minutes later, while I was getting someone else's medication, saying they wanted pain meds. Why couldn't they have said that when I was in there? They didn't just suddenly start having pain. Once I would take care of that person, more people would be asking for pain meds. I quickly learned that I couldn't keep being interrupted, that it would be impossible to get medications passed, and that I'd go crazy or make a serious mistake if I kept stopping and running up and down the hall to take care of someone else's pain at that moment. They simply would have to wait their turn. It may sound harsh (though it's not meant to), but no one has ever died of pain.

Fascinating. Were they patients in the same room?

You know.. they were! Blood bank did not want to issue two units to me at the same time.

However, they realized it was an emergent situation for both patients .. knew me to be a professional and issued both units.

I see you are also an attorney.Therefore , herein.. and forthwith.. you are referring to my statement regarding pain control as an "exhibit".

I am most certainly aware that there are higher priorities in nursing care.

My statement was meant to point out that ... in the case of a patient experiencing pain.. that is indeed THEIR priority.

I am simply stating that the nurse needs to juggle the administration of pain medication...without her workflow foremost in mind.

I think you are letting your emotions about your father get in the way of seeing this in a rational way. Someone having to wait a few minutes for their pain meds is not the same as ignoring them and not addressing the problem.

Pain control is not number one. I'm more concerned about that whole breathing thing that people need to be doing.

Wow. That's rude.

Yeah, pain is what the patient says it is, but no one is saying that the patient wasn't in pain, so that's not the issue here. The issue is that patients/families think you should stop what you're doing to bring them/their loved one pain meds right now, and that's unrealistic. I can't stop what I'm doing every time someone says they want pain meds. I did that during one of the very first shifts I ever worked. I would leave someone's room, and they'd be on the call bell less than 3 minutes later, while I was getting someone else's medication, saying they wanted pain meds. Why couldn't they have said that when I was in there? They didn't just suddenly start having pain. Once I would take care of that person, more people would be asking for pain meds. I quickly learned that I couldn't keep being interrupted, that it would be impossible to get medications passed, and that I'd go crazy or make a serious mistake if I kept stopping and running up and down the hall to take care of someone else's pain at that moment. They simply would have to wait their turn. It may sound harsh (though it's not meant to), but no one has ever died of pain.

I don't know why they did not ask for pain medication when you were in the room. Did you ASK if they needed anything for pain while you were at the bedside?(Nursing 101)

I have found that patients surely realize that ''damn .. I should of asked for that while she was here.. she won't be back for awhile." Grab her before she gets too far away.

No.. no one ever died from pain.. they just wished they would.

Specializes in Emergency.

I don't know why they did not ask for pain medication when you were in the room. Did you ASK if they needed anything for pain while you were at the bedside?(Nursing 101)

I have found that patients surely realize that ''damn .. I should of asked for that while she was here.. she won't be back for awhile." Grab her before she gets too far away.

No.. no one ever died from pain.. they just wished they would.

That nursing 101 crack is pretty snarky. And now we're back to interrupting a med pass.

Specializes in Oncology.

You think you know it all and are super nurse and insult the rest of us. I feel sorry for the patient who gets the wrong meds or worse from you when you make a mistake. It can happen to anyone. I'd rather be safe than sorry.

Specializes in Cardiac/Step-Down, MedSurg, LTC.

I would have done the same thing as the OP. How would it make the resident feel if the nurse dropped what she was doing for patient care for a pain med that could wait 10 minutes or so? If I were a resident receiving incontinent care, or having a dressing change done, I'd be royally P.O.'d. To me, this isn't just nursing prioritization, it's common courtesy.

Let me explain in more specific terms. I am currently a float nurse, that can go to most units..in multiple facilities in the largest health care system in a large city.

I have no problem pulling any narcotic I need from the pyxis , at the same time..even if it is for two different patients. I am a professional. I am expected to give narcotic A to patient A and narcotic B to patient B.

I can administer the correct medication to the first patient... walk down the hall and medicate the other patient PDQ. I fail to see how that would be a safety violation.

I have also started a blood transfusion on two patients at the same time. I can read.

30 years of experience will do that for ya.

Unless the two patients you started a blood transfusion on were either in the same room or in a room right next to each other, this is not something to be proud of. If you start a transfusion on one patient, then walk down the hall to start one on another, the first pt. could be having the beginning symptoms of anaphalaxis before you make it back. With all your experience you should know this, as the pt. is supposed to be checked every 15 minutes for the first hour of starting a transfusion.

Maybe this could be possible, if the pt's were in the same room or in rooms right next to each other, and if neither pt has any questions, family members, reactions, request an extra pillow or more ice, etc. that would keep you from hoping right back to the other room.

My statement was meant to point out that ... in the case of a patient experiencing pain.. that is indeed THEIR priority.

I am simply stating that the nurse needs to juggle the administration of pain medication...without her workflow foremost in mind.

Just because it was THEIR priority, doesn't make it YOUR priority.

When a nurse is juggling the admin of meds she needs to keep her workflow FOREMOST in mind, she will not do her pt's any service otherwise, because she will be running around like a chicken with her head cut off, getting half the work done in twice the time and most likely to make multiple mistakes.

This is incredibly unfortunate.. my DON is the same way, if we are wrong we take it .. but when we aren't and the patient is clearly giving us a run around all day our DON never sticks up for her staff. We have excellent understanding patients most of the time.. but every once in a while we have one that is clearly out of there mind and we don't treat them any different.. we get to them when we do at my facility and they complain complain.. sigh. Sometimes I have 25 patients... and one ME and one CNA. Tube feedings, colostomys, iv fluids, etc Right now I even have one pt that has the whole nine yards colostomy, iv in PICC, wound vac for decub wound on sacrum, foley.. oh yeah and I have 25 pts... and 4 pts ask for pain meds on the dot all night. I had one on IV pain med Q15min.

Sorry for venting.. but it's impossible to accommodate everyone , I wish I had a clone. Nursing needs to change!! I'm afraid of protesting because I need a job, I feel like we are all easily replaceable because of all the new RNs begging for jobs. :(

I don't know why they did not ask for pain medication when you were in the room. Did you ASK if they needed anything for pain while you were at the bedside?(Nursing 101)

I have found that patients surely realize that ''damn .. I should of asked for that while she was here.. she won't be back for awhile." Grab her before she gets too far away.

No.. no one ever died from pain.. they just wished they would.

Nope, I sure didn't ask them if they needed pain meds. When I have 20-something people to pass meds to, I'm not going to ask every single one of them if they need pain meds, especially when nearly all of them are able to (and do) say what they need. Heck, even if I had one-fourth of that amount, I'm not going to ask every single one of them if they need pain meds if they're capable of making it known. If their pain was so bad that they wished they would die from it, I don't think they'd hesitate to say they need something for it. Nursing 101? Other than some important skills and important information, the majority of what I learned in Fundamentals was a lot of BS like butt-kissing demanding patients and families, therapeutic communication (see aforementioned butt-kissing), and how we should all strive to be little angelic clones of Flo. But I'm wasting my time with this. You think you're perfect. I don't want to get the OP's thread locked, so I'm letting this go.

OP, I agree with you. I wouldn't have stopped what I was doing for another patient if it wasn't an emergency. People just have to wait sometimes.

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