Angry Nurse

Nurses Relations

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I am wondering if this has happened to any of you.... I got "talked to" by my Assistant Nurse Manager (charge nurse) because of an incident with a patient. My patient asked for some water, and I went to get it, but on the way to the kitchen, got stopped by another family member stating my one of my other patients had CP. After 30 minutes, I took my patient her water, only to find out her son called community relations saying that his mother was ignored. I apologized, saying that we were short staffed that day, that I had an emergency to attend to. He said there was no excuse for his mother not getting water. Anyway, I got "talked to" because I was not supposed to tell patients and family members that we are short staffed. What am I supposed to tell them, that I a retard? Why do they think that nurses should take all the blame? What do you think?

I really do wonder how my patients see me sometimes. What do they think I do all day? What do you think goes through our patient's minds?

We have a rule that you are to never tell "customers" that you are short staffed. However, when they see you working double after double, they figure it out for themselves.

As for complaints, well, people these days will complain if you put the ice cubes in their glass wrong. They have no clue or concept of what nurses do all day. As long as we continue to treat patient's as "customers" and give them the sense they are staying at a resort, we will always be regarded as nothing more than the hired help as opposed to the professionals we are.

I understand the frustration here, however, as a former staff nurse and a current ANM, I must throw in my 2 cents.

I agree with those who feel that staff shortages should not be mentioned. This is not the patients problem, it is ours. You need not justify the complaint with an excuse, just apologize for the delay, and explain that an emergency occurred.

I realize that some patients and families will think that their need for water was an "emergency". You have to realize the water was just as important to them, as the chest pain was to the other patient.

Is this unrealistic on the part of the patient and family? Of course it is, but there is nothing you can do to change their perception...to them you are only making excuses and trivializing their needs.

As for the nursing shortage problem, you need to document your concerns, and pass them along to your manager. And remember, the nursing shortage is as equally frustrating for the frontline managers as it is for the staff nurses. We do not have the answers, but we are being hardpressed to do more and more with less staff and resources. This is not an excuse or a sob story, but the key here is dialogue...between the staff, the NM/ANM, and the upper management. This shortage is not going away soon, and we need to protect the nurses we have from being burned and becoming burned-out.

Best of luck to all of us!

[This message has been edited by dskrn (edited November 04, 2000).]

Hi goldilocksrn,

we are told not to tell patients that we a short staffed also, sometimes that statement tells some patients that we are not there for them and they get more anxious and upset. What I would have told the son was that I was sorry that I didn't get the water before now was because another patient had an emergency that needed my attention at that moment. Sometimes if you can get the patient or family to think on someone else's problem (I don't mean going into detail, because you are violating patient confidentiality) they will see that maybe their request was a little less pressing than the chest pain. Also think of the son, he's worried about his mom, and probably anxious about her condition, he probably can't see past her condition. Also, not matter what you do, sometimes it's never right. Just take a deep breath and remember all the good you do to your other patient. Nursing can be a thankless profession, but sometimes one thank you is allwe need.

Originally posted by goldilocksrn:

I am wondering if this has happened to any of you.... I got "talked to" by my Assistant Nurse Manager (charge nurse) because of an incident with a patient. My patient asked for some water, and I went to get it, but on the way to the kitchen, got stopped by another family member stating my one of my other patients had CP. After 30 minutes, I took my patient her water, only to find out her son called community relations saying that his mother was ignored. I apologized, saying that we were short staffed that day, that I had an emergency to attend to. He said there was no excuse for his mother not getting water. Anyway, I got "talked to" because I was not supposed to tell patients and family members that we are short staffed. What am I supposed to tell them, that I a retard? Why do they think that nurses should take all the blame? What do you think?

many places do not like you telling families you are short staffed, even where i work. all i would have said is im sorry, i had an emergency on the way to get the water, and i came as soon as i could. relatives don't care what the nurse load is or anything really. they want what they want, and yesterday. your charge nurse should have stood up for you, as cp comes first.

I really don't believe this!! What are we, for heaven's sake -- waitresses?? In most hospitals I've worked in, the ice machine is out in the corridor, and patients/family are encouraged to help themselves! If they need water, there's a bathroom right in the patient's room!! Also, fetching water is NOT a nursing responsibility...usually health care aides or other less skilled staff are expected to do this task.

This is one example of why nurses leave nursing. You have the responsibility of giving the best care you can - under stressful circumstances with little or no authority and then you have the extra responsibility of treating "the customer" in such a way that he will think only good thoughts of the hospital. Nurses did not make patients "customers". The business people who take over healthcare did that.

Then you go home and read a nursing mag and the editorial says, nurses, it is up to you to speak up for yourselves and make the public aware of our situation. But you know the next day you're going to work and tip-toe around the issues all over again. If your loyalty is to the patient, how can you be loyal to the cutting-corners system? And if you're loyal to the hospital, do you honestly think you're doing the best possible for the patient? I went to school to take care of the sick not to be loyal to a business corporation.

By the way, I respectfully disagree 100% that a staffing shortage is not the patient's problem. It is very much the patient's problem and it is his/her care that is directly impacted by this shortage.

Inappropriate staffing levels are the nurses' problem only in that they impinge upon the care that nurse gives. Nurses are not complaining because they're tired and stressed; they are tired and stressed from complaining that they cannot give the care they believe the patient deserves to receive.

Specializes in CV-ICU.

I know a supervisor who quit hospital nursing because she got tired of nurses on poorly staffed units demanding more nurses when there were no warm bodies (nurses) to be found anywhere. I don't think it's the middle managers who are to blame; but the manager in this instance should have supported her staff. As nurses, we are always trying to "fix" things and bending over backwards to make it easier on the patients, etc. Maybe it's time to be honest with the public and let them know that we can't keep doing what we used to. I believe that most nurses try their best, but I feel the public needs to know that we aren't waitresses, and chest pain is a priority over a glass of water.

This is a "let it go" situation. I agree with the poster that said that telling families you are short never helps; but the smart ones figure it out by looking at what is happening.

Next time, trying agreeing with your complaintant. Agree with them that it is frustrating that they didn't get their water promptly. Tell them you got "derailed" and apologize. [not profusely, just: "I got distracted by another situation and I am really sorry I didn't get back promptly. I know that is frustrating for patients and families alike."] Get them their water. Try to check on them a little more frequently that night and there after.

Since there is nothing you can say that will necessarily mollify them, agree on the part you can agree on: that this is a frustrating situation for them. you know all about prioritization and you did it right, but they're not going to go there. You're not going to get exonerated by them (or by your nurse manager, either it appears). Plan on this scenario playing out frequently in your future and develop the ability to take pleasure and comfort from the fact that you did good by the person that needed you most. The people that work with you and your high acuity patients appreciate your ability and skills, but it is a fallacy that we can make all the people happy all of the time.

I stew over situations just like this to this day, but ultimately I resolve it by talking to myself along the lines I just talked about. Good luck.

About 15 years ago at a "mandatory service management class we were told not to tell patients we were understaffed. An RN asked,"what should we say to the patient when we are short staffed?" No answer from management at all. (I left there after >20 years).

If they cannot tell you what to say, the advice to let the patient you take the concerns seriously yet have to prioritize may be the only option. Not details, just that you are doing your best but can only be in one place at a time.

I have a job at a good hospital where I can ask management for help. I wish this were so everywhere. What happens if nurses ask nursing management for help where you nurses work?

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Originally posted by Mijourney:

Hi goldilocksrn. I agree that someone who is designated as a leader should approach an employee regarding an incident in an objective way. If you were at fault for something, the ANM didn't demonstrate, in my opinion, a professional approach in managing the situation. Therefore, learning by example would be difficult.

I side with the posters who feel that you give a general response to a family member who inquires about a customer service issue. For example, you could have told the son, that on the way to get water, you were immediately summoned to another pt's room and left it at that. It's not his business to know why another patient/family needed you, because that would sacrifice confidentiality. You definitely want to avoid opening the door to potential legal problems that would involve you. I agree the honest approach would be best, but the fact that the son went out of his way to report the incident indicates that he has some internal issues to deal with. He may be stressed out. Just document this incident in your personal log so that you will have something to refer to if it goes any further or if it comes up on your job evaluation. If you encounter the patient or son again, just offer a sincere apology and show the son where he can get water if that's not out of the question. Families need to be encouraged to be actively involved in patient care, if feasible. Best wishes.

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