can we legally refuse patient care in this situation? it's driving me crazyyyy

[willowRN]

i work in a telemetry/ progressive care unit and we get like 7 patients max of 8

Now some patients and their family members are so demanding you're gonna spend all your day in their room with all their requests. Like wanting to transfer patient every hour when she's like total assist.. stuff like that. what can we do ?!

[ckh23, BSN, RN]

Give the family the things they need to get involved and provide some basic care of their own. I find that families are more than willing to help if you guide them and give them boundaries on what they can and cannot do. I also find that by letting them be involved decreases the amount of time they spend asking for things. Sometimes it is just a control issue. Now of course this doesn't work for every patient and family and sometimes there just needs to be tough love.

[SHGR, MSN, RN, CNS]

I think you (or your patients' family members?) are confusing limit-setting with refusing care. Setting limits is an important skill and it will save your sanity. I don't mean in a mean way, I mean you have to be honest about what you can and cannot do, and you have to safely take care of all your patients.

Everything else is gravy. Or frosting. Or whatever that metaphor is.

[HeartsOpenWide, RN]

Move to ca. Max ratio 1:4, 1:3 for more high risk in pacu

[RNsRWe, ASN, RN]

I agree that you have to set boundaries for families that are this demanding. You need to pull out your diplomacy skills, because you're going to have to make them understand that you are going to do everything you possibly can for their loved one, BUT you cannot accomplish everything they are asking for and still take care of everyone else's loved ones. Therefore, they have to be on the same 'team' with you in that they can/should do everything THEY can for the patient, and provide you with a (hopefully short) list every few hours of what they'd like. They need to know that if it were within your power and abililty, yessiree you'd be right there. But as it is, you just can't, so maybe they can help you get so much more for Loved One?

MOST families, when presented this in a pleasant, non-judgmental, gosh-I-love-your-Loved-One sort of manner, will work with you. They want you on their side, after all, and sometimes they just honestly haven't figured out that they ARE too demanding. Remember, they see Loved One as your only patient, regardless of the fact that you have six or seven others.

I have had success with asking Family Member to write down a list of what they absolutely must have me do for Loved One that shift, or at least for the next few hours. Tends to make the silly requests minimized, as they stand out.

[N.U.R.S.E.]

you must care for your pt however you should learn to delegate the tasks that can be delegated. and sometimes you must tell the family member no or let them speak with your supervisor and practice your therapeutic communication skills most people will see that you are go and do everything that is in their care plan and try to anticipate their needs

[martymoose, BSN, RN]

how can you set limits when you are being told in essence to kiss these people's and pts orifices????All for customer satisfaction? Will you customer be satisfied that you gave them limits as to what theycan or can't have? that will garner you a score of ZERO on your PG or hcaps.

any suggestion?

[elprup, BSN, RN]

One thing is to voice your concern to legislature. N-STAT! - American Nurses Association

[MunoRN, RN]

Whether or not someone is satisfied with the care (and service) you provide is not so much based on the care you provide as it is on how the care you provide compares to their expectation. Setting reasonable and attainable expectations from the very beginning is the key. Other than that, delegate as much as possible and get the family to do as much as possible; who's gonna get grandpa to the commode when he gets discharged? To answer your first question, you can legally refuse any unsafe assignment, but your employer can also legally fire you for doing so.

Staffing ratios hold some promise, but not the ANA's version. I work in a state with the ANA safe staffing law. All it requires is that hospitals set up a committee to make safe staffing ratio recommendations, which hospitals are then free to ignore if they so choose. (Guess what hospitals are choosing?)