Come backs...

well....

how long is it going to be?

answer: "and what time was your appt?? oh, that's right - there wasn't one...."

for pt's on the phone ...

answer: "hang up the phone now, or get placed behind all the other pt's"

call light pt's ....

answer: (i once truly told a pt this, my co-workers still laugh)

"do not ring that button unless you are having chest pain or you cannot breath - otherwise, i don't want to hear it"

for those extra people....or eavesdroppers...

answer: simply tell them to leave

for those who have multiple phone calls/messages....

answer: go to the pt room - tell them that the ER is busy and they need to let family/friends know to stop calling - provide them w/ the phone if neccesary.

and my most favorite answer to absolutely any complaint/gripe of pt's re: care, past care etc....

in the nicest voice and most pleasant smile "I understand that due to your lack of medical knowledge it is difficult for you to understand, but.......(and then explain an answer to whatever question they asked)...... it kinda answers their question, shows them how stupid it was to ask in such a way....and says f$&% you in a pleasant way......:chuckle

I like Althomas answer for the pts who don't get off the phone when you walk in.

As far as having too many visitors, our policy is also 1 visitor per pt, and is usually strictly enforced with some exceptions, like parents of small children.

#3 is my pet peeve, usually it's the family members standing at the door, walking in the hall, and some even trying to peek in other rooms to see whats going on. I always ask them in a firm voice to remain in the room with the patient, or they can go to the lobby, because they are compromising the privacy of the other patients.

It seems like everyone wants to know exactly how long the wait is, how long it will take labwork to get back, etc. I usually try to overestimate the time so if the wait is shorter than my estimate, they are happy, if not, they were expecting it anyway.

Most of the time it depends on the person you are dealing with, some people you just can't please no matter what you say or do.

For people that are nosing around, try to find out what is going on with other pts, I usually say quietly,"Excuse me, I need you to return to your( room, waiting room, whatever,)how would you feel if this were (you, your mom, dad, child,whatever) and strangers were looking in?"

Altho I have also been known to say,"Do you see something you want to buy, or are you just browsing?"

I think you may just need to remind yourself that you are not there to support violation of hospital rules, rude behavior or satisfy everyone's "need to know". I never worked in a hospital without phones in the rooms (other than ICU and I never worked there) so that one I never dealt with. The others, though, I was just firm and clear about what needed to happen. We need to provide professional and compassionate care, but that doesn't mean we have to be put up with patients and families behaving badly!

my favorite when pt's and or thier visitors (and alot of time the visitors are the worst) get.... well you know. "and you went to what medical school?" :roll

Originally posted by MAGIK GIRL

my favorite reply for when pt's and or thier visitors (and alot of time the visitors are the worst) get.... well you know... is "and you went to what medical school?" :roll

This is one chance to use HIPPA to your advantage. Just say, " Sorry, due to federal guidelines and HIPPA, only 1 visitor, no phone calls, can't give out info, stay in the patients room, no looking at the pt board for your friends names, no more eavesdropping...etc...." I never hesitate to tell people to go to the waiting room, they are violating other patients privacy and such. and I don't ask them, I pleasantly "tell" them.

Originally posted by momoftriplets

This is one chance to use HIPPA to your advantage. Just say, " Sorry, due to federal guidelines and HIPPA, only 1 visitor, no phone calls, can't give out info, stay in the patients room, no looking at the pt board for your friends names, no more eavesdropping...etc...." I never hesitate to tell people to go to the waiting room, they are violating other patients privacy and such. and I don't ask them, I pleasantly "tell" them.

don't ya just love havin' the "power" ?:roll

Where I USE to work, there was only one statement that the nurse needed to be mindful of when dealing with patients and family members:

"The patient is always right. It's their right to have their own way. Do whatever it takes to see to it that they get what they want when they want it, or if you don't.......it will become a BIG 'PR' issue."

As long as we nurses kept that in mind, all was well. To heck with the stress placed on us for trying to do patient care safely and without 'PR' on our backs.

Nurses were the only ones scolded. Docs got their way, patients, visitors, and family members got their own way, and no matter how good you tried to do your job......it was never good enough. Treat 100 patients well, and no glory for you. BUT...let ONE doc or patient get unhappy and you were crucified for it.

There is NO mercy on the nurses!

I think the way to deal with most of these situations is just use firmness. I always fall back on the saying "I don't make the rules, I just enforce/follow them. It seems to work most of the time.

As for the question we all love "can you tell me how much longer?" I just tell them; if I told you a definite time I would be lying.

I however, do not tolerate rudeness or verbal abuse. I know the patient is the customer and we cannot refuse treatment, but there is nothing in my job description that says i have the be treated badly by anyone.

I may come off as being harsh sometimes, but it is my job to take care of patients and that is my number one priority.

Cant do that nowadays with Press gainey, and all that consumer satisfaction stuff.

the good old days

1. Pt. talking on the phone while I am trying to triage, assess, or discharge.

I tell them they can either get off the phone or they can wait till I am done with the next patient or anything else that pops up. They put down the phone right away.

2. To many patients family members in room- can't barely get to the patient. (Even though there is a sign stating 1 visitor per pt.)

Usually start off with reminding them that we only allow 2 visitors per room (I am trying to reduce it to 1 visitor), and kindly ask them to thin their numbers. Most of the time, I don't care, but if the visitors get loud or needy, I ask them to leave. Our people in the front desk are great about calling back and seeing if there are already visitors in a room. Also, in situations like chest pains, the front desk/triage asks all "visitors" to stay in the waiting room until we are done with the line, labs, ecg, and chest x. After that, visitors are more than welcome, even if it is over the allowed number.

3. Pt's or thier family members standing in the doorway/hallways listening to everything at the nurses station, staring the doctors/nurses down being impatient.

Like others have said, I tell them to stay in the room or they can go to the waiting room due to patient privacy laws.

4. How long is the wait today? Do you tell the pt's it is going to be several hours??

I do try and give a number, based on their triage acuity and longest current wait time I try to estimate. But I always say that it can be longer, especially if ambulances come in with really sick patients. I usually overestimate by at least 20 min.

5. The patient that is on their call light every few min. for stupid things.

First couple times, I answer. I even bring in blankets and pillows to make them comfortable which sometimes stops the constant buzzing. If this does not work, I take the button away or disable it. (I have done this very few times, never with a critical patient.)

6. The family member that rings the call light constantly to adjust mom's pillow, feed her, fix the blanket, get water etc.

I tell the family members that they can do simple things themselves and show them where the food and water is only if the patient can eat/drink.

7. "I had to wait here 6 hours last time and you (the ER) didn't do a *@#! thing and it better not be like that this time"

8. Little kids running around the ER, in the room even though there is a sign at the door stating no visitors under 12.

9. Family members, friends, cousins, etc all calling for the same patient, we don't have phones in the rooms and this is very time consuming and then when you ask to have one person designated to call they get nasty or state- I don't have that phone number and can't get it unless I talk to ---(the pt). or worse- you have 50 people calling to "give messages" to the patient. HELP!

We have phones in the rooms, so I have not had this problem. I would follow other peoples advice.

A common thing I hear, especially in triage is something like "Why are people going before me? I was here first."

I simply explain that while we do bring people in back based on first come first serve, we still need to cut people to the front if they need immediate life saving attention. I never ever ever ever ever ever say things like "because that patient complained of chest pain so he needs to go back first." If I did, I am afraid everyone in the waiting room would have a sudden onset.

I believe in being direct and explaining why. It usually solves all problems the first time.