Come backs...

Come backs are only thought, never spoken. You are right, it is bad for business and bad for me when they complain.

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

Start talking to the patient (with an expectant smile). They generally hang up. If they know I need to spend time with them, most people cut things short for me.

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.)

Depends, sometimes I send some out, sometimes I just let them know that they will have to move depending on where I want to be. We usually laugh about everyone having to shift around in the room. It doesn't happen to often. The other day the heater was broken in the waiting room so I let more people in. We have a 1 visitor rule but it doesn't always apply well. I use it when needed.

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.

Give them the choice of being inside the patient room (privacy and all that) or in the waiting room.

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

Tell them how many people are in front of them, tell them the approximate times for most tests, tell them the plan for what is going to happen. Keep them updated as we go along. I am generally proactive on this and tell them before they ask so they won't have to wonder.

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

Do everything I can think of all at once and ask for whatever else the patient needs. Let them know when I will be back. Sometimes there is just no hope for this one.

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

I set boundaries pretty quickly with this bunch. Let them know I will do whatever I can but show them how to help as well. Make a quick contract that we have everything addressed and that I am continuing on with my work. I try to let them know that I will be back in a while to check on them so they don't have to make up excuses to call me. Again, the power of knowledge, let them know what to expect.

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"

I always laugh inside at this group. Why are they back to see me if they don't want to be here? Once again, the power of what to expect in terms of how things are going to happen. I assure them that they will get the evaluation they need to rule out life threatening conditions but we may still have to refer them to another physician if they need more of a workup.

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

I close the door and keep the little critters in with their parent. I haven't yet turned a 3 yr old out into the waiting room by themselves. Keep any other adult in the waiting room with the kids.

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!

I transfer the call to the patient's room. This sounds like an equipment problem. I hope you have phones by now.

The last MVA I took care of the pt was on his cell phone. Im doing my head to toe assessment. The other RN is recording. Airway patent, pt has a positive CPS. the recorder stopped and looked at me questioningly. Pt has a positive Cell Phone Sign. If they are alert enough to use a Cell then they are neurologically intact.

The last MVA I took care of the pt was on his cell phone. Im doing my head to toe assessment. The other RN is recording. Airway patent, pt has a positive CPS. the recorder stopped and looked at me questioningly. Pt has a positive Cell Phone Sign. If they are alert enough to use a Cell then they are neurologically intact.

OK, so it's the middle of the night and I did not read carefully...

When I got to the "positive CPS" I kind of freaked because I didn't know what that was!:chuckle

With me, it is safe to say. That a lot of people truly dont know me or what I have said. I am an Original. Original what, though, no one can say for sure.

Just kidding

If family is standing around the doorway trying to spy on other patients I just tell them they need to stay inside the room or they might get shot by the next gangbanger bouncing through the ER.

Of course I say it with a smile

I am the queen of comebacks.