Exit Strategies For Nurses Who Deal With Overly Talkative Patients

[TheCommuter]

Quote

I am a nurse who deals with multiple patients during the course of each shift. Sometimes I'll get a patient who simply talks too much and won't let me leave the room. Sometimes a family member will be the one who is talking too much, keeping me in the room and hogging my limited time. My question is this - how do I remove myself from overly chatty people like this without being rude? I am busy at work and have other things to do, so I can't talk to these people all day.

Many nurses seem to ask variations of the aforementioned question. We want to be polite to our patients and visitors, albeit for different reasons. Some of us believe in the, "treat others as you would want to be treated," mantra, whereas other nurses are merely trying to avoid being reported to management because some excessively chatty patient or family member wanted us to sit in the room and talk to them all day. Still, other nurses have fast-paced, busy workloads and just do not have the time to hold a lengthy discussion with someone who wants to tell you his life story. Either way, nurses want courteous ploys that will get them the heck away from that talkative person, if only for a brief period of time.

The timeless exit strategy for nurses is an adaptation of, "I really need to be somewhere right now, so you'll have to excuse me, but we will definitely talk later."

Some variants that sound truthful and plausible in the healthcare environment

• I am expecting an important phone call from a doctor right about now. (S)he is going to phone the nurses station, not my personal phone, so I need to be there to take the call.
• A meeting is scheduled to start in a few minutes and I am supposed to be present
• I need to accompany one of my other patients to another department for an appointment.
• I am beginning to feel dizzy. I need to get something to drink, but I'll be back to see you later.
• I forgot to do something very important. Please excuse me for a moment.
• My manager wants to see me right now. You will have to excuse me.
• Of course, always feel free to say, "I enjoyed talking to you. We can resume this discussion at some other time," if you want to maintain an impression of warmth and geniality. Smile while you are telling the patient or family member these things.

Here are a few more pointers

• Keep in mind that you are telling the patient or visitor that you're leaving the room. You are not asking them if you can leave the room, so do not ever frame your statement as a question.
• Please don't kick yourself over the fact that you are telling the patient or family a little white lie.
• If the patient or family member does not seem to understand the hints you are dropping, you will need to be more upfront: "It's been a pleasure talking with you, but I really need to see my other patients and get started on my other tasks." Although management does not want nursing staff to mention the other patients they have, sometimes this is the only way the overly babbly patient or visitor will catch a clue that you have other things to do.

[HikingEDRN, BSN, RN]

I won't lie to a patient either. However, lol, as another poster mentioned, some people appear that they don't require breathing! I've had to insert my "I have to step out now, I'll be back to check on you," mid-word sometimes. I try not to do this but sometimes it's unavoidable. I usually accompany this with a light touch on the arm if appropriate.

[Kay28]

I work inpatient psych and some of my manic patients can be so hyper verbal and tangential you wouldn't believe it! Thankfully my coworkers are pretty good about rescuing each other from these situations.

[Ruby Vee, BSN]

I'm feeling dizzy and I need to get something to drink -- REALLY? I can just hear my manager if I said that to a patient. "What do you mean, you're putting your physical needs above the patient's need to gab?"

Seriously, I'd never use that one -- I wouldn't want the patients worried that their nurse might collapse on them!

[SubSippi]

My problem isn't figuring out what to say, it's waiting for them to take a breath so I can say it! I hate it when I have to cut someone off.

[Penelope_Pitstop, BSN, RN]

Say "ooh, that Mexican food I had at lunch isn't sitting well!" and run off.

I kid, I kid. :)

This is one thing that my Vocera is good for. Tell another nurse, "if I'm not out in five minutes, Vocera me." It works much better than someone coming to get you, because that person could end up being roped in as your replacement.

[817nurse]

If I know the patient talks a lot, I tell a coworker to come get me after about 10 minutes.

[DoeRN]

I'll tell them I have to make rounds and I'll be back in to check on you. I used to wait and try to talk to them but I also lived in a state that had fair nurse patient ratios. Where I am now I barely have a chance to eat let alone spend 10 minutes talking to people. I hate it but it's my reality. I would love to spend time talking and getting to know my patients.

Sent from my iPhone using allnurses.com

[Nashvillejeanne]

Oh, I sure can relate. I did home care and when people are isolated at home they LOVE the company. My advise....set boundaries.

So, when I arrive, " Hi, it is so nice to see you again. You look great, I have an hour today, so let's get started."

Towards the end of the visit, "I need to go on to my next patient. I really enjoyed our chat today and I will see you next week!"

I always let them know when I will return...seemed to work. In a hospital environment, I think I would do the same thing, just modified. Let the patient know when you will be back to check on them...

[m4howie, ADN, BSN]

Usually patients have questions or are talking about a very specific topic. I refocus the conversation onto that one issue and state, "Did you have any more questions about (insert topic)?" They usually get the hint and say no and I can exit with their blessing. I have learned with certain patients to give a disclaimer on entry like, "I'm in the middle of something but I wanted to check on you real quick." This way the know right away that this is not social hour chat time.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

I'm forthcoming with my patients. I introduce myself and explain my approach/plan for the shift. I tell each of them that I am required to divide my time up equally amongst each of my patients. I explain to them that I will stay and chat for as long as they like, but the clock starts ticking as soon as I enter the room. So, "if I'm 'needed' in your room for an hour, in an effort to be fair, you can multiply that by 6 and that's when you can expect to see me again:nailbiting:, since management dictates that we treat all of our customers fairly and with respect".

I point out the tracking device that is attached to our badges which shows our location every second of every day, and explain its mechanism of action. I've even gone so far as to demonstrate to family members how the badge triggers the light above the door to the patient's room so that others will know exactly where I am and how long I've been at that location. This works especially well for those patients who end every sentence with "and-umm", (letting you know there is more to come):***:.

I had to get creative after that one introduction at the beginning of the shift took me all the way back to great-great-great-granddaddy's Civil War days!

[SENSUALBLISSINFL, BSN, RN]

Where I work in ophthalmology, we are not so bound by what we can say, however, we get patients that are chatty and those 65 plus patients that we see a day per doctor do want to have that personal time with us technicians. I usually tell them "it was so nice seeing you again (insert name), I better get going, the doctor is waiting for me to finish so he can come in and see you". This works like a charm. As for when I work in the floor, I suppose one can know which ones are the chatty ones, if the team is a cohesive one, alerting some co-workers in the team (after all just telling one to come to the rescue may not be successful in case they have the same issue at the same time....LOL) to come and get me in five minutes or page me, is the tactic I may want to use. Definitely, I will not use the fainting one....LOL

[malestunurse]

I point out the tracking device that is attached to our badges which shows our location every second of every day, and explain its mechanism of action.

You are tracked everywhere you go? That sounds horrible. Why?