Advice on "setting boundaries" - page 2

Hi! I recently passed the NCLEX, got my license, and will start my very first job in a couple of weeks. Aside from all the other new grad concerns (time management, etc.), I know that I will have a... Read More

  1. by   Morainey
    Being calm and assertive is something I still struggle with, but it's a 'fake it til you make it' skill. My helpful hints are don't blather on and don't apologize if the request is unreasonable.

    Scenario: A 15 year old patient's mom is staying with him the night. She asks for applesauce, apple juice, orange juice, toast, and if we have any sandwiches, that would be GREAT. No please, thank you, or alternatives sought (ie, "are there any vending machines or places open in town where I could get XY and Z?")

    Old me: "Ummm... sure. Let me just get those for you." *goes, gets the stuff, complains about them at the nurses' station*

    New, calm, more assertive me: "We don't, unfortunately. There is a vending machine on the ground floor". *leaves*

    Fight the urge to apologize or blather away excuses. The more you do it, the easier it gets.

    BY THE WAY this doesn't apply to reasonable requests of the actual patient.
  2. by   MrChicagoRN
    Quote from meanmaryjean
    I think the BEST approach is to run these scenarios and responses past your new manager- and say "What is acceptable on this unit? How would you like me to respond when these types of situations arise?"

    You did an excellent job of presenting your issue in writing, analytically and with good self-awareness - do the same verbally to your manager. If you respond in a manner he/she has already said is OK- you will always be backed up.

    Good advice.
    And seeking the counsel of other reasonable clinicians is never a bad idea.

    to OP:

    It's OK to say no, but a brief explanation and offering an alternative is a great way to handle it. And by brief, I mean ~15 words or less. "No, I'm sorry I can't do _______, because_______, but perhaps (you/I/visitor/the doctor) could _________"

    Somebody is mildy rude, ignore it. They're sick, scared, angry, under a lot of stress, whatever. They're reacting to what's going on, and it has nothing to do with you.

    Very rude? I just say, I'll try to help you to resolve this issue, but I would never speak to you that way, and would appreciate it if you would do the same.

    Continuing rude? You're upset right now, I'll come back when you are feeling calmer

    Keep in mind that acting out may also be due, in part, to pain or anxiety, so an offer of medication may be appropriate.