How much is too much?

[EricTAMUCC-BSN, BSN, RN]

Yesterday I was caring for a patient with chest pain during my med.-surg. clinical. She was agitated stating "no one has told me anything about what's going on!" She had just been brought up to the floor and I was one of the first people to talk to her following the admission paper work. She stated she came to the ER around 0230. I asked her about her symptoms to try and understand what was going on. After looking in the chart and talking to her I tried to tell her what might be happening with her. I also warned her I didn't want to go into detail since she hadn't talked to the physician since the ER. The information comforted her, but she was a demanding patient. She demanded coffee, and complained about receiving sausage on her breakfast tray. She demanded constant consoling and conversing. She was impatient and I went out of my way to console her and assist her. She took time away from my other patient who was just as important. How far should a nurse go to please the patient/ customer?

[roxannekkb]

First off, I have never seen a patient as my "customer" even though that is becoming hospital newspeak. People who are sick and need to be hospitalized are patients. Second, I think you have to do what you can. Take care of your priorities first. Don't delay a medication for one patient, say, if another is demaning that you bring her fresh coffee. It can be difficult, but you have to be polite, courteous and firm. Saying something like, "I will check back with you in an hour," and then leave the room.

Patients are difficult and demanding for any number of reasons. For some, it's just their normal personality! For others, they are frightened, confused, in pain, depressed and so on. But healthcare being what it is, you can't be a person's private maid service. Spend as much time as you can, trying to find out where the problem may lie. But then you have to move on--and as I said, you never delay essential work with another patient.

Hope this helps.

[Tweety, BSN, RN]

Sounds like this patient is one of those who never will be happy no matter what. With a patient like this I do my best to stay cheerful, win them over, give them the impression that I care and that I'm trying. But also set limits, not be at their beck and call, knowing that they might complain. Alert your charge nurse and manager to the potential that they may complain and that you are doing your best.

roxannekkb, our hospital too is using "the patient as a customer concept". But also the "nurse as a customer" concept to in their new nurse rential and recruitment goals. As well as "physician as a customer". We're all customers, isn't that special. (rolling of eyes).

[roxannekkb]

When I was in nursing school, they wanted us to call patients "clients." I told my instructors that until that time when I set up an office and hung up a shingle, and people came to me (as opposed to being assigned to care for them), and paid me directly--they would remain patients.

My speech generally left my instructors somewhat speechless, but I never used that client word.

This customer service bit is really grating. How about doing some of the old fashioned things to keep patients happy, like supplying enough nurses! And as far as nurse and physician as customers, well, my eyes are rolling right out of the sockets. LOL, is that the way they hope to retain nursing staff?:roll :roll :roll

[AHarri66, BSN, RN]

I don't see the problem with calling patients "clients." They are clients by definition. They are, either directly or indirectly, paying us for our services. They expect a certain level of expertise and professionalism, as well as to be a part of the decision-making process regarding their care. And if they aren't pleased with what they receive (barring emergent situations) they can and do take their "business" elsewhere. And in the event of a "bad" situation (emergent or otherwise), they can and do sue "us" for not upholding our part of the "contract."

Healthcare is a contract: we contract with our employers to provide care under their umbrella, and the employer contracts with the "client" to provide them with the umbrella's services. Simple economics.

I think considering a patient a "patient" places them at a disadvantage, in which their care is something that is done to them, rather than a contractual agreement in which they are a part.

[sbic56, BSN, RN]

Yes, clients fits for me, too. Customers, absolutely not. Wal Mart and LLBean serve customers. I provide a service and certainly will treat you well, give you the best care I know how and hopefully be instrumental in helping you, but I am not a waitress. There is nothing wrong with waitresses. I used to be one, but now I am a nurse. Sometimes I feel like a waitress with an advanced education and there lies a portion of the reason for my dissatisfaction with the profession.

[Rapheal]

How much is too much? You will learn more how to deal with this type of patient when you have more experience. It will just come to you with time. Until you have the experience here is a phrase I use that I hope may help you. I say "I need to attend to another patient - I will be back to check on you." Bear in mind to never say what you are doing for another patient and to never say a set time unless you will be back exactly when you say you will- because that patient will be counting the minutes. You probally will have it down before you finish school. Good luck and hurry up and get out of school-we need more nurses.