How to artfully dodge conversation?

[PeachPie]

Most patients know that you're in for a few minutes for your nursing duties, but there are always some who expect you to be an audience. Saying, "I'm sorry, but I really need to start a blood transfusion," or similar doesn't work. I'm all for some chatting a bit and building rapport, but how to I artfully and tactfully dodge people who want to talk and talk and talk? I had a lady the other day who expected me to sit down and talk to her every time I had to give a med or something. Since her family had called administration over a "rude" nurse, I had to indulge her and spent an average of 30 minutes in her room at a time, nurse manager's orders. Another time while giving an admit interview, a man kept lecturing me on politics and religion. When I asked him to please answer the questions so there would be no delay in delivering his necessary treatment, he said, "You people only care about making money, don't you?" Beforehand I had let him lecture me a bit to try to get to know him and build a bit of rapport. All the staff commented on how he's talk your ear off and throw a hissy fit if you tried to leave.

These kind of people are egocentric and accuse staff of rudeness if we do not sit down and talk/listen to things totally unrelated to their medical care. I've tried making excuses, I've tried twisting towards the door to show that I'm trying to leave, I've tried just leaving the room after asking them if they need anything. I try to butter them up beforehand with smiles and asking how they are. Sometimes it works, sometimes I still get reported as being a rude nurse. How do you deal with these people?

[Virgo_RN, BSN, RN]

One technique is to say "I'm sorry to interrupt, but I need to get going....is there anything else you need?" as you quickly move toward and out the door.

[justjRN]

These type of patients are manipulative of your time- whether they realize it or not sorry to say. Easiest thing i have found to do is tell a CNA, secretary or even the charge nurse to call my zone phone if i am not out of the room in such and such minutes depending on how long i will need to get done what needs to be done. When they call i will say something like "oh... i'll be RIGHT there" and immediately after hanging up say you're sorry but you have to go. Or have someone knock on the door and say Lab is on the phone or the doc or something.... just a couple ideas for you!! They have worked pretty good for me. I really have only had to "use" them on a couple ppl the past couple years- i do try to take some time to listen... but 30 minutes is excessive. That is 30 minutes i am not able to help my CNA or my other patients.

[mauxtav8r]

I will but in and ask (maybe bluntly) "Is there anything I can do before I go?"

Also, when enduring a sermonizer (on politics, religion, travel, life, death, etc.) I will purse my lips and ask something about the disease process, such as "hmmm. That's interesting. But, I need to ask you, was your blood sugar below 180 this morning?"

Also, the ever-popular, "That brings to mind a question. Do you mind if I take a look at your chart and we can talk again when I've had a chance to look into something?"

[kaiasunshine]

If you can't find any point in conversation to cut in and escape, which I've definitely had happen (some people won't let you get a word in edgewise), just interrupt and say "I'm so sorry to interrupt you because this is really interesting, but I told one of the other nurses that I would be out to help her as soon as I was finished in here, and she really needs me now. Before I head out is there anything else I can do for you?"

If there IS a brief pause in conversation where you are given an opportunity to respond, walk towards the door as you're replying, and the second you finish the reply ("I know, this world is getting crazy!" or whatever you're talking about) add "Well I have to get going, is there anything else you need before I do?" Or something like that.

I work in LTC and unfortunately many of the people in the facility are pretty lonely, so there are a few people in your day who will talk and talk and talk and never let you leave. Sometimes I ask them to "hold onto that thought" because I have to get onto my next task, but "I'd love to come back finish this conversation when I'm not so swamped." That works too but not so much in acute care or when you know you won't get any free time that day!

It's sad, so many people in this world just need someone to talk to, but have absolutely no idea just how busy a nurse's day is and sometimes it's so hard to break away!

[november17, ASN, RN]

Learn to take control of the conversation the second you first walk into the room. It takes a little practice! I generally don't ever tell people I'm busy and if they ask if I am I skirt around the answer. Be firm, but sweet and nice.

[scg08rn]

Some patients in my facility are well known to talk your ear off and keep you in the room for non-nursing reasons or to complain about what they've already complained about to the ombudsman/previous shift. However, the staff knows who these people are and we all help each other out by calling the "held hostage staff member" out of the room for "so and so patient needing them" or paging them overhead/in the rooms to report to the nursing station for xyz reasons. It's hard to steer away from some patients, but they can't gobble up all your time when you have other patients to see and take care of. Unless it is a medical reason, I will take the extra 5-10 minutes to listen. But once they start going off topic or elaborating on what they've already elaborated on once, I usually rephrase their complaint and tell them it'll be addressed to the appropriate person / doctor and I'll get back to them about it as soon as I can. I never phrase the time limit of which I will return, cause they will hold it against you.

You are one person with listening ears for not just them, but they don't realize that all the time

But for 30 minutes for one patient just generally speaking? If he wants all that attention, might as well just be his private nurse!!

[anonymurse]

My pager is set to the loudest tone and it's pretty much guaranteed it'll go off every 5 minutes, so all I have to do is hit the button, peer at the screen, smile and say "sorry, I have to get this," and I'm gone.

[mauxtav8r]

I generally don't ever tell people I'm busy and if they ask if I am I skirt around the answer. Be firm, but sweet and nice.

Excellent point. I, too, NEVER tell pts I'm busy.

[jessiern, BSN, RN]

Since her family had called administration over a "rude" nurse, I had to indulge her and spent an average of 30 minutes in her room at a time, nurse manager's orders.

/rant

Did this same nurse manager also "order" a lesser amount of patients for the nurse given this patient to make up for her monopoly of time. If not (and I'm sure not), other less demeanding patient will only suffer in the end. If the nurse manager is that concerned, perhaps she should spend her precious time in the room all day listening to Ms. Motormouth.

/rantover

Sorry, sometimes management really irks me

[thegreenmile]

"Oh, that's ______ and, I apologize but we need to focus on_______at the moment, when I have a break in between patients, I'll be happy to chat"

[JB2007, ASN, RN]

I let them talk as I give them care. When I am done with the care I ask if there is anything else they need and then I leave the room. I wish I had time to hold their hands and talk for hours, but I do not have that kind of time.