help!! very frustrated

Wow. I'm so sorry to hear about your frustration. I'm just a nursing student trying to overcome HUGE hurdles just to become a nurse! (I'm 34 years old, second career). I really feel that this is what I REALLY want to do. But back to your story. What you describe is what my (uneducated) opinion was of a nurse MANY years ago. Little did I know how much education a nurse really has! The passion, the drive...you would't be there otherwise. How long have you been a nurse? Would you consider working someplace else?

Ah, yes. We are "just" the nurse that patients can call on when their backs need to be scratched and the like. While we may recall that in nursing school, it is the nurses job to be the primary caregiver/health provider ala Florence Nightingale, meaning we do EVERYTHING from bedmaking to spongebath to massage to offering of bed pan, I so agree that there is a limit especially when the patient who asks for it is in stable condition, and there are other patients who should be prioritized more as they are in critical care. First, I believe that we must act and look in authority all the time. I bet they don't ask ice chips from the doctor. Meaning, stand proud, make your voice clear and with distinction instead of acting meek and silent so that when you enter a room, patients will recognize your "credibility". As superficial as this may seem, but so true. Second, draw the line when needed and be firm without being rude. Try saying, "Okay, I'll help you to the bathroom this time, but later on, you should do this yourself as you should now be walking." But of course, tell the patient that you're in the station if anything happens.

i think this is what frustrates me the most. i am trying to bea good nurse. one who is smart enough to recognize a bad satiation and notify the doctor. one who is well informed to know the pathophysiology of a disease and to be able to anticipate the ordered rx before the doctor even sees the patient. one who knows about every medication there is out there, their side effects and expected outcomes. one who has multiple iv skills, f/c, ng tubes, jp tubes, all tube skills for christ’s sake!!! but how the hell are we supposed to be that nurse when you spend half your time, fluffing pillows, filling water pitches, getting news papers etc!!! i feel the urge to yell very loudly right now!!!!

Please tell me it's not really like that!...

i think this is what frustrates me the most. i am trying to bea good nurse. one who is smart enough to recognize a bad satiation and notify the doctor. one who is well informed to know the pathophysiology of a disease and to be able to anticipate the ordered rx before the doctor even sees the patient. one who knows about every medication there is out there, their side effects and expected outcomes. one who has multiple iv skills, f/c, ng tubes, jp tubes, all tube skills for christ's sake!!! but how the hell are we supposed to be that nurse when you spend half your time, fluffing pillows, filling water pitches, getting news papers etc!!! i feel the urge to yell very loudly right now!!!!

a-men!!!!!! this is exactly what i am saying!! i am the professional, knowledgable, competent rn who struggled to get thru school, so that patients who are admitted to the hospital can have their very own maid, waitress, or babysitter!!! i am very frustrated!!

Setting limits can be huge. Saying sure I'll adjust the head of your bed for you, next time though this is the button you push to move your bed. Or I can grab your tissues, and I'll move them closer so next time you can reach them.

If you're doing frequent rounding before you leave the room ask them if they need anything then. Hopefully you can deal with the ice, fluffing, positioning issues right then and not when you're in the middle of something else.

Or like someone else mentioned just anticipating needs. If you know needy nellie like her ice water get it for her ahead of time.

If you really don't have the time tell your patient that they'll have to wait for you to get their coke. water. whatever and tell them when you'll be back. Then try your best to actually be back at that time.

Sometimes the reason for that kind of behavior maybe something else. Your patient might be scared and not want to be alone. Or is unsure that you'll actually be there if they call. An experienced nurse told me that she deals with these kind of patients by being in that room as much as possible for the first part of the shift to reassure the patient that she will be there if something happens.

I haven't tried that myself but it's an idea.

I see two things. One is that it appears that the auxilliary staff are not doing there jobs. I only just graduated, but from my experience working as a tech it was always our jobs to do this sort of thing and if we didn't we were quickly reminded that it was our jobs and we needed to get busy about it. The second is that you need to remember that for many older people a trip to the hospital is like a trip to the spa. They are probably lonely at home, so when the get to go to the hospital, it is like a treat because of all the attention and company they will get. My grandmother, after my grandfather died was that exact way. She could not wait to go to the doctor because of the attention she received when she was at his office. Not only that, but she even had a clock that she would mess with, make it not work right, then have to take it to the clock maker in order to get it fixed...once again, extra attention. It got to the point to where the clock make told her not to touch it again. My point is that these are lonely people and probably looking for attention. So, pass it to your techs and CNAs to take care of the small stuff so you can focus on what's important. One last thought. Have you talked to other nurses on the floor to get a sense of how they feel? You may not be the only one. This is a concern you may want to take to your manager, especially if there is more than one of you who feels this way. That way you could come up with ideas as a unit, as to how to deal with this problem. Good luck to you, I hope you get it worked out.

When you first round on your patients, be sure to scan the room in anticipation of things they might want/need. Make sure the bedside table is on their preferred side, that everything on it is within reach, that they have full water pitchers, that they have enough blankets, that they are offered the opportunity to use the restroom, etc. etc. When I worked the floor, this frustrated me to no end. I would literally watch an aide walk out of the room, then two minutes later when I went in to do my assessment, I'd find the water pitcher bone dry, the patient freezing cold or needing to use the restroom, and the bedside table clear across the room. It's frustrating to go into the room for a specific purpose, and have to tend to all of these needs when the UAP was *just in there* a few minutes ago, and did none of it. But, I'm not sure that's what's going on where you work. At any rate, the general survey of the room at the very start of the shift should help some. Next, whenever you leave the room, ask if there is anything they need, and tell them it may be an hour before you can get back to them. Tell them that you will be back, and that you will address anything that can wait until you get back at that time, and to feel free to use the call button if there is anything that cannot wait, such as an emergency. Then, do your best to check on your patients every hour or so. Enlist the help of the aides to alternate hours with you. You could take even hours and the aides could take odd hours, or vice versa.

I do have to ask, where are your aides? They are supposed to be answering those call lights too.

Cant patients raise the head of the bed on their own?!

Cant patients raise the head of the bed on their own?!

Many can. Although on our beds, the controls are in a spot that can be hard to reach for people with limited mobility. Or the person can't see very well to determine which buttons do what.

One place I worked had a pretty good system. All call lights were routed through the UC. She would ask do you need a nurse or tech. Then ask what they needed. She would then phone the appropriate person. (We all carried phones). It helped we had great techs and great nurses. And good ratios! The current place I work has one tech at night despite our census which can be from the teens to high 20s. I still made it a practice to try and address needs when I do my initial assessment. Asking ahead about pain meds and sleep meds. i have noticed this helps some.

My Alzheimer's patient yell "Waitress! Waitress!" at me. They come up to the nurses station thinking they are at a bus terminal. They want a ticket out of there, now! Nothing these dear people do bothers me. The phone calls from families who call me to relieve their guilt at not coming to see their mothers bothers me though. They seem to think that visiting me on the phone is good enough. I really try to be polite. I have a MILLION things to do!