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How would you handle this?

Nurses   (4,004 Views 13 Comments)
by CrystalSSA CrystalSSA (Member)

CrystalSSA works as a RN.

1,465 Visitors; 31 Posts

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I work on a floor that is a medical floor. Many of the patients on my floor need tests and procedures, but are not on the schedule for them. The result is that we do not know when a slot will be open. We know they are going, we just don't know when. The hospital policy is that once we are told they are to go, we have 15 minutes to get them to the holding area.

The procedure areas are constantly telling us that we are not meeting that 15 minute rule, and we are not.

I tell the patient they are having the procedure, they are aware, but when they phone and tell me to send the patient, the patient always ALWAYS has some excuse as to why they cant be pushed down now.

The patient seems to think they have the right to delay. Since we don't know ahead, we cannot go into the room and make sure the patient has had everything they desire prior to going.

Does anyone else have to deal with this, and how to do meet the deadline? Sometimes I think telling the patient there is a deadline makes the patient go slower. They do not care that it is costing the tax payer up to $500 an hour to hold that spot for them, they suddenly decide they want to do "Whatever" before they go.

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6,851 Visitors; 230 Posts

Seems like an absurd policy. Nothing happens in under 15 minutes in a hospital. What kind of delay is the patient causing? They need to give you a 30 minute heads up or an estimated time if they plan to require a 15 minute turn around. Most procedures in my hospital (which is large) take more than 15 minutes to even GET to never mind get ready, in the chair or stretcher, and taken down. If you know a patient has to go at some point, all paperwork and prep work should be done. We also do not have a transporter, so most of the time patients are taken down by a tech or aide, so if the tech or aid is with another patient, that causes a delay.

I think your policy is unrealistic. But I guess it depends on your facility size, do you have a transporter, what is causing the delay. You need to tell the patient they need to go now. Only delay I can see on their part would be if they were using the restroom or need pain medication. You will need to manage the patients expectations too. In the morning tell them, you have this procedure and when they call you will need to leave immediately. So they know.

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7 Likes; 13,742 Visitors; 11,114 Posts

It appears by your description that this policy isn't working for anyone-- your floor (and probably others), the departments, and the patients. So, the obvious answer is that expectations and policy need to change.

 

Most departments have a decent idea about their workflows and can estimate when a testing slot will be opening up. Can they be persuaded to expand their notice to 30 or 45 minutes? That would seem to go a long way to meeting their needs and yours.

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1 Follower; 16,204 Visitors; 1,003 Posts

15 minutes is a bit absurd. Depending on the patients condition it might take longer than that to get the patient ready for transport. Some patients require a nurse to escort them and it takes time to round on the rest of my assignment and find someone who can cover. Is there someone that you can give feedback to? Sometimes polices are not effective, this seems like one of those.

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12,889 Visitors; 905 Posts

Do you all tell the patients "sometime today we will be going down to blah blah place and doing x test. I'll come and get you when we can go." Or do you all spring it as a surprise? People like routines; make sure they're prepared for what will occur.

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Ruas61 has 35 years experience as a BSN, RN and works as a Nurse.

8 Likes; 31,212 Visitors; 1,366 Posts

They do not care that it is costing the tax payer up to $500 an hour to hold that spot for them, they suddenly decide they want to do "Whatever" before they go.

Whoa, Nellie. You bringing up payer source is not appropriate. It comes across real bias.

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applewhitern has 30 years experience.

3 Likes; 25,262 Visitors; 1,871 Posts

Crystal, for now just document that you informed the patient, had the patient ready, and the patient caused the delay. This is just so they don't "blame the nurse," because they will! I agree the 15 min. time span can be problematic. Most places do the "outpatients" first, and can only guess what time inpatients can be done. I know exactly what you mean, though. No matter how much prep goes into it, the patient seems to always have to pee, take another bath, make a phone call, etc. etc., just when they need to go.

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VANurse2010 has 6 years experience.

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I think it's a legitimate concern. The patients' unwillingness to meet us halfway is a huge reason health care costs are out of control.

Whoa, Nellie. You bringing up payer source is not appropriate. It comes across real bias.

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CrystalSSA works as a RN.

1,465 Visitors; 31 Posts

The elevator to the procedure area is right beside the rooms. They allow us to either push the patient down in a wheelchair or their bed, the choice is ours or the patients, they will accept either. Sometimes I feel like its a control issue. I come in and say, "Hey, it's time to go", and they say, "I need to poop" or "I didn't finish eating yet", or "I want a new gown first and new bedding on this bed". Since we don't know exactly when they will be called, I cant make sure the patient has pain medications, so I usually have to give those too.

I am not blaming the procedure area, they are doing us a favor by squeezing the patients in.

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Ruas61 has 35 years experience as a BSN, RN and works as a Nurse.

8 Likes; 31,212 Visitors; 1,366 Posts

I think it's a legitimate concern. The patients' unwillingness to meet us halfway is a huge reason health care costs are out of control.

She spoke directly about tax payers money being wasted. That implies people on government assistance programs. I don't think that is an appropriate remark. Please re-read the post.

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7 Likes; 13,742 Visitors; 11,114 Posts

Could be a VA, could be someone who's just cranky. Don't think it matters-- any patient in a hospital needs some modicum of control, and this might be the only one any of us ever get if we're in the bed. I hope they can work out the advance notice thing because if they can't it will never change.

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SoldierNurse22 works as a L&D Nurse.

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She spoke directly about tax payers money being wasted. That implies people on government assistance programs. I don't think that is an appropriate remark. Please re-read the post.

...because taxpayers never waste their own money, right? If you're offended because you think she "implied" something...well, wow.

OP, I understand your frustration. Our hospital was huge and we had the same policy. Transporters could barely make it to the floor in 15 minutes, much less have the patient to their procedure in that time. It was a constant battle between the transporters, the floor staff, and the procedure techs/physicians. Of course, no one thought to change it.

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