How honest are you?

Specialties Emergency

Published

Venting on another thread got me thinking about this. In our ED, all the rooms including the trauma bays are private, with both curtains and doors that close. Because of this, it's very easy for the patients, in their private rooms with curtains drawn and doors closed, to be completely unaware of the chaos that is unfolding around them.

Most people are pretty nice, and are very understanding, when asking what's taking the doctor/scan results/blood work so long, when you explain politely that there are a lot of sick people here today, and your doctor is taking care of the sickest first, the sickest people go to the scanner first, the lab is backed up because we've had a lot of really sick people, etc.

But some people just don't get that. How honest are you when communicating with such an individual?

Normally, I just give my standard response about the sickest taking priority, and they either get it or they don't. Only once have I been more blunt than that.

It was a well dressed middle aged woman in for a medication request; very low acuity. She didn't want to wait until her PCP could see her and adjust her meds, so she had come to the ED. She kept complaining and complaining about how long it was taking for the doctor to come back, how rude the doctor had been by taking a phone call and then leaving the room (the phone call was the charge nurse letting the doctor know that her pediatric patient had gone into respiratory failure).

After my standard response failed repeatedly to appease her, I finally told her that the doctor was with a very sick child. She said "Oh, my grandson was really sick once. He had a really bad cold. We took him to the doctor and got him some cold medicine.", then went right back to complaining.

I just walked out of the room and implemented the BNPOC- Benign Neglect Plan of Care.

Now, I realize it's not all about me, it is about the patient. I totally get that. And each patient is in a different place. Some are actively trying to die, some are nowhere near dying, and some are somewhere in between, and they all have individual emotional responses to where they are.

I question how much value it really has to be completely open with the less/not sick about why things are taking longer than they would like.

Have any of you Emergency Nurses been completely candid with a not-sick patient about this? Have you ever told them that the reason they are waiting is that everyone is in with a teenager who is bleeding out internally from a car accident, or a father/husband/grandfather who slumped over at the dinner table from a massive MI, or that their doctor is intubating a child?

Do you think there is any therapeutic value in communication this direct? Do you think there are some people that need to hear this, so they can put their own situation into perspective, or do you think it is more of a self serving move on the part of the nurse?

I wasn't calling him mean, I meant that my keyboard was blurry as a result of having tears in my eyes.

Oh, I understand completely...I just reread my post and wanted to clarify. Sometimes I wish I could be as elegant as some of the other posters when it comes to phrasing things, unfortunately I am not. For me it is a struggle to put down in words a scene I wish to convey, that is so poignant yet I feel important to share. I often feel I don't do it justice in my attempt to find the right words.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i have been very lucky (but then again, i have not had too many years experience yet) because most of my patients are very understanding and willing to deal w/a little wait time since when their turn comes i will strive to give them as much attention as i give the other patients.

one time i had a patient start crashing and we took an hour to stabilize him...we finally managed it. i turn to see a family member of a patient across the way at the door hesitating. i moved toward her and asked what was wrong. she stated, "something is not right with mom...she just lays there and has stopped talking." this was an acute cva we had admitted earlier.

well, my patient was now stable and good to go, so i let the charge nurse know i was going to check on my other lady. i walk into the room, lady turns to look at me...and proceeds to seize. later on it was determined she had also had another stroke! daughter was right to come get me, but when i first saw her at the door, for a split second i was annoyed...lol. i am so glad it only lasted for that split second. thankfully, rapid response was still across the way.;)

oh, and i forgot to mention: the daughter was very grateful and kept apologizing for coming to get me.

it's interesting, isn't it, that the daughter who really needed you was grateful and apologetic. someone who just wants more ice for their soda will be neither grateful nor apologetic.

Specializes in Trauma, Teaching.

I tell people "we've had a serious emergency down the hall, people are a little tied up right now". Sometimes follow it up with, "around here, you DON'T want to be the one who gets all the attention." It usually gets a smile.

On the other hand, the ones who complian the loudest about the wait, tend to be the psych consults, who aren't allowed to leave AMA. Only one counselor, and each eval can take up to an hour. ARGH.

Specializes in Pediatrics, ER.

If I think they are going to get something out of the truth then I'll them if it's been a very long time and I can see the frustration building. If they're the type of patient to complain about the wait as there's a code going on right beside them in the same room then I'll save my breath and my time and they can continue to complain and wait.

Specializes in PCU.
it's interesting, isn't it, that the daughter who really needed you was grateful and apologetic. someone who just wants more ice for their soda will be neither grateful nor apologetic.

aint that the truth :) she was feeling so bad about coming to the room when she knew we had an emergency going on that i had our director go talk to her and reassure her that her response was, in fact, precisely what it should have been and how glad we were that she had the presence of mind to come get us.

Have any of you Emergency Nurses been completely candid with a not-sick patient about this?

No, because in my limited experience, folks that don't "get it" are also the folks that would get a rise out of hearing something "exciting" like that, and I don't want to give them the enjoyment of a juicy bit of tragedy.

I had a parent once who had brought her child in for some BS reason and was sitting near our trauma room when a pretty dramatic and loud trauma came in. The mom pulled her curtain open so she could watch the festivities. I pulled it closed a couple of times and she kept opening it to watch. When she was discharged she still complained about having to wait. It didn't sink in for her, that her entertainment had been the reason we were all too busy to care for her completely stable child who should have seen the pediatrician in the office.

I think telling them that it's a busy night, and the sickest patients are seen first is just fine. If that doesn't do it, I'm fine with letting them stew and be annoyed.

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