How do I get out of a pt's room politely?

sunnycalifRN · Feb 19, 2011

You just tell them, "Sorry, I've got to see my other patients" and leave. It the ER, not an outpatient clinic!!

llerkl, ADN · Feb 19, 2011

I really try to keep patients "in the moment". i KNOW it is really hard to do! (and let me tell you.......I am asking patients about their pain......so you KNOW that is like opening THE can of worms. I can't tell you how often I have to gently refocus them in the current moment, where I can help them. I have actually said, "I am here to help you now.....let's talk about that"). Things like, "sounds like that happened to you last month or last year (whenever).....let's talk about and focus on right now". This, coupled with a polite, " I am sorry to have to do this, but I am needed in another patient's room at this time. I will return at XX time".

At times the "assembly line" type of care gets to be overwhelming. But we work the best with the situation and systems we have.

FancypantsRN · Feb 19, 2011

I just cut them off - in a caring way. Ex: "so what you are saying is ____" , and then continue to interview with yes and no questions. I have never had a problem with them thinking I am rude so far. If they are wanting to continue to tell their life story with the questions - I say something like "ok, let's get through these questions so we quickly take care of your medical needs".

I try not to let them take over the process - they may not know what the routine is, so it's up to us to step in and keep the information gathering organized.

I am not ER yet (until next week) - but as far as impatient family awaiting DC, I am just honest with them. I tell them it'll take a bit for the paperwork to be prepared, what we are waiting for to do the DC paperwork - and ask them to be patient as I will get to it as soon as possible.

Again, I just have floor experience - so it may be diff in the ER - guess I'll find out.

EmergencyNrse · Feb 19, 2011

It's amazing how gabby people really are when they come to be seen. Maybe it's a defense mechanism for being hurt and/or scared but it's the ER and you really just have to find a way to get away. You really don't have time for socializing.

Be polite. Be cordial. Sometimes after a little while...

...when the EKG, Monitor, O2, IV, CXR, secondary assessment, history, pictures of pressure sores, listing all their medications, med reconciliation, NIH and swallow eval, sepsis screen, labs, cultures, urine dip, accucheck, consent forms, meds, IV bolus, IV drips, PO contrast, CT, reassessment, repositioning, trips to the bathroom, placed back on the monitor, pain reassessment, turkey sandwich, crackers, juice off ALL your patients. THEN you might have time to have a conversation while you do their SBAR before admission.(I probably forgot a bunch of things but I'm tired.)

But we never really DO anything in the ER do we?

ImThatGuy, BSN, RN · Feb 19, 2011

I just say something like "Well, I've got to go tend to some other matters. Be back later." I then leave.

General E. Speaking, RN, RN · Feb 19, 2011

Sometimes people feel like they tell you the WHOLE story so you get the BIG picture. Like the other poster said, rephrasing what they are saying and then trying to give yes/no questions may help.

Sometimes, it doesn't matter and they will continue talking even though you have looked at your watch 5 times, are walking backwards out the door and answering your pocket phone. Those you have to cut off mid sentence and say with a smile, "I'm sorry, I have to go". After that, if they continue speaking, I walk out the door...

NoviceRN10 · Feb 19, 2011

Sometimes people feel like they tell you the WHOLE story so you get the BIG picture. Like the other poster said, rephrasing what they are saying and then trying to give yes/no questions may help.
Sometimes, it doesn't matter and they will continue talking even though you have looked at your watch 5 times, are walking backwards out the door and answering your pocket phone. Those you have to cut off mid sentence and say with a smile, "I'm sorry, I have to go". After that, if they continue speaking, I walk out the door...

And some people are just lonely and want to chat! I was stuck in an elderly gentleman's room last week for almost half an hour because he kept going off on tangents and I wasn't sure how to get myself out of the conversation that he thought we were having :coollook: . He kept wanting to talk about his medical condition that he was not being currently treated for (which had nothing to do with his hospitalization). This happened to be after my late night med pass and inbetween pt issues but I didn't like the feeling of being trapped in his room not knowing what other problems or requests may have cropped up while I was stuck back in no man's land with him. I kept backing up and trying to cut him off to no avail. I finally just said I had to go and would check on him later and left before he could say another word. Sometimes it's hard when you know they could use an ear and all you can think about is the 50 other things you need to get done on time.

canesdukegirl, BSN, RN · Feb 19, 2011

This is what I have done in the past:

"Hello Mr./Mrs. X, my name is Canes and I will be your nurse while you are here in the ER. As you can tell, the place is full tonight, so I will be asking you some brief questions regarding what brings you here tonight. Although I wish that I could sit down and spend some time talking to you about your medical history, I can only take a few minutes, but after we discuss your symptoms, I will be checking on you frequently."

This sets the expectation that you can't hang out for half an hour, and lets the pt know that you are busy without you actually stating, "I have a ton of pts tonight!" Patients want to feel as if they are the only ones that you are caring for, and although this is ridiculously inaccurate. However, when a pt comes into the ER, they don't really give a hairy rat's patootie about other patients, so we have to be focused on one patient at a time when we are face to face...as hard as it may be.

If the patient clearly does not have any intention on making their answers brief, then gently re-focus, as other posters have suggested.

My goodness, our jobs are hard sometimes!

Traum-a-Rama · Feb 19, 2011

Thank you all for such great tips on how to set the tone at the start of the conversation AND how to refocus the patient on the here and now! It's so hard because I know that a lot of these patients (especially the elderly) really just need someone to listen and hold their hand for awhile. And, when you're sick, you really don't care about the nurse's other patients or the full waiting room of people still waiting for a bed...

I will definitely use these conversation guidelines on my next night...thanks:redpinkhe

APRN., DNP, RN, APRN, NP · Feb 19, 2011

"Hold on to that thought.....I'll try to get back to it after a little bit"

"Hold on to that thought....I have to get an answer to this question."

"Hold on to that thought....I'll be right back"

"Hold on to that thought.....(insert your statement here)"

Never fails....

Ayeloflo · Feb 20, 2011

Also please remember that when you are new, it will take quite some time before you feel comfortable about being firm. It will take a while for you to not feel bad about interrupting patients and preventing them from interrupting you. It's take a while to make patients accept your priorities. Your goal is to get your work done. So, I'd say, be patient and allow yourself to deal with them in a way that you are comfortable with. I had to learn to be firm, grow a thick skin, work in an environment of backstabbing, etc. Let time help you. First year is very uncomfortable. You are pushed miles outside your comfort zone.