How to politely tell a patient "do it yourself"

MrNurse(x2), ADN · Sep 27, 2016

My wife worked at a HD clinic, hats off to you, she couldn't do it, too grueling. Knowing your schedule, I would say that making those calls is out of your scope of practice. They are sitting there for hours, can they not make these calls while they are under treatment?

Anonymous865 · Sep 27, 2016

The trick is to act like you think they are asking you to do something that they think they aren't allowed to do themselves.

1. In a cheerful helpful voice say, "Oh, you can do that for yourself! That way you can set up the appointment at a time convenient to you!"

2. Again, "Oh, you can do that for yourself!" (Assume that they don't know that they can call ahead for a refill. You are just teaching them and empowering them. ) Most pharmacies have refill phone lines and allow patients to request refills on the web.

3. "Oh, I'm sure the state wouldn't let me request someone else's birth certificate. They are really concerned about identity theft now. " (You are just protecting them.)

4. "Oh, you can do that for yourself! . I'm sure your Dr will have questions about your ER visit that I wouldn't know."

5. "Oh, you can do that for yourself! The trash can is right over there." (Assume that the patient is asking, because they don't know where the trash can is. You are being helpful.)

Been there,done that, ASN, RN · Sep 27, 2016

"I won't be able to do that, patient XYZ needs my nursing care".

taivin · Sep 27, 2016

What are you doing? Those aren't your jobs. A big part of being an RN is teaching. Teach them that it's not your job and get on with yours. You sound like you need a course in how to say no. Your big problem now is you may have regular patients in there; they will expect you to do those things now...don't. You're a nurse not a secretary/housekeeper. Especially #2 & #4... :no:

Don't go into long explanations with them, just tell them to do it themselves...politely of course. The trash; tell them to hold onto it, don't break what you're doing. Aren't there waist baskets by each suite or in between at least? I'm assuming these are all older people with no smart phones or any type of cell phone. Tell them to do it when they get home...the appointments.

You could save yourself a lot of heartache and interpret the refills and doc appointments are against the privacy act. Most older folks don't know what HIPAA is and sure I could find a way to do that. OR...you could tell them you are unable to provide that service any longer due to policy of the facility (look it up). Or, you could also just tell them the truth, that it's not your job and you have way too much to do. Good luck!

SmilingBluEyes · Sep 27, 2016

I explain how those are things they are welcome to take care of themselves and assess if teaching/learning is a problem. If it is, then I educate and empower patients to do for themselves what they can. There is a LOT learned helplessness in outpatient dialysis. It can be frustrating but I find the changes can be made. Just do them slowly; also make sure all nurses are on the same page. It won't do you one bit of good to tell a patient they can do something for themselves if the others enable them to be helpless. Consistency among staff is essential.

Here.I.Stand, BSN, RN · Sep 27, 2016

There is nothing IMpolite about simply saying that isn't something you can take HD nursing time for. In my hospital I'd say "I'll get you a phone," since we have a stock of them that plug into the phone jacks in the room; there isn't a permanent phone in each room.

I do help with trash when needed...but again I'm inpatient--EVS workers come BID for trash, and my patients physically can't get to the trash can themselves. HD patient who will be done with the room in a few hours might have to wait longer. In any case though, I finish with one task before addressing non-emergent requests.

KatieMI, BSN, MSN, RN · Sep 27, 2016

Universal one: "I am so sorry but I cannot do it". Give a somewhat plaucible reason: you're doing some task, you need to finish X, Y, Z, you do not know the doctor, you're not familiar with practice, the practice wants some info being private, pharmacy will want to speak with the patient (which they, actually, should, especially for scheduled drugs, and not doing so is HIPAA violation), you may not know insurance or spme other private info, etc, whatever.

Upon the almost mandatory following of "but THEY always do it for me", offer to contact THEM, whoever THEY might be and say that you have nothing to do with THEM. Offer phone, paper, pen, move trash can closely, etc.

Sometimes, for things like throwing out thrash, it sounds good to ask if the patient is in much pain; upon negative answer, play a bit of surprised look. "I just thought that you could do it, you must be in pain if no..."

All that done nicely, with a smile and with NO EXCLUSIONS early or later gets things on their proper places. Still, I would be very careful if your place is going bananas about "customer service"; if it is so, it would probably be wasier to find another job.

Sour Lemon · Sep 27, 2016

I tell them my job as a nurse is to help them maintain optimal independence by NOT doing things for them that them could do for themselves. A healthy body and mind need to stay active. They need to "use it so they don't lose it".

Meriwhen, ASN, BSN, MSN, RN · Sep 28, 2016

1. Make an appt. for them with another md (not even neph) and also call and schedule transportation to get them there. They have transporation to get everywhere else, just apparently not to this md appointment?

I'm sorry, but I'm unable to do that. But I can get you the phone/there's the phone over there, so you can call them while you're waiting to finish up here.

2. Call to pharm for refills - only to get on the phone with pharmacist and discover they have 8 refills. When I told the patient, they said "oh I know I have refills, I just wanted you to call to have them filled so they would be ready when I go get them later." So I took time out of my work day to wait on hold for a pharmacist so you wouldn't have to wait for your refill?

I'm sorry, but I'm unable to do that. Besides, my calling doesn't get your prescriptions filled any faster. But I can get you the phone/here's the phone...

3. Request a copy of their birth certificate....?

I'm sorry, but you will have to contact public records because they will require your ID to process the request.

4. Ask me to call a doctor I don't know or work for to ask for refills on a med they got from an ER doc

I'm sorry, but I'm not allowed to do that. You will have to call directly.

5. I will be in gloves and giving a patient medications or doing an assessment and a patient will call me over to them to ask me to throw their trash away for them.

I'm sorry, but I'm in the middle of something right now and it will be a while before I can get to it. You'll have to wait. Then finish doing whatever you're doing, and don't you dare rush. Odds are when you return to the trash requestor, they will have done it themselves.

The key is to not bark "No" at them, even if it's the most idiotic request. If you can't (or choose not to) do something for them, apologize for the inconvenience but state you are unable to and why. And offer an alternative solution if possible.

bgxyrnf, MSN, RN · Sep 28, 2016

[h=1]How to politely tell a patient "do it yourself"[/h]

1. Make an appt. for them with another md (not even neph) and also call and schedule transportation to get them there.

I'm sorry, that's something that you'll have to take care of for yourself.

2. Call to pharm for refills

I'm sorry, that's something that you'll have to take care of yourself. Would you like use our phone or your own?

3. Request a copy of their birth certificate....?

I'm sorry, that's something that you'll have to take care of yourself.

4. Ask me to call a doctor I don't know or work for to ask for refills on a med they got from an ER doc

I'm sorry, that's something that you'll have to take care of yourself.

5. I will be in gloves and giving a patient medications or doing an assessment and a patient will call me over to them to ask me to throw their trash away for them.

Either, "oh, there's a trash can right over there," or, "I'll be there in a bit..."

These are just a few things out of many that eat up my time and have absolutely nothing to do with my responsibilities. I always try to be as helpful as possible but now I realize I'm being taken advantage of, and I need some advice...what can I say to these patients to firmly but politely let them know that I am not their maid/personal assistant/mama/etc. and that I am not responsible for handling their day to day errands that they are MORE than capable of handling on their own?

Why do they do it? Because it's working for them, of course.

If you comply with tangential requests, you're just enabling the inappropriate requests.

With me, now: "I'm sorry, that's something that you'll have to take care of yourself."

Pretty simple, really, though admittedly it can make some people uncomfortable to say, "no." For me, it's easy-peazy.

KatieMI, BSN, MSN, RN · Sep 28, 2016

Merlwhen,

This is it.

I'm not allowed to do that.

Period. End of discussion. Those forever miraculous THEY just don't let you do (whatever). You wish you could help but there are THEY.

I'm going to borrow it right away. Wish I could give you 1000 "likes" for the idea (but "they" won't let me).