Let me preface by saying I love my job and I love my patients. I work at a chronic hemodialysis center as a charge nurse. I stay very busy, as I doubt there is any nursing specialty that leaves a nurse twiddling their thumbs. I have many tasks to complete during the day but I am starting to find myself short on time due to taking on what I call "chores" for my patients. Now, I do NOT mind going out of my way for any patient that truly needs my help. But my day gets away from me and I am starting to get behind in my own work because patients (not all of them) are expecting me to do things for them that are quite frankly not my job...and I hate that phrase! Here are
some of the things that able-bodied, able-minded patients have asked me (a floor nurse) to do for them:
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?
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?
3. Request a copy of their birth certificate....?
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
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.
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?
This is kind of a joke on my unit, and the other nurses will call me in to address the "wipe my butt," "reach my soda," "change the channel" type requests:
"You're not able to (insert basic personal care activity) yourself? Oh, no! (With concern) Who does this for you at home!?!?"
(9/10 times met with a growl)
"Oh, well this sure is a shame!" (Sugar sweet) " I guess I will have to talk to Case Management about placement. This sure is unfortunate, cause we were hoping you could go home soon! Oh, well, let me get some help, and then I'll talk to the social worker about a nursing home 'till you're able to take care of yourself."
At this point, the COMPLETELY SELF SUFFICIENT, INDEPENDENT patient gets a look of absolute panic, and sputters "What! Nursing home! NO, I... what? I don't need that!
At which I point out that "I understand, but our policy states that if you are unable to complete basic care activities like cleaning your own body, reaching your own food and drink or adjusting your own blankets, we can't send you home on your own. We'll have to have PT and OT reevaluate you and they will likely recommend a few weeks at a nursing home until you can relearn to do those things yourself."
HALLELUJAH, GLORY BE, Miracle of Miracles....suddenly everyone's arms and legs suddenly decide to work!
Very simple, state the following "I am sorry, but I am here to provide medical/nursing care to yourself and the other patients in the building. I am unable to ***insert request here*** for you". You could even state the company does not allow it's staff to perform these duties...I'm certain they wouldn't be too pleased hearing that you are off the floor making phone calls for your patients med refills & arranging transportation that has nothing to do with their care at your dialysis center.
I tell my patients "no" when warranted. You are a nurse; not a personal assistant. Patients will walk all over you IF you let them :)
This is kind of a joke on my unit, and the other nurses will call me in to address the "wipe my butt," "reach my soda," "change the channel" type requests:
"You're not able to (insert basic personal care activity) yourself? Oh, no! (With concern) Who does this for you at home!?!?"
(9/10 times met with a growl)
"Oh, well this sure is a shame!" (Sugar sweet) " I guess I will have to talk to Case Management about placement. This sure is unfortunate, cause we were hoping you could go home soon! Oh, well, let me get some help, and then I'll talk to the social worker about a nursing home 'till you're able to take care of yourself."
At this point, the COMPLETELY SELF SUFFICIENT, INDEPENDENT patient gets a look of absolute panic, and sputters "What! Nursing home! NO, I... what? I don't need that!
At which I point out that "I understand, but our policy states that if you are unable to complete basic care activities like cleaning your own body, reaching your own food and drink or adjusting your own blankets, we can't send you home on your own. We'll have to have PT and OT reevaluate you and they will likely recommend a few weeks at a nursing home until you can relearn to do those things yourself."
HALLELUJAH, GLORY BE, Miracle of Miracles....suddenly everyone's arms and legs suddenly decide to work!
Gotta love the power of the loss of control :-(
lol
I work in inpatient rehab. We do this sometimes. I will ask " so what is your goal from here, a nursing home? Oh you plan on going home? Well you had better get up and do these things for yourself then hadn't you?"
Show me how you would...call your doctor so I know you are able to be independent at home. Show me how you would call for your medication refillst? Show me how you will clean up for yourself at home? Great! Now that you have shown me you are able to do all of these things, I am fully confident you will be able to handle them going forward. Works well for me. My line of work is patient centric so we try to empower them to be self sufficient.
PPs have had lots of great advice, including reframing as empowerment and simply explaining that you are not allowed to do it. If taking care of patient's non-medical personal to-do lists is interfering with getting your job done, you'll hear about it from superiors sooner or later. Better to head that off.
Regarding the interruption to take care of someone's trash: If a patient or family member hunts me down while I'm in/entering another patient's room, I will pleasantly explain that while I'm with the other patient, I am wholly focused on their medical needs and care, and that when I make my way back to them, they will also be provided my undivided attention. If a patient interrupts your assessment for a non-urgent need, they are announcing that their desires are more important than what the other patient needs. If you comply, you are agreeing with them. Don't do it. Don't disrespect the patient you are with by letting another one call you away mid-task.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
This is kind of a joke on my unit, and the other nurses will call me in to address the "wipe my butt," "reach my soda," "change the channel" type requests:
"You're not able to (insert basic personal care activity) yourself? Oh, no! (With concern) Who does this for you at home!?!?"
(9/10 times met with a growl)
"Oh, well this sure is a shame!" (Sugar sweet) " I guess I will have to talk to Case Management about placement. This sure is unfortunate, cause we were hoping you could go home soon! Oh, well, let me get some help, and then I'll talk to the social worker about a nursing home 'till you're able to take care of yourself."
At this point, the COMPLETELY SELF SUFFICIENT, INDEPENDENT patient gets a look of absolute panic, and sputters "What! Nursing home! NO, I... what? I don't need that!
At which I point out that "I understand, but our policy states that if you are unable to complete basic care activities like cleaning your own body, reaching your own food and drink or adjusting your own blankets, we can't send you home on your own. We'll have to have PT and OT reevaluate you and they will likely recommend a few weeks at a nursing home until you can relearn to do those things yourself."
HALLELUJAH, GLORY BE, Miracle of Miracles....suddenly everyone's arms and legs suddenly decide to work!
Gotta love the power of the loss of control :-(
I'll second this suggestion. It works great for "helpless" visitors as well.
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).
Don't forget the apologetic smile and the look of "I really wish I could, but..." on your face as you say it.
I've had years of honing my skills on Axis II patients. My goal is to get to the point where--like the Irish saying goes--I'd be able to tell them to go to Hell in such a way that they look forward to the trip.
Well, substitute "No" for "Hell" and "they thank you" instead of "they look forward to." You get the idea.
Specializes in LTC Management, Community Nursing, HHC.
I have many tasks to complete during the day but I am starting to find myself short on time due to taking on what I call "chores" for my patients:
I'm curious as to whether the same patients are asking you to do these things over and over again, or if many of your patients ask you to do these things for them? If it's the same few patients, I'd do it once more, and tell the that I won't be able to do that again in the future (for example to call other doctors, or to call their pharmacist about meds that have nothing to do with you!) because I've learned that it's outside my scope of practice and i could get in trouble for doing that OR that I have a lot to do, but I can get the phone number for them if they need it, although it may take some time before I can look up the number.
As for the trashcan person, I'd pick up a trashcan and put it by their bedside. Or, I'd tell them that if they're unable to throw the trash away themselves I'll get it later when I'm on break.
Could you probably just not look busy enough to them so they think you have lots of time to do their little odds and ends and errands? And why would you stop in the middle of patient care to walk over to someone who's asking you to throw away some trash for them? Just say that you're in the middle of patient care.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I'm curious as to whether the same patients are asking you to do these things over and over again, or if many of your patients ask you to do these things for them? If it's the same few patients, I'd do it once more, and tell the that I won't be able to do that again in the future (for example to call other doctors, or to call their pharmacist about meds that have nothing to do with you!) because I've learned that it's outside my scope of practice and i could get in trouble for doing that OR that I have a lot to do, but I can get the phone number for them if they need it, although it may take some time before I can look up the number.
As for the trashcan person, I'd pick up a trashcan and put it by their bedside. Or, I'd tell them that if they're unable to throw the trash away themselves I'll get it later when I'm on break.
Could you probably just not look busy enough to them so they think you have lots of time to do their little odds and ends and errands? And why would you stop in the middle of patient care to walk over to someone who's asking you to throw away some trash for them? Just say that you're in the middle of patient care.
If the OP does electronic charting, she probably doesn't look "busy enough." Patients LOVE to complain that their nurse was "on the internet all night" when in reality, the nurse is in the EMR, charting.
Apples&Oranges
171 Posts
This is kind of a joke on my unit, and the other nurses will call me in to address the "wipe my butt," "reach my soda," "change the channel" type requests:
"You're not able to (insert basic personal care activity) yourself? Oh, no! (With concern) Who does this for you at home!?!?"
(9/10 times met with a growl)
"Oh, well this sure is a shame!" (Sugar sweet) " I guess I will have to talk to Case Management about placement. This sure is unfortunate, cause we were hoping you could go home soon! Oh, well, let me get some help, and then I'll talk to the social worker about a nursing home 'till you're able to take care of yourself."
At this point, the COMPLETELY SELF SUFFICIENT, INDEPENDENT patient gets a look of absolute panic, and sputters "What! Nursing home! NO, I... what? I don't need that!
At which I point out that "I understand, but our policy states that if you are unable to complete basic care activities like cleaning your own body, reaching your own food and drink or adjusting your own blankets, we can't send you home on your own. We'll have to have PT and OT reevaluate you and they will likely recommend a few weeks at a nursing home until you can relearn to do those things yourself."
HALLELUJAH, GLORY BE, Miracle of Miracles....suddenly everyone's arms and legs suddenly decide to work!
Gotta love the power of the loss of control :-(