How to politely tell a patient "do it yourself"

[railroadrn]

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?

[bgxyrnf, MSN, RN]

Many people here are saying don't make excuses or apologize just take a firm approach. I've tried that and the problem in my experience is that the TYPE of person who asks you to 'itch their nose' is the type that complains about how terrible you are if you refuse and especially if you're firm with them. Even if you take the "I"m so sorry but I can't because xyz..." they still get mad at you for being a terrible nurse or something and heaven forbid you don't give a reason they say "but why" the last nurse did it. I'm still working on my approach that's firm but doesn't send them into a tailspin, have gotten better but it's an art.

It's true, some of them do. However, I have a much longer list of people who will provide a testament to my compassionate and attentive care of their legitimate needs than the few who will summon the energy to file a complaint because I wouldn't call their MD for them or what have you.

A firm but polite "no," without explanation or excuse simply closes the door and, in my experience, it's only a small subset of people who will complain beyond a bit whining in the present.

I do recognize that my experience as a 50+ yo male is probably very different than that of a 20-something young lady.

[bgxyrnf, MSN, RN]

I have, on a few occasions, when a patient starts demanding the most ridiculous assistance asked them "what nursing home do you prefer because I'm concerned if you can't do (insert simple task) here you won't be able to do it at home and we can't discharge you if you won't be safe." The trick is to maintain a look of deep concern and sincerity. I've seen absolute miracles happen many times over.

I have had this approach blow up in my face when they earnestly say, "yes, I want to go to a nursing home."

Some people have taken the helplessness mantle to such an extreme that they would consider that preferable. Think about the number of people who will willingly soil themselves either to 'punish' the nursing staff or simply because they refuse to get out of bed.

[paramedic-RN]

I have had this approach blow up in my face when they earnestly say, "yes, I want to go to a nursing home."

Some people have taken the helplessness mantle to such an extreme that they would consider that preferable. Think about the number of people who will willingly soil themselves either to 'punish' the nursing staff or simply because they refuse to get out of bed.

Same here, I've tried the nursing home approach a couple times and was met with something like "well that'd be fine".