How do you politely walk away or say no?

redessa · Jun 8, 2011

After making sure their needs are taken care of, if someone makes an over-the top request how about saying, "I'm sorry, I need to check on my other patients now. I'll be back to see how you're doing at such-and-such time. Use the call bell if you need anything before then."

RNforLongTime · Jun 8, 2011

You are going to need to learn to set boundaries...a tough thing to do as a new nurse. I've no qualms telling patients that while they are important to me, I also have two other patients who also need me to do things for them and since we do not have a CNA in our unit, it's just me and another nurse for up to 6 patients. So if another one of my pt's is trying to die on me...a neck rub is NOT at the top of my priority list at that exact moment in time.

To the lady who asked help in setting up Christmas decorations(first of all, did they get clearance from maintenance to string those lights??), you tell her although you'd love to help, time doesn't permit you to do so as you have x additional pt's to care for.

To the patient who needed to go to the BR and then wanted a neck massage, Id have said, I'm sorry but I must get back to the desk to watch the monitors but I'll tell your nurse when she returns from dinner break.

To the patient who wanted you to stand there and watch her look through her purse, I'd hand it to her, ask if there is anything else they need right now and unless it's something dire like needing a pain pill or going to the BR, you tell them you need to go check on your other patients.

Good luck to you in your career.

kool-aide, RN · Jun 8, 2011

Unfortunately, this just comes with time. (sounds kinda funny coming from a 20 y/o, huh? lol)

It took me about a year to be able to turn down unimportant requests from pts/family members. You'll get there.

In my experience, using the "I need to check on my other pts…" line works pretty well. Unless the pt/family member is a complete self-centered jerk, they won't argue with the fact that you have to take care of someone else….

canesdukegirl, BSN, RN · Jun 8, 2011

It is tough to say no, isn't it?

Patients by and large want to feel like they are the only patient you have. When I first started out, I had a very high maintenance medical student who acted like a princess (partly because her parents treated her like one). I mention the fact that she was a medical student because SHE KNEW how busy our unit was, but still acted as if the nurses had nothing better to do than brush her hair, massage her feet and rub a cool cloth on her face and neck "to help her calm down". I finally had it with the requests and set boundaries with her. I told her that although I would love to be able to have the time to do all of these things for her, there were so many tasks that I had to accomplish-"you know the routine," I said. "Administration loves to generate more paperwork for us! Perhaps you can call a friend or have your Mom come and visit for a while with you to help you control your anxiety." She left me alone after that.

Don't feel like a jackwagon for setting boundaries. You are not going to be accused of being an awful person if you tell someone no. You are protecting your own sanity! What is the worst thing that would happen if you said no? The world will not end, but your shift will and you want to make sure you aren't behind the 8 ball when you have to finish the plethora of work before you leave.

LoveMyBugs, BSN, CNA, RN · Jun 8, 2011

You have to learn to say I will check back on you later.

I had a stressful day today and I had one family member who kept wanting to pull me back into the patients room, I had already been in the room 3 times, and I had 18 patients. I finally told him that while your family member is important to me and I will be in the room again at X time tonight, I currently have patients that I have not seen yet today (this was 3 hours into my shift)

It is not fair to the rest of my patients when 2-3 will try to take all of my time and keep calling me in the room.

chicookie, BSN, RN · Jun 8, 2011

I always say, "Please excuse me. I have to check on other patients."

But at first it wasn't easy. Once I walked to the ER parking lot on the other side of the hospital to take this patients' purse out of her car. -_- It wasn't until I got fed up with it then I would say, Sorry I can't help you with that right now.

You will get there. Slowly but surely.

locolorenzo22, BSN, RN · Jun 8, 2011

You have to get your job/tasks done, because honestly, the patient can't do it for you.

Simple things like that, I simply do what I can.

The decoration request? Seriously? I would have sincerly replied "A) I'll be happy to help you if I have time. I have to check in on all the patients still and I'll see if I can find 5 or 10 minutes to help later." Also, I would have said that I must have been absent the day they went over light untangling. I wonder if that was between my cardiac and IV therapy lectures?

B. The massage guy? May have been doing something there. If he's claiming stiffness/pain, 5 minutes is usually enough. Flat out refuse when a patient asks you to do something you are not comfortable with. If he's still having pain, offer or get orders for a pain med.

C. Purse lady? here's your purse, call me if you need anything before I come back. You don't need to stand there.

You'll find your boundries. But start now before you get so worn out with the petty C$$P some families comeup with that you think you hate nursing when it's really just the people.

Been there,done that, ASN, RN · Jun 8, 2011

Just give a quick "Sorry but I have to get a patient off the bedpan". Works every time.

Try to avoid what I recently did when a patient asked for a massage. I couldn't help it ,I burst out laughing.

hiddencatRN, BSN, RN · Jun 8, 2011

It was hard at first for me too. I still have trouble sometimes. But just remember that you have other patients and that your time is best spent doing patient care- that's what you're there for. The extra stuff is just....extra.

CNA2bRN13 · Jun 8, 2011

Thank you so much for posting this! I'm doing my CNA clinicals after next week, and hoping to work as a PCT in July, and I have a huge problem with being too nice for my own good! When I worked in a pharmacy, we would have customers that would hold up the whole line (and only line) telling me their whole life stories, showing me the blisters on their feet, crying about what their daughter said, on and on and on. They didn't bother anyone else. It got to the point where the managers had to work out a code word to call me to the office to let me escape. (And sometimes they followed me). Also, I can't get patients to stop talking when I'm doing blood pressures and pulses!! In school they teach you to talk, look at pictures, and do puzzles with patients, but in the real world they give you 18 patients and leave you no time for this kind of stuff. I feel your pain!

heartflutter, ADN, BSN · Jun 8, 2011

--It was close to Christmas time, and one of my patient's family members was trying to decorate the patient's room and wanted me to help her. That would be fun and all if I didn't have any other patients or a million other priorities, but I didn't really know how to say that nicely. When I tried to help her, she sat back and started commanding me how to decorate. "Untangle those lights...wow, you went to school for how many years and you are having trouble untangling that string of lights? () Hang those decorations on the tree but make sure they are spaced out well...No, no, that's no good, do it like this/like that."

I tell the individual I'm Jewish.

Which is true, but it could work for you too!

--Another example: There was a patient (not my patient) who needed help to the bathroom. I was alone at the nurse's station, so I ran over and helped him out of bed, to the bathroom, and back to bed. That's fine, except when I was leaving, he asked me to massage his neck. I needed to get back to the nurses' station to watch the phones and call lights, but I thought "What the heck, 10 seconds won't hurt". But when I tried to stop and leave the room, he told me not to stop and to keep massaging his neck and to also start massaging his head. I was a little creeped out, but I didn't really want to say that, so I did it for several minutes. Later that night, I went to the room for some reason, and he asked for another massage. He already had me in the room, so I felt bad just leaving, so there I was giving him another long neck and head massage. He wouldn't ask anyone else for massages, just me. I was really creeped out by then and tried to avoid walking by that room.

I tell patients it's something I'm not comfortable doing (and I do think it crosses a professional boundary depending on the circumstances). If you give a mouse a cookie...

:uhoh3:

--My patient wanted me to hand her her purse so she could get something out of it. I gave it to her and asked if there was anything else I could do for her before leaving. She wanted me to stay in the room and wait while she looked through her purse. So I stood there while she went through everything till she finally found what she wanted. I didn't see the point of this since it's not like she wanted me to put her purse away when she was done. She just wanted me to stand there. She did this several times throughout the night. I grew more and more frustrated and eventually asked if there was something she needed help finding. Nope...no reason for me to stand there as she looked through her purse. But didn't really know how to say "Yeeeah I've got stuff to do. Bye."

Move quickly without seeming like you're in a hurry. I used to work in a mom and pop drive through so I got good at the quick and quiet customer service thing. I'd have handed her the purse and said to put on her light if she needed anything else later. Or apologize and tell her you have meds to pass.

I understand people in a hospital setting (I'm assuming) want to be taken care of, but they need to do things for themselves too.

If all else fails, tell them doing things on their own is a part of their recovery (whatever that may be).