How to set limits?

AprilRNurse · Feb 2, 2011

Such as???

Some patient's will always be demanding...and it's our job to put up with it- especially with the new movement of treating patient's like "customers"

However... with patient's that constantly want you to wipe their butt when they are capable, or hand them a drink, pull up covers etc.... I have a nice little conversation I learned from an older nurse...

Oh! I thought you came from home... You do live at home? Part of my job as a nurse is to help ensure you are capable of caring for yourself after discharge. If you feel like you need assistance with feeding/toileting I can have the social worker speak with you about local nursing homes...

Fixes it 90% of the time....

missladyrn · Feb 2, 2011

Make sure you always ask, is there anything else you need before going to get anything. I usually say is there ANYTHING else because it will be at least xx amount of minutes before I can come back. I dont do the run back & forth thing for a constant string of little things.

If someone is really a pain in the you know what, we take turns (nurses, techs etc) and try to lighten the load for each other by alternating if we can. And it is like the little boy cried wolf, you ride the call light too much you end up being low priority. Got to answer the one for the patients that actually need something first.

carolmaccas66, BSN, RN · Feb 2, 2011

What area/s do you work in firstly? Some areas have more demanding patients than others.

I'm not a CNA, I am a RN, but nursing assistants in some of the hospitals I work in have a daily plan they follow for patient care - some take any problems to the RN. For example, you might go on on your shift, and give your patients a run down of how the shift will go. For example you might say to patient A: I will be back in 30 minutes to do your shower, or to patient B, I cannot do such-and-such for you now, but after I do patient A's shower, I will come back in 30 minutes or something to that affect.

Work our on each shift b4 u start what you have to get done, then you have a better idea of your time management and can tell the patients.

Be firm with some people. If they are taking up ur time with things they can do themselves, encourage them to do it or make them do things themselves.

If someone is still demanding and rude, set boundaries with them. After all, you are in charge (under the RN I presume), so if you don't set boundaries, people will just use you in any situation or work place. If u run around like an idiot, after idiots, that is what you will become.

I also always speak in a calm, professional voice, and give patients a run down of their care and the time things will take, that seems to help a lot. I also turn my back on them when they are still talking and repeating the same info, and it's not urgent, start to move out of the room and say something like: "Yes Mr _______ I will be back in such-and-such a time." Then they get the message.

JenniferSews · Feb 2, 2011

Oh! I thought you came from home... You do live at home? Part of my job as a nurse is to help ensure you are capable of caring for yourself after discharge. If you feel like you need assistance with feeding/toileting I can have the social worker speak with you about local nursing homes...
Fixes it 90% of the time....

I have used this approach without guilt in sub acute rehab. I start with "My job is to get you out of here and back home where you belong! The goal is for you to do as much as possible for yourself so you can get back home as fast a possible." Of course when you are IN a nursing home that possibility may seem a lot more real. :lol2: But I think this approach can't be modified for acute care.

General E. Speaking, RN, RN · Feb 2, 2011

... with patient's that constantly want you to wipe their butt when they are capable, or hand them a drink, pull up covers etc....

Ug. The dreaded TRS!!! (Tyrannosaurus Rex Syndrome) Meaning those wavy little arms up front are just for show :rolleyes:

kool-aide, RN · Feb 2, 2011

I work in the nursing float pool at my hospital so I go to med/surg, ortho, cardiac med, cardiac surg, rehab, etc, etc... so I kind of see it all.... It's the pts that call me 20 times a night to do ridiculous things like cover their feet or pour them some water when I know they can do it themselves. ya'know??? I do say the "you need to be more independent..." thing but sometimes people are either not smart enough or are to lazy/stubborn to take the hint. lol I'm betting it's the latter of the two...

Thanks for the suggestions, keep 'em coming!

Kool-aide.