It happens to all of us. We're in a patient's room, we go out intending to get that pillow, that sleeping med, whatever (it's usually something minor), and as you're passing another patient's room, Something Very Bad is happening and you're suddenly taking care of a crashing patient, and Stable Patient's pillow is the furthest thing from your mind.
We're not allowed to say to Stable Patient, "I had a patient who needed me more" and now when we go back there a half-hour later, Stable Patient is ready to spit nails because she's been waiting so long for something that seems so simple. She's threatening to write to everyone up to the Pope about this inefficient service, and you know that she's the type to do it.
You now have to calm this patient down and take care of her.
How do you handle it? What do you say? How do you smooth things over?
I always say "I was tied up with an crisis in another room". I use that line even when the crisis was merely answering a callight and then forgetting the 1st pt's pillow fluffing request. I find it to immediately diffuse any impatience. Of course, if they ask for details, I blame my inability to share that information on the Federal Government. (I love HIPPA)
I have said that I was stuck with another pt who wasn't doing well, etc, etc. Sometimes they are okay with it, and sometimes not. If they are being a jerk, I usually just tell my charge nurse and let her handle it. She knows why I couldn't bring them that popsicle right away. I also chart everything, but telling my charge nurse/manager also gets someone else involved and makes them aware of what's going on. I have left pts rooms who are angry with me and will not listen to reason, and come back later to settle things when they are calmer. I have to watch myself, because I tend to be very unwilling to take abuse (another reason that I go to my chrage nurse!). I don't give a rats you-know-what about your stupid toothbrush if there is another pt in distress at the time. You'll get it eventually - that's why I write myself notes. You are in a hospital, not a hotel, AND since when do hotel workers wait on you hand and foot anyway? If you want a shower cap, you have to get up and steal it out of the bathroom yourself, they aren't going to bring it straight in to your bed for you.
Much like the others, I just would say that I'm very sorry but someone needed me for an urgent matter and I got back as soon as I possibly could. If the pt insists that it wasn't his or her problem, I just smile sweetly and say, "well, unfortunately, that's what happened." and I walk out after doing what it was I was going to do. All gets charted, including the comment that patient used a few choice words, or whatever.
I was curious if anyone tells patients up front that it might be a few minutes before they can get back with their pillow, toothbrush, etc. For instance if you are in the middle of 9 Am meds. I'm a student, so I'm trying to stockpile my responses for these situations I know I'll encounter.
I was curious if anyone tells patients up front that it might be a few minutes before they can get back with their pillow, toothbrush, etc. For instance if you are in the middle of 9 Am meds. I'm a student, so I'm trying to stockpile my responses for these situations I know I'll encounter.
I've been a nurse for awhile and that's pretty much why I'm asking. Delays in care will happen, we must prioritize. I might be in the midst of getting your pillow when I see that someone is crashing and simply be unable to tell you that there was an unexpected delay.
Unfortunately, the patients who can wait and who have all the time in the world to sit and stew over these things are precisely the patients that Management hears about.
They'll forget very easily that we saved their lives two days ago and remember only that you were late when they wanted an assist to wash up at the sink for 30 minutes--with you standing at their side handing them face cloths.
Even Management will take the position that we somehow needed to be in that complaining patient's room faster, never mind that our Coding patient delayed all the meds, treatments, and care for all the patients.
So in the end, I guess my position is that I'm finding it irritating that I am expected by both patients and Management to be all things to all people and be in all places at once, somehow.
Has anyone mastered the technique? If so, please pass it on. Omnipresence sounds like a lovely superpower and I think it should be listed in the staff nurse's job description.
I was curious if anyone tells patients up front that it might be a few minutes before they can get back with their pillow, toothbrush, etc. For instance if you are in the middle of 9 Am meds. I'm a student, so I'm trying to stockpile my responses for these situations I know I'll encounter.
Yes, I do that too. For example, the other night a pt asked me for new slipper socks. I said that the next time I came into her room, I would bring them with me. She was fine with that, and I did it. I do find that, if you're going to do that, make a note somewhere so you don't forget - and then put the item in your pocket (if it will fit) the next time you go past the supply area. That way, even if you do forget, the pt can say, "where are my socks?" and you can say, "oh, right here". Otherwise, you will go back in the room later and the pt will say, "where are my socks?" Then you have to go back and get them right then, and it defeats the purpose of telling them you will bring it later. :wink2:
nurse nan, i loved this post. i totally agree! very rarely have i had clashes, but those are the ones i looove to explain to the admin.
On the other hand, I have had patients who have looked me straight in the eye and clearly stated, I really don't care about what is going on with anyone else. Where upon I usually smile back at them and say, I sure hope no one needs a pillow when you are having your emergency! And leave. Some people are the same considerate, socially conscious people in the hospital that they are outside of it and realize that priorities have to be made when taking care of mass amounts of sick people. Others are the same rude, arrogant jacks in the hospital as they are on the highway, in the supermarket, and anywhere else you find them. It's all about them. And I love it when they write the nasty letters because then I can tell administration all about the encounter and smile and say now what would you have done. They usually agree with saving lives comes first.
One gentleman did not want to wait in medline for his meds while I was taking care of another resident who had coded conviently directly in front of the med room door. He was yelling and ranting quite loudly. I told him that she was very very sick and he would have to wait while I took care of her and helped until the paramedics got there. He then replied, "I don't care, she's taking too much time. She needs to go to the back of the line and wait. The paramedics can get her there!" To which I replied a very not correct, and very terse, "I don't think so." Followed by a, "Could someone get Mr. So&So out of medline!!" He was "placated" with his favorite movie after that.
(I work in a facility for DD patients who also have mental illnesses. They come to me for the meds)
Why can't you tell a stable patient that you had a critical patient that needed attention? We are nurses not hand maids. On my way to the other patients room I might ask the tech to take a pillow to the stable patient.
Why can't you tell a stable patient that you had a critical patient that needed attention? We are nurses not hand maids.
Well, in a DD/mentally ill population it isn't really understood.
A lot of my time is spent placating demented elderly folks. I have one guy who wants whatever someone else has, including, ystdy, the very chair in which my butt was planted. I gave it to him and then asked if he'd prefer one I know he likes. It worked.
When I worked med-surg, staffing on night shift was at a bare minimum as it is in most med-surg units. When we had a code one night (with 28 pts on the floor, 3 nurses, no aides or unit clerk) somehow a pt had to wait about 20 minutes for a bowl of soup she wanted. She got upset, calling her son in at 2 am because she was being "neglected". He called the surgeon in. The surgeon went berserk, yelling and screaming, threatening to have all of us fired, got all of us wrote up, and ultimately caused one of the nurses to quit and another one of us to transfer to another unit. Nursing administration never backed any of us up that we had more pressing things to deal with at that time. No one ever got an apology for this mess. All over a &$%#@* bowl of soup. This is why no one wants to be a nurse anymore. Where is our support for just doing our job?
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:angryfire 
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GardenDove
962 Posts
I always say "I was tied up with an crisis in another room". I use that line even when the crisis was merely answering a callight and then forgetting the 1st pt's pillow fluffing request. I find it to immediately diffuse any impatience. Of course, if they ask for details, I blame my inability to share that information on the Federal Government. (I love HIPPA)