I think I will give negative feedback

[Emergent]

The day after the election I had minor surgery. During the preparatory phase, the crew began to negatively discuss the presidential election, specifically their unhappiness with the president elect.

I said "Are you really going to talk about Trump?", in disbelief.

Thankfully, they shut the ---- up.

I think I'll mention this on the feedback survey. I thought it inappropriate. The patient shouldn't have to correct professionals in this way.

[DeeAngel]

There is a good reason etiquette books used to recommend that politics not be discussed in general company.

[macawake, MSN]

I agree with previous posters that discussing the outcome of the election in front of patients was inappropriate. There are some potentially divisive topics like for example politics and religion that are best avoided altogether in the workplace, especially so in front of patients.

Not to defend the staff who discussed the election, but I do wonder if the fact that the campaign had been so vicious and the voters so polarized might have contributed to the inappropriate conduct. Less than 24 hours after the result was in, I assume many people were still reeling from shock of the election outcome. It might have made people who wouldn't normally talk about things like politics in front of patients become more "loose-lipped" as they were processing the result of the election.

As I've already mentioned, I don't think that politics and religion are ever suitable topics for staff to discuss amongst themselves in front of the patient. But I do think that there are times when staff discussing less incendiary topics in front of patients can actually be beneficial. Of course it depends on the patient, we all have different preferences but as a nurse anesthetist I find that patients often find it calming when the medical team around them are relaxed enough to discuss their dinner plans or child's birthday party or whatever. I've had many regional anesthesia, minimal or moderate sedation, surgical patients express that they get scared when the team is all quiet and focused on the job. Even though I'm talking with my patient, the silence from the rest of the team, makes the patient fear that something's not going well since the team is concentrating so hard instead of talking and sounding like they're having a routine day at work. Some patients certainly prefer this quiet focused on the "task at hand" approach, but some definitely don't.

[WKShadowNP, DNP, APRN]

Macawake. I see how different patient preferences can be. I would prefer the focus on me as a patient. Talking amongst yourselves while I'm lying there conscious is a distracted, perceived from a patients point of view.

Yet, we are inured to our environment that I see how easily slipping into chatter is .

[HeySis, BSN, RN]

l patients express that they get scared when the team is all quiet and focused on the job. Even though I'm talking with my patient, the silence from the rest of the team, makes the patient fear that something's not going well since the team is concentrating so hard instead of talking and sounding like they're having a routine day at work. Some patients certainly prefer this quiet focused on the "task at hand" approach, but some definitely don't.

While I definitely think talk should be patient focused. I don't think it needs to be silent in order to remain professional.

How about we talk to our patients instead of each other, ask them about where they live, what they do, who's waiting for them? do they have kids?

When a patient is waking up out of anesthesia and I want them to come around, these are the things I ask and depending on their answers what the topic centers around. So still an easy and relaxed conversation and they are not just listening in, but participating.

[Spidey's mom, ADN, BSN, RN]

I would definitely give the feedback. I would also tell them that they stopped when you asked, but that you should not have had to ask. And then I would suggest a refresher in professional communication with patients.

It may not be on this topic, but we all need reminders about things. I think feedback from patients is a perfect way to remind the staff to talk to their patients and not over them. And that "hot button" topics should be a no go.

I agree that feedback should be given and it should include that the staff stopped as requested. I also know that sometimes WE just don't see ourselves sliding into conversations like this around patients and so it is a good reminder. This thread is a good reminder too!

Macawake. I see how different patient preferences can be. I would prefer the focus on me as a patient. Talking amongst yourselves while I'm lying there conscious is a distracted, perceived from a patients point of view.

Yet, we are inured to our environment that I see how easily slipping into chatter is .

I agree.

[anangelsmommy, ADN, BSN, RN]

If a patient or even a co-worker brings up the election, I try to find a way to stay positive and bring it around to something that everyone can talk about without getting upset such as "I am keeping my fingers crossed for better healthcare changes in the future for everyone" or something like that, But we will have to wait and see and then talk about the weather or something neutral cause it seems that everyone would like better healthcare options!

[Here.I.Stand, BSN, RN]

I love HeySis's recommendation. I work with some chatty CNAs who will make conversations with me as we are working with a patient. If appropriate I will steer the conversation to include the patient (e.g. if pt is awake and seems to be expressing interest in what the CNA is talking about), otherwise I change the subject back to patient care. It's unprofessional and just plain rude to talk in front of people as though they're not there.

Those Polzrizing Topics in particularly inappropriate to discuss in front of patients because they are in a vulnerable position. Emergent was assertive enough to say something, but others might feel too intimidated to correct the professionals in whose hands they are.

[macawake, MSN]

How about we talk to our patients instead of each other, ask them about where they live, what they do, who's waiting for them? do they have kids?

So still an easy and relaxed conversation and they are not just listening in, but participating.

I'm trying hard here to not get annoyed at the suggestion "how about we talk to our patients instead of each other". Perhaps you didn't mean to sound condescending but that's how I interpreted the wording "how about" and perhaps you weren't implying that I don't talk to my patients and ask them questions. I specifically wrote that I do talk to my patients. I've done many

c-sections lately. The surgical drape prevents the patient from having the surgeon/OB/gyn, OR scrub nurse and nurse midwife in her direct line of sight. The patient usually see their surgical caps above the drapes, but that's about it. The surgical staff of course mostly have their eyes directed at the surgical site but even if they were to turn their heads in the patient's direction and address her, the patient wouldn't see their faces. I however for obvious reasons sit next to the patient's head on the non-surgical site side of the drape and can speak to my patient and have eye contact with her. So yes, the patient and I generally have patient focused discussions. Sometimes just chit-chatting about mundane/everyday topics like for example the questions you listed and sometimes if the patient wants to know; explaining how the surgery is progressing.

Some patients actually don't want you to talk to them and they don't want to answer questions but prefer to just listen to what others are saying and some want the room to be as quiet as possible and just relax/doze off. Some want to listen to music but no conversation. They/we are all different.

If the patient clearly expresses that hearing the rest of the team chatting away is soothing/ comforting as it reassures the patient that the surgery is undramatic, I'm not going to fault the team simply because it doesn't meet some people's idea/standard of professional behavior. As always, it's of course important to talk to your patient and find out what he or she prefers. The patient gets to decide.

[Emergent, RN]

For the record, I think it's only natural for the surgical team to have some light banter among themselves. A better subject matter would have been "I think Russell Wilson is getting healthy again, his mobility outside the pocket is getting back to normal" "Yes, and I'm glad Kam Chancellor is back, now we can get back to kicking some serious ass!"

That conversation would have engendered some positive feedback!:)

[Boomer MS, RN]

My initial response to Emergent's post was to address what I consider inappropriate behavior by some staff in today's environment. This is not specific to comments about politics. I used this forum to express my distain for witnessing staff talking about themselves in front of patients. I find it to be ubiquitous. I acknowledge that some patients may want to engage nurses in conversations about issues, even controversial ones. My point is my concern in the decline in professionalism when the focus needs to be on the patient, not on the staff and their private lives. Again, kudos to Emergent for giving feedback.

[Spidey's mom, ADN, BSN, RN]

My initial response to Emergent's post was to address what I consider inappropriate behavior by some staff in today's environment. This is not specific to comments about politics. I used this forum to express my distain for witnessing staff talking about themselves in front of patients. I find it to be ubiquitous. I acknowledge that some patients may want to engage nurses in conversations about issues, even controversial ones. My point is my concern in the decline in professionalism when the focus needs to be on the patient, not on the staff and their private lives. Again, kudos to Emergent for giving feedback.

I became a nurse at 40 but I was taught by many old-school profs who were pretty tough on the students when it came to professionalism. I appreciated it because I had zero medical experience before deciding at age 36 that a nursing career might be in my future. (I also read Echo Heron's book about her experience in nursing school in the 1970's the summer before my nursing school experience - scary).

I ended up working with many old-school nurses as well because they were my age now or older and I quickly got schooled by them too.

Today I walk by the nurses' station and see nurses on their cell phones on FB. Absolutely drives me crazy. That should be for the break room only. It looks very unprofessional as our nurses' station is in a public area where people walk by to get to LTC, the cafeteria, lab, x-ray, admin offices, etc.

I know those COB nurses who trained me would never have allowed that.

It does seem like there is a lack of professionalism . . . or maybe I'm just getting old. I distinctly remember being told not to discuss your personal issues/opinions with patients and redirect back to them.

Heck, there are a myriad of threads on AN about discussing your religious beliefs with patients and that's met with "Don't you dare!" Unless they ask questions and even then, be careful.

macawake's comments as a CRNA reminded me of my last baby who got here via an emergent cesarean. It was scary for me because the baby wasn't on the monitor and I wanted to hear his heartbeat. I don't remember much banter but then it was an emergency.

But I've been the baby-nurse in cesareans and usually the CRNA is the one focused on the mom/patient. You're in a unique position makawake!

[Teresag_CNS]

Definitely. This is inappropriate. They were speaking above you, as if you weren't there.