Is it OK to say no to a nurse?

Nurses Relations

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I'm a new NA on a very busy GI Med-Surg unit and often have up to 15 pts. We do q4h vitals (unless they're post-op then it's q15 or q30 minutes for the first 2 hours), hourly rounds, strict I/Os, along with all the usual NA duties. I hit the ground running every night crazy busy trying to get my vitals/glucose checks in because many nurses will start calling me wanting them done ASAP so they can pass their meds early, along with tending to call lights that have been on for some time due to the chaos of shift change (we get written report so the day shift is gone at 7 on the nose).

However, the other night I was in the middle of vitals and had to stop to assist a bedbound pt who had soiled himself (no briefs per hospital policy) and was up to my elbows in stool when an RN called me 3 times until I answered to inform me that I needed to put one of her pts on a bedpan. I politely told her I was in the middle of something, and asked if I could get to her in 5 minutes, to which she responded NO, I needed to go now. I told her I will finish up as quickly as I can and get there ASAP, but alas, I didn't make it in time and the pt soiled herself.

The thing that really bothers me is that as I was running to that pts room, I spotted the RN sitting at the nurse's station on Facebook, and I couldn't help but want to say something to her! I didn't, but I was so upset that she demanded I perform this task NOW while she had nothing to do! This is just one isolated incident of times when nurses call me to perform random tasks when I'm in the middle of something else that is difficult for me to get away from immediately, and I was wondering if it's okay for me to sometimes say NO, I can't get to that right now without repercussion? I want to do my best and I don't want to jeopardize anyone's safety, but I'm only one person and I'm beginning to feel very distressed by trying to accommodate every RN immediately when they call throughout my entire shifts.

Specializes in critical care.
Thank you so, so much. You have no idea how much your kind words mean to me right now.

Big hugs to you, love. Feel free to PM anytime you're having a hard time, okay?

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Big hugs to you, love. Feel free to PM anytime you're having a hard time, okay?

I will, thank you again.

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Specializes in SICU, trauma, neuro.

Seriously?!?! What were you supposed to do, divide yourself in half so you could attend to both at once? Leave pt #1 to lie in stool while you attended to pt #2?

You were absolutely fine to say no, to discreetly inform her over the communication device that you're unable to leave the room at the moment. You're a nursing ASSISTANT, not the nurse's LACKEY. Bathroom needs ARE the nurse's responsibility--they just frequently are delegated because one doesn't need an RN or LPN license to do them. You are not guilty of insubordination here--SHE is guilty of neglecting her pt.

Once when I was a CNA, I had 3 pts on a rehab floor ringing while the RN had her feet up on a chair, working on her cross-stitch. I actually did tell her that I can't be in all 3 rooms at once so she needs to get up and help. I wasn't a witch about it, but matter-of-fact.

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Specializes in SICU, trauma, neuro.
P.S. I wonder if the nurse in question is AN user NoADLs. 

:roflmao: I wondered the same thing!!!

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Specializes in Neurosurgery, Neurology.

Yes, it is okay to say no to a nurse. I work as a PCA (starting BSN in September) on a busy floor as well (though I couldn't imagine having 15 patients!), and there are indeed times where it is clearly okay to say no. The situation you describe is one such case. Our unit manager would always state in the minutes for staff meetings that RNs must also answer call lights and address the issue if they are right there. It's always amusing to see particular nurses run around looking for the PCA/NA/etc to help a patient to the bathroom or put them on the bedpan, when, in the time they spent looking, they could have already done it.

If this has happened more than once, then I would definitely mention it to your nurse manager (Esme12's post was great on what to say). It isn't acceptable. Also, don't be afraid to speak up for yourself. If you are busy with one patient, say what you're doing, and ask if he/she can do it. If the RN gives you grief, you should clearly and firmly state why it isn't logical to do what he/she is asking you to do. ALWAYS remain calm, never make a scene, as some people do.

How close are you to the 90 days? If close, I would wait until the evaluation to discuss your experience on the floor with those particular nurses.

I have also looked at this sort of thing as a learning experience. As future nurses, we should learn from this sort of behavior, and not turn into this type of nurse. I'm sure you have great examples of nurses that aren't like you describe on your floor. Follow their example.

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I am an RN and I'm always asking my STNAs to do little things for me. Vitals, stool samples....whatever. My aides are what keep me going! If she knew someone needed a bedpan, why couldn't she have at least put them ON the bedpan? I'd rather go in to give someone their meds and put them on the bedpan than have to go help change a bed 15 min later! Next time, tell her you're dealing with a code brown and unless she wants another one, she better go deal with it! ;)

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Specializes in Cardiac, Med-Surg.

Wow! I'm sorry you have to deal with this. I was taught in nursing school that we are never above nurse's aides, and should never act as if we are. If I ever need something done, I usually just ask an aide for an extra hand, not to go do it themselves (unless I'm absolutely too busy at the moment). Besides, it's a good time to do a good skin assessment and see how well your patient ambulates, etc. If this continues to happen, you should bring it up to the nurse or your nurse manager. If she has time for Facebook, she definitely has time to assist a patient!!

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Specializes in Acute Care Pediatrics.

I find it incredibly sad when we forget the true value of teamwork. That nurse has also lost sight of true patient care. It makes me sad.

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Specializes in orthopedic/trauma, Informatics, diabetes.

I am embarassed too. I work with people like that. One nurse will spend 10 min looking for the aide to tell them to put a pt on a bedpan when she could have done it and been finished by the time she found the aide. I always help when I can. On the flip side, I have had an aide yell at me when I ask for something to be done when I cannot do it myself. Or when they won't help because they are "on lunch" for 45 min during an 8 hour shift and I don't get lunch during a 12 hour shift.

We really need to work together.

I just had a discussion with my manager about nurses like you described. that kind of nurse makes more work for other nurses, too.

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Specializes in dementia/LTC.

I am a nurse that used to be a cna in ltc and I never order my aides around. And I help them as much as I can. I can't stand it when other nurses order aides around that are clearly doing their best and working hard. You need to go to the manager.

And next time you tell her "its going to be 5 min before I can get there I am busy with pt x, unless you want to come take over in here for me I have to finish with this pt first and then I'll be right there"

If this continues its time to look at switching to a different shift, unit, or facility.

Good luck, and use this nurse as the example in the back of your head as the type of nurse you DON'T want to be.

It does get easier, in a few more months you will have gained a lot of experience that will help make day to day tasks easier.

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I once overheard another nurse say, "I don't have to answer my call lights, I have a NA to do that for me." - please note, the NA's are assigned to specific patients and NOT to specific nurses. I happened to know that the NA to whom he was referring was on the edge of a meltdown because she had been running so hard to get her other duties done, and that the nurse was doing Facebook (or something similar). He was told with as much tact as I possess (approximately a thimble-full, less when I hear such idiocy) to get up off his orifice and take care of his call lights. The NA has since moved on to greener pastures. The nurse is still with us, though I can't imagine how he skates through his evals. I somehow think that the floor ended up rather poorer in that deal...

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I find it incredibly sad when we forget the true value of teamwork. That nurse has also lost sight of true patient care. It makes me sad.

I have found in all my years nurses seldom "lose" the value of teamwork...they NEVER had it in the first place

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