I am always gracious and try to accomodate reasonable patient/family requests, but my name tag yesterday must have read 'Handmaid' instead of RN. I was instructed (not asked) by several different patients/family members the following:
"Go get us about eight or ten chairs so everybody can sit down in here."
"The baby's father hasn't had anything to eat today, can you make him something?" (This was 1930 and FOB who missed the 0915 delivery had just shown up).
"Can't you get the kids sandwiches?" (I was happy to bring graham crackers and juice, but was met with "Well, that's not enough for dinner.")
"I can't use a taxi voucher because that way I have to go right home. Don't you have a petty cash fund? I need to stop at my friend's house and the store first."
"My boyfriend wants a set of the baby's footprints, a copy of the baby's picture, and that test to make sure he's the father."
This, of course, all in addition to the usual "The baby's diaper needs to be changed," "Bring me another Percocet. Somebody here (a visitor, not the patient) has a headache," "Take his (another visitor's) blood pressure," and "He needs some scrubs to wear."
Sorry for the rant. Yesterday was a long 14-hour day and I just needed to get it out. :angryfire :angryfire :angryfire
Ok, I'm not a nurse yet, but is it acceptable to kick visitors out of the room without a warning? Like if they curse, yell, make a scene, obviously that's not good for the patient.
Personally, I don't think I'll be able to tolerate a visitor acting innappropriately.
I have absolutely NO problem asking abusive visitors/family to step out of the room. Usually, the patient is relieved that you have helped as well.
On our postpartum unit, we have had to lock our small kitchen to keep it from being raided. We lock our linen and supply rooms as well. This isn't as cumbersome as it sounds. Our employee badges (which most of us wear on retractable cords) have bar codes that we hold up to a reader which unlocks the doors. If we didn't do this, patients, family members and friends would clean us out in short order.
We have learned to keep close tabs on the drawers beneath the baby cribs, as well. If a mom tells me she's out of diapers or formula (or pads for herself), I check. If the amount consumed seems way out of line for the time she's been on the unit, I start asking questions. If the answers lead me to believe she's hiding the stuff or has already sent some of it home, I'll open new packages of pads or diapers and bring her two. Same for bottles. I think they get the hint that I'm on to them and that, even though I can't do anything about what has already disappeared, I won't be fooled again. I warn the oncoming shift, too.
The kitchen situation is this. We keep only the absolute basics on hand. Bread, a few individual-size boxes of cereal, fresh fruit, 3 or 4 kinds of juice, canned soda, and the universal snack--crackers. We also keep a couple of box lunches on hand for noc shift deliveries but these are also basic. Our reasoning is that if anyone is truly hungry, they will be glad to have toast, a banana, and juice. If someone just wants to graze, they aren't going to find pizza and frozen dinners and other goodies that a lot of hospitals used to stock. Even so, as I said, we still keep the door locked but we will gladly provide for the postpartum mom. And I've been known to bring wiped out dads a snack or two. There isn't much available at 3:00 AM and they're really gratefull. I do make a point of telling them that this is truly an exception and, thus far, I haven't had a problem.
Oh, and the break room with the fridge for staff is also locked or I'm sure our lunches would be considered fair game for anyone out trolling for goodies.
The reason the other managers and administrators don't do anything is because we are a million dollar industry. My manager always sides with the pt and their family. We wouldn't want to rock the boat. We may not get a good Press-Ganey score if we make our pts, or shall I call them customers, unhappy. "Welcome to McDonalds. May I take your order please." It's easier and less costly to the hospital to upset the staff than it is to not kiss some pts behind.
Actually, that may be incorrect.
If you make your staff unhappy enough with poor treatment, they take more sick time, more PTO time, and they are more likely to quit, or transfer to another department. That is highly expensive to employers, in staffing OT/agency use. The shear physical cost of hiring a new staff member, orienting them as well as the cost of getting them "up to speed" as the staffer that was lost is high. There are also more mistakes, slower responses as they get use to the system.
And quite frankly some patients will always be difficult. Better facilities sometimes recognize that some regular patients have control issues and they institute "limitations" on them, requiring reasonable behavior. It is difficult to enforce but cuts down on staff abuse and burnout.
I wonder why the high "costs" of using Press Gainey or the Hunter Group is not considered excessive.
Ok, I'm not a nurse yet, but is it acceptable to kick visitors out of the room without a warning? Like if they curse, yell, make a scene, obviously that's not good for the patient.
Heck, I've had them carried out by security. In a hospital ranked in the top ten in the US. (And probably there because they didn't put up with that crap)
Heck, I've had them carried out by security. In a hospital ranked in the top ten in the US. (And probably there because they didn't put up with that crap)
We have NO trouble at all calling security to come up to our floor and stroll around:even go into a room and ask visitors to leave.
As far as cost of staff turnover, training of new people, etc., a lot of places, not just hospitals, don't seem to care about that. For example, the hospital I volunteer at, in the last 3-4 years, decided that ALL RN's have to have ACLS, not just those on critical care units. If a new hire doesn't have it, the hospital pays for it. With all the turnover, lots of other hospitals around have ACLS-certified nurses that my hospital paid for!
I once read an example of this thinking in a business magazine. If someone stole $5,000 from a business, the bigshots would turn the place upside down trying to find the culprit and trying to prevent a re-occurance. Yet it can easily cost $5,000 or more to replace someone who leaves a professional position. The hospital administrators who would blow a gasket at the rare theft think nothing of spending big bucks to constantly find and train new people!
As far as cost of staff turnover, training of new people, etc., a lot of places, not just hospitals, don't seem to care about that. For example, the hospital I volunteer at, in the last 3-4 years, decided that ALL RN's have to have ACLS, not just those on critical care units. If a new hire doesn't have it, the hospital pays for it. With all the turnover, lots of other hospitals around have ACLS-certified nurses that my hospital paid for!
I once read an example of this thinking in a business magazine. If someone stole $5,000 from a business, the bigshots would turn the place upside down trying to find the culprit and trying to prevent a re-occurance. Yet it can easily cost $5,000 or more to replace someone who leaves a professional position. The hospital administrators who would blow a gasket at the rare theft think nothing of spending big bucks to constantly find and train new people!
The cost of hiring a new person is substantially higher than $5,000 - estimates are closer to 6-10 times that amount, or higher.
And I've worked in those places that "require" everyone to have ACLS....the requirement lasts about 6-24 monthes because it is not cost /personnel effective. They were trying to phase out "Code Teams".
I know a lot of awesome nurses that I would never want running a code on me. I do not think that skill is quite as interchangeable as others.
:confused: Has anybody noticed how our hospitals' entrances, the VIP floor and some other areas are becoming more like hotels with commodities that frankly, I doubt sick patients will be able to enjoy that much. I am talking about internet access in the rooms, wood laminated walls and marble in the bathrooms. These items raise costs and do not improve patient care; only giving the impression that a person actually chooses the hospital stay instead of having to be there because of a health problem.
When I have visitors or patients ask for more chairs, I politely explain to them that it is against our hospital policy to have more chairs added to the room due to fire hazards. !
I ask why they need more chairs when there is a sign stating only 2 visitors per room and there are already 2 chairs in the room. Then go to the room and request all but 2 visitors leave.
Now I speak fluent spanish however I am not of latin background. However further in her complaint she stated that my pronouciation was horrible and that administration had better straighten out the matter.
When I worked in California, Texas and Florida had several patients make remarks about my pronounciation was awful, so I told them that they were right and would only speak english in the future.
I don't doubt the patients would like longer stays to actually be able to recover, yet I know that in this day and age of Managed Care and Drive-By-Surgeries, none are allowed that perceived "luxury" . 23-hour total modified mastectomies and highly publicized reconstructive cosmetic surgeries done as out-patient procedures do not even allow the visitors, let alone the patient, to enjoy those expensive attractions. I think it is the corporate mentality that is driving this competition for a "more pleasant, surrounded by the comforts...., nicer, more luxurious hospital room/stay".:redlight:
:confused: Has anybody noticed how our hospitals' entrances, the VIP floor and some other areas are becoming more like hotels with commodities that frankly, I doubt sick patients will be able to enjoy that much. I am talking about internet access in the rooms, wood laminated walls and marble in the bathrooms. These items raise costs and do not improve patient care; only giving the impression that a person actually chooses the hospital stay instead of having to be there because of a health problem.
BETSRN
1,378 Posts
I have absolutely NO problem asking abusive visitors/family to step out of the room. Usually, the patient is relieved that you have helped as well.