I discovered something about myself this week: I hate the phrase "I'll go get your nurse." I also have a similar disdain for the phrase "I'll have your nurse take care of it." They're simple, innocent enough phrases, but their implications are loud and clear.
G, a co-worker and CM, stopped in to see my patient to discuss matters pertaining to discharge. While speaking to the patient and his daughter, the daughter requested that the patients' vital signs be re-checked as she's worried about his condition. V, my PCA, happened to be in that room, organizing supplies. G exits the patient's room, spends approximately 10 minutes (per her report) looking for me, and once she finally is able to spot me, says this: "Mr. __ 's daughter would like his vital signs re-checked. Can you do that when you have a minute?" ...
I pause for a minute and decide I have two ways to handle this: I can either endorse the theory that the nurse is *the* essential personnel and all issues/requests big and small (and tedious) ought be reported to her so she can carry out the request, or I can begin holding other members of the health care team accountable for the things which they are effectively able to delegate and/or take care of themselves. I choose the latter.
I say to G: "V is in the room organizing supplies. Could you please let her know?" G stares at me, stunned, and is unable to form a sentence for a minute. When she finally collects herself, she says, "Well, you're the nurse, why can't YOU do it?" I politely explain that a vital signs check is an appropriate task to delegate and at the moment I am taking care of a nursing responsibility that only I am able to complete. G stands there for a few more moments and then turns back around to finish her conversation with two other staff members, and I finally resign to the fact that my subtle message has fallen on deaf ears. I sign, find V, and ask her to please re-check the vital signs.
This, while a small and isolated issue, represents a larger problem. It is my belief that ancillary staff (those unlicensed) and other members of the health care team (including CM, SW, MD, RD, PT, and OT) should be able/willing to assist with requests presented to them that require a) little time to do, b) no nursing experience or license, and c) are appropriate to delegate to another person. I do realize that as an RN I represent the center of the patient's entire care experience, but I refute the idea that the nurse ought to be preoccupied with obtaining ginger ale's, extra pillows, changing the television station, or obtaining a telephone. As you're expecting me to carry out these menial, easily delegated tasks, I am often in the middle of more serious issues such as stabilizing a blood pressure, inserting a new IV, re-assessing a patient that has fallen, or being present with a physician to discuss end-of-life issues. Why has it become unacceptable to hold other staff members accountable for the things they are able to do?
It's the age old concept: nurses' can do everyone else's job (except portions of an MD's occupation), but not all staff can do a nurses' job. However, in the era of patient satisfaction surveys being tied to re-imbursement, nurses struggle day-to-day to provide safe, competent care while also balancing the needs (and often demands) for miscellaneous items that do not contribute to the overall picture. In nursing school, delegation is stressed to the maximum, as way to assist the patient in obtaining those "creature comforts," while also respecting the nurses' right to focus on the nursing care plan, perform interventions, re-evaluate those interventions, and document accordingly. While it seems as though I am suggesting that the nurses' time is more valuable than that of other ancillary staff, that is not the case. My point is simply that when an ASA receives a call over the call light system for an extra blanket, a box of tissues, and a magazine, he/she is capable of providing those items so that the nurse can carry out nursing-specific tasks that cannot be delegated.
As I step off my soapbox, I'm interested to hear the thoughts of others. Do you feel frustrated when pulled to perform tasks that are easily able to be performed by the person requesting your attention? How do you balance the demand to do all things related to the patient with ensuring the important nursing-only tasks are carried out? Is this isolated or does this happen in your environment as well?
I was so glad to see this. One of my biggest issues with RNs is their failure to delegate those tasks that can be done by others. I was a patient for 4 months this past year, intermittently. The one thing I noticed above all else is the failure of nurses to utilize the people they are teamed up with to assist them. I started deliberately asking for the patient tech or the housekeeper, or the particular person I needed if it was a non nursing task. I still ended up with the nurse most of the time. I was not able to get up and help myself for a good portion of the time I was in the hospital, so was dependent upon others to help me. I tried very hard to not burden the nurses, so frequently asked for a tech or CNA.
I am a Nurse Manager for a Home Dialysis center. I just was allowed to hire a Tech. It is going to be quite an experience teaching my RNs how to utilize our new Technician. He is experienced and will be very useful. It will be training the RNs to utilize him properly. I chose him because he is quite assertive and will be able to say: "Let me do that for you".
And I'm sorry I didn't clarify before hand. But what I was referring to above was the snarky, passive aggressive post clearly aimed at me.
You are under no obligation to clarify acronyms. This is a fun forum not a piece of official documentation or an assignment for college. I'm from the UK, I just google all the stuff I don't understand. All the members of this forum can obviously use the internet and it doesn't take long.
Regarding the OP, I would also like to ban the phrase. If there were enough RN's to do all the tasks it would be more tolerable but there aren't and it isn't.
KatieMI - I so wish it were true that "... nurses do not cook, swipe floors and sew bandages anymore" but I just took a 2-hour training course in serving food because our LTC facility is changing to a "household" model where everyone pitches in to give the residents a more home-like environment. Next up is a training session on "throwing in load of laundry when you have time." When do the support staff get trained on doing my med-pass and assessments? You can bet that resumes are being updated and as quickly as possible. Two of six nurses on my unit have already given notice.
I 100% agree with you, that being said, if you worked where I work, what you said and how you handled it would be immediately reported to your manager and you would be reprimanded. Believe me I have handled similar situations and I have gotten nothing but a talking to about my insubordination. I have had situations where I am forced to take a phone call in the middle of a dire situation and when I took the phone I told that person (an administrative support person) that it wasn't the best time and I would need to follow up later and BOOM, next thing I know I'm getting a talking to because this secretary called my manager and reported insubordination. Heck everyone, ancillary staff, other professionals, etc think they can have you at their beck and call and the minute you refuse, put them off, whatever, at least in my hospital, you will have your ass in the office so fast your head will spin and it's everyone else accusing nursing of insubordination. I love what you wrote, but we aren't there yet. There is no respect of the nurses time and if we aren't acting like a waitress/waiter, then the person using you will think they are not getting satisfactory service after all.
The other ting that cracks me up at my place is our administrative assistant who e mails us RNs all day with demands and information and in bold caps puts, at the end of the e mail ...RESPOND BY END OF DAY. Then when we don't respond, and we don't because who has time to check e mail all day, she says "they didn't e mail me back and it's not MY responsibility...LOL...whatever....
I worked at a hospital once where a medical resident (a RESIDENT!) visiting a patient at bedside put my patient on a bedpan at her request. She came to the nurse's station (where I was busy charting) to tell me that she did that. This was the first time a doctor had ever done anything like this in my experience, so I was a bit shocked. She shrugged it off as it not being a big deal, but just wanted to let me know so that I was aware when the patient was done. That doctor earned my highest respect from that day on. She was quite awesome in all respects. Oh how I hated the day she left for another rotation
But I have also had frustrations with these moments you describe, where personnel take MORE time to find a nurse to perform a menial task that could have been done quicker doing it themselves. And case managers who now think they are above floor RN status and dont need to touch patients anymore, I really resent this. What is wrong with doing a blood pressure yourself? Arent you still a licensed RN?
BTW, there are some days when patients take me to the point where I start thinking about becoming a flight attendant, because it is exactly how I sometimes feel. But just when I am convinced that I should go that route, another patient experience reminds me that nursing is truly where I am meant to be.
... I just took a 2-hour training course in serving food because our LTC facility is changing to a "household" model where everyone pitches in to give the residents a more home-like environment. Next up is a training session on "throwing in load of laundry when you have time." ... Two of six nurses on my unit have already given notice.
I would have walked out the door straight off. No notice. No way.
Ban the phrase "pt x wants to talk to his/her nurse". No one ever asks why. So I go, and it's bs like "When is my supper coming?" "My pillow is flat and my feet are cold" "My urinal is full".
Last weekend, I gave my cna's report for the shift, and then reminded all of them to not come to me with "pt x wants to talk to you" without at least attempting to find out if it is something they can attend to.
They thought I was kidding. They found out I wasnt.
I agree. Ban this sentence. If a person uses this line this implies irresponsibility.
That's exactly why some people *do* use that line. Because they are not the party responsible for executing the request being made of them. One thing I realized during my many years working as an RT was that, in the vast majority of patient's eyes, every warm-bodied female that enters their room must be a nurse. I was regularly asked for pain medicine, or if they would be discharged that day, or for the results of some diagnostic test, or told they're having chest pain... (you get the idea). By telling the patient that I would get the nurse, I was essentially telling them that I am not their nurse but I will be sure to pass their request/inquiry/concern on to the appropriate person.
If the request being made of me within my scope/ability then I would personally assist them. Need another blanket or pillow? Sure thing. Asking for ice or water? I'd get that too after I hunted down the nurse to make sure it was OK for them to have water and that it didn't need to be thickened. Need the bedpan? I'd tell whoever I found first - the nurse or the aide.
Sometimes it is perfectly appropriate to tell a patient that you'll go get their nurse.
Ban the phrase "pt x wants to talk to his/her nurse". No one ever asks why. So I go, and it's bs like "When is my supper coming?" "My pillow is flat and my feet are cold" "My urinal is full".
Last weekend, I gave my cna's report for the shift, and then reminded all of them to not come to me with "pt x wants to talk to you" without at least attempting to find out if it is something they can attend to.
They thought I was kidding. They found out I wasnt.
Best response I've ever seen! I will definitely be using this if/when the opportunity presents itself...
That's exactly why some people *do* use that line. Because they are not the party responsible for executing the request being made of them. One thing I realized during my many years working as an RT was that, in the vast majority of patient's eyes, every warm-bodied female that enters their room must be a nurse. I was regularly asked for pain medicine, or if they would be discharged that day, or for the results of some diagnostic test, or told they're having chest pain... (you get the idea). By telling the patient that I would get the nurse, I was essentially telling them that I am not their nurse but I will be sure to pass their request/inquiry/concern on to the appropriate person.
If the request being made of me within my scope/ability then I would personally assist them. Need another blanket or pillow? Sure thing. Asking for ice or water? I'd get that too after I hunted down the nurse to make sure it was OK for them to have water and that it didn't need to be thickened. Need the bedpan? I'd tell whoever I found first - the nurse or the aide.
Sometimes it is perfectly appropriate to tell a patient that you'll go get their nurse.
Request for pain medication are appropriate to request of the nurse.
Needing a bedpan is not. Surely you know this. And fetching a pitcher of water, if you're concerned for a patient, can also be delegated to the PCA. I suspect you also know this as well.
Request for pain medication are appropriate to request of the nurse.
Needing a bedpan is not. Surely you know this. And fetching a pitcher of water, if you're concerned for a patient, can also be delegated to the PCA. I suspect you also know this as well.
"Fetching a pitcher of water" was something I was perfectly willing and able to do, once I ascertained from the nurse that it was OK to do so. I didn't delegate that task to a PCA when I was willing and capable of doing so myself. As for the bedpan - I relayed those requests to the first person on the patient's team that was able to help them, whether it was the nurse or the aide. Assisting a patient onto a bedpan is not solely the role of a PCA, but surely you know that.
GaleSRN51
12 Posts
I was so glad to see this. One of my biggest issues with RNs is their failure to delegate those tasks that can be done by others. I was a patient for 4 months this past year, intermittently. The one thing I noticed above all else is the failure of nurses to utilize the people they are teamed up with to assist them. I started deliberately asking for the patient tech or the housekeeper, or the particular person I needed if it was a non nursing task. I still ended up with the nurse most of the time. I was not able to get up and help myself for a good portion of the time I was in the hospital, so was dependent upon others to help me. I tried very hard to not burden the nurses, so frequently asked for a tech or CNA.
I am a Nurse Manager for a Home Dialysis center. I just was allowed to hire a Tech. It is going to be quite an experience teaching my RNs how to utilize our new Technician. He is experienced and will be very useful. It will be training the RNs to utilize him properly. I chose him because he is quite assertive and will be able to say: "Let me do that for you".