I guess I am starting to wonder why we can't tell the patient that.
I thought I knew- that it was rude- that it equated to saying "I don't have time for you"- "you aren't important" etc.
However, in my garbled mind, I am starting to wonder who, exactly, this omission really protects.
As a nurse, slammed and hurried, rushed and prodded by the latest budget meetings, job stability feeling shaky in her mind... along with the disease processes, the calculations, the mental to do lists, the hourly rounding to be signed on the doors, constant charting- in multiple locations, phone calls, the sounding alarms, the delegation, the collaborative efforts, new orders, lab interpretation, the basic ABC's...
that's a lot going on... and that doesn't even take into consideration the patient...and it's true! We DO have harder times getting into patient's rooms, we do spend less time "actively listening"... hard to do with that work load on your back...
If a patient is attentive, they know that the nurse is overloaded... aside from avoiding a lawsuit, what is the point.
There are ways to say things that do not covey that the patient is not important..
Now- I am not going to say it, and I understand why it's not appropriate, but I just wonder....
Don't forget ... Part of what you are protecting your employer from is a lawsuit. And while we sometimes may really wish our employers would get sued, in reality, a lawsuit would be bad for us, too ... and we are usually better-off without getting sued. Most of us don't really want to be hounded on the witness stand by the plaintiff's lawyer trying to get us to admit to giving bad care, regardless of the reason for that bad care.
Don't forget ... Part of what you are protecting your employer from is a lawsuit. And while we sometimes may really wish our employers would get sued, in reality, a lawsuit would be bad for us, too ... and we are usually better-off without getting sued. Most of us don't really want to be hounded on the witness stand by the plaintiff's lawyer trying to get us to admit to giving bad care, regardless of the reason for that bad care.
I understand that short staffing is a real issue, but the reason I wouldn't say to a patient that we are short staffed is because I would be concerned it could open the door for patients to be looking for reasons to find fault with nurses. I would be concerned that they could look at that as being a real structural issue within the institution, and therefore something that could add to a complaint or a lawsuit should they have a reason to claim negligence or fault with their care.
If a patient complains about something taking a long time, I'd rather just say "it's been really busy, I'm sorry to keep you waiting." By saying "we are short staffed," it also appears like you might be trying to pass the buck (even though lack of staff is the issue) as opposed to taking responsibility for whatever is happening and addressing the needs of the patient.
Could you say something like "Sorry it took so long to bring you your xx, the floor is full tonight?" so you aren't saying you are short staffed, just have a full census? I'm not even in NS yet, still doing prereqs. Just wondering!
I understand that the economy is coming down hard on workers and companies alike, but expecting one person to do the work of three or four is short-sighted in ANY industry! You can only push worker productivity so far before you just hit the wall. Throwing in additional responsibilities on the vastly reduced number of employees who remain makes the situation even worse. An insufficient number of workers adds up to more mistakes and associated legal costs, higher turnover and additional training costs, rotten employee morale, weaker care, and poorer customer service ratings, among other problems. This is basic management theory!!!
I understand the need to cut back a bit, because that's just what you have to do when your revenue stream weakens. However, cutting back to such an extreme degree is counterproductive in the long run for everyone involved.
I would much rather know the facility is short-staffed than come away with the mistaken impression that the nursing staff is lazy. Of course, knowing that information might encourage patients to place the blame for slow care or any mistake made by a nurse trying to complete a herculean workload where that blame actually belongs! Gosh, who (in management) would want that?
As a future paper-pusher, if I ever end up in a management position, I promise I'll take The Pledge proposed by Fungez. :)
I work on a Med A floor where most of the patients are in for ortho related issues and need PT/OT. When they are out of their bed and walking up the corridors with the PT they can see me running around.
So when I say "I'm sorry this is late, I had an urgent issue with another patient" they believe me. I don't say we're short staffed or that I have far too much to do, even though it's the truth.
I do believe that saying "I was with another patient" is perfectly fine, even though some facilities don't even want you to say that anymore.
Specializes in General adult inpatient psychiatry.
I had practically no other excuse a couple of weeks ago. We were told that because day shift was only having 3 nurses instead of 4, night shift should give out 1000 AM meds (daily, not specifically scheduled QAM for a reason). It confused the hell out of patients to be woken up @ 0630 with offers of their morning Lithium or Cymbalta. God forbid they were getting labs that morning too because if we'd screwed it up, it wouldn't have been our faults because our NM told us to.
Okay we all agree we are short staffed!. as nurse lets do what we canb do best. Come up with creative ideas to combat this problem. can we go back to the older ways of. taking the non-nursing duties away from the nurse, and letting us do what we are trained and expected to do. It does not take a nurse to draw blood,do resp tx, and yes place food trays in a room just because the pt's in isolation. Okay lets go even to higher degree. The ideas of helping the new nurses pay off their school cost is great. But how about us vintage nurse who long ago have paid back their loans. Tax cuts for not only nurses but any public service careers that are suffering from shortages.fireman,police, teachers, nurses and more. Its not a matter of who is more important but as simple issue of supply and demand. may be an incentive to stay in the field longer, and if your forced out premature, a comfort that if it is R/T your work history, then you can rest assure that you will be able to retire without fear of losing everything or at least have an affordable healthcare program for those of us that may fall into these situations. okay maybe not the best ideas from me but at least lets get our minds stimulated to come up with some ideas instead of just worrying and complaining. Wow that's weird coming from me. Oh well take care
I had practically no other excuse a couple of weeks ago. We were told that because day shift was only having 3 nurses instead of 4, night shift should give out 1000 AM meds (daily, not specifically scheduled QAM for a reason). It confused the hell out of patients to be woken up @ 0630 with offers of their morning Lithium or Cymbalta. God forbid they were getting labs that morning too because if we'd screwed it up, it wouldn't have been our faults because our NM told us to.
oh my g__!!!!! Now, let me say that this draws the line. The ENTIRE system is at jeopardy- patients and nurses alike. Is your NM still enforcing this?? I do not have a clue as to what I would do.
Specializes in General adult inpatient psychiatry.
oh my g__!!!!! Now, let me say that this draws the line. The ENTIRE system is at jeopardy- patients and nurses alike. Is your NM still enforcing this?? I do not have a clue as to what I would do.
:eek:
This was a one time thing and while she's asked us to pull meds ahead of time and put them in the pts drawers in the locked med room before, we do have safetys in place, like electronic charting and barcode scanning of patients and meds.
Every hospital I've worked in for the last 13 years has had a strict policy never to let your patients know the floor is short of staff or that any agency, or travel RN's are working on the the floor. - Better to have patients think the night shift has ample experienced RN's, and CNA's who have all worked on that floor a long time.
Personally I've always assumed it's to protect the hospital at the expense of the RN's license. Sure hospital lawsuits take time if you're deposed but it's much worse if a patient thinks YOU are incompetent and files a complaint against your license. For the hospital it's better to make the RN look slow or uncaring when the pain med isn't right on time rather then have the patient know you have 9 patients per RN and only one CNA on the floor. Sheesh. Some of the realities of hospital nursing can turn you into a cynic.
:eek:
llg, PhD, RN
13,469 Posts
Don't forget ... Part of what you are protecting your employer from is a lawsuit. And while we sometimes may really wish our employers would get sued, in reality, a lawsuit would be bad for us, too ... and we are usually better-off without getting sued. Most of us don't really want to be hounded on the witness stand by the plaintiff's lawyer trying to get us to admit to giving bad care, regardless of the reason for that bad care.