Not allowed to say "I was busy w/ another pt"

Published

Specializes in floor to ICU.

I work Tele. I was recently told by my manager (after a patient complained) that I cannot tell patient's that I am busy with another. Where does this leave me? What should I say? "I'm sorry I am an incompetent nurse who cannot time manage very well 'cause I didn't know that my nap and eating those bon bon's in the break room would take so long?"

Seriously, I came straight out of report and went to see my first patient (turned out to be unstable). Older gent on a bipap that he pulled off, he was hypoxic (60%), restless, pulling at his IV lines, etc...Managed to get the bipap back on but he was slow to oxygenate up. I was at his bedside continuously, then his SBP was running 180-190, DBP 100's. Called the MD, lots of new orders. FULL CODE btw. Call from lab: another patient with a critical K+ of 2.9- needed riders. I quickly go down to assess her IV site which is red as hell and infiltrated. She was crying about getting more K+ thru her IV so I had to call and get a Lidocaine order for Pharmacy to mix in the bag. No veins, of course. Charge nurse managed to get another line in her for me. Another patient going for surgery, etc...on and on- I was running! Charge nurse was helping (thankfully)

I know this patient well who complained about me. She is a frequent flyer who is a frequent complainer. I did manage to go in and make sure she was breathing and no acute distress. She kept calling for nonessential things during my busy time (see above). I sent the tech in and the charge went in a couple of times. When I finally got my other patients somewhat stable and settled (although I had a dry mouth and a full bladder) I went in to see her (her light was on AGAIN- no surprise) She started complaining that we weren't paying attention to her needs, etc. It just came out. I said, "I am sorry but I was busy with an unstable patient. I am here for you now. What can I do for you?"

When the chaplain did his "customer service" rounds, she complained that my nurse said she was busy with another and didn't have time for me, blah blah He immediately went to my supervisor. They gave her a balloon as an apology!:angryfire

In the end, my supervisor and others shrugged off her complaints (as she is well-known for never being satisfied) but I am still struggling with the whole 'I can't tell patient's I am busy'. Is it just word play? Am I getting unraveled for nothing?

What do you think?

Up Vote Up Vote ×

They don't want patients aware of poor staffing ratios so they will make nurses the scapegoat instead. It's the dirty little secret hospitals like to keep.

I've apologized to patients who've had to wait for non-essentials due to other patients having dire needs. Most seem to understand and accept the explanation. If they don't they should because if they were going downhill they'd want me by their side to assist them not getting someone else a soda.

Up Vote Up Vote ×
Specializes in ccu cardiovascular.

What are their responses to what you are suppose to say. I say what i was doing "I was in report, I was performing a procedure or assisiting another patient" Face it you cannot always be with every patient at any given moment. If they expect that then maybe they like to have a one to one patient staffing.

Up Vote Up Vote ×
Specializes in Home Care, Hospice, OB.

what do you think?

i think that your manager wants to pretend that the nursing ratio on your unit is 1:1, so if you are not available every second it's because you are napping and eating bon-bons!!!

i wouldn't buy this for an instant. i have, and would continue (if still at bedside) to state that "i am sorry for the delay, but i was caring for another patient who was unstable, the same way others would wait if your life was on the line, ma'am.":devil:

Up Vote Up Vote ×
Specializes in ICU/CCU.

Don't let this eat at you!! :banghead::barf02:You know what the deal is and I wouldn't loose sleep over this. Next time, just say...(just like you said) im here for you now..what can I do for you?? Have a good night and hope you next shift is better!!:urck:*wine

Up Vote Up Vote ×

this is the case everywhere, because it could cause unwanted fear for a patient. a little ridiculous, i know.

i am a waitress at a retirement community and i can't say "i'll be with your table in a minute, we're a little short staffed tonight" because they could fear that they will be neglected. i know, having to wait an extra 10 minutes for dinner is a scary thought for some of those people... they can get quite worked up over the littlest things.

Up Vote Up Vote ×
Specializes in Maternal - Child Health.

Well, since the truth is no longer allowed, I suggest lying.

Tell your patient that you were finishing your 2-hour lunch break and just couldn't pull yourself away from your flaming bananas Foster :)

I'm sure that will sit much better with the patient and your manager!

Up Vote Up Vote ×
Specializes in floor to ICU.

The thing is I had 4 patients (we can go up to 5) so I didn't necessarily feel I started out understaffed. It is just so frustrating because we cannot be in 4 places at once. This is why we learn to critically think and prioritize.

I am so sick of the customer service aspect of hospital nursing...

Up Vote Up Vote ×

I like Jolie's advice . . . :D

Seriously, I am not a robot to be programmed. I'll say what I think is the professional thing to say and that is it.

steph

Up Vote Up Vote ×
Specializes in ICU.

Can you say, "I'm sorry, things have been busy for me this morning, but (tech and charge nurse) and I have been keeping an eye on you and right now you have my undivided attention." That way you are giving your excuse, but letting her know that she is important. Some people are scared that when you aren't paying attention to them, something bad could happen and you wouldn't be aware. Of course, that easier to say in the ICU when they have monitors and we can say we're watching them constantly. But seriously, some patients aren't happy unless you are in their room giving them a back rub on the hour every hour and are therefore not going to be happy.

Up Vote Up Vote ×
Specializes in Community Health, Med-Surg, Home Health.

I think this sucks, because I had a situation in a clinic where a patient who did not require nurse counseling (at least according to the doctor) asked the PCA about her medication regimen. I brought her into my office and started teaching her about her meds, side effects and self administration. Another PCA came running into my room and told me that a patient has to go to the ER because she had chest pains. I politely tied up the meeting with the first one, and then, she pulls out a glucometer and demanded that I teach her how to use it NOW. I said to her that if she is willing to wait, I'll demonstrate, however, and I quote: "As you just heard, I have an emergency. I cannot guarentee how long you'll have to wait, but if you do, after things settle down, I'll be happy to show you". She starts making a major scene and I had to basically walk out on her. She follows me and I then said "This patient is allowed emergent care as well as privacy, so, you cannot follow me any further. If you really need to leave, you can come back tomorrow, or there is an 800 number in your new package and they can walk you through it" (I know, because that is the number I usually call when I am at a loss).

If that patient died, the family would not want to hear that she didn't make it to the emergency room because I had to save the day and show someone else how to use a glucometer. I didn't turn her away, but it didn't matter...prioritization of care is what nurses do.

Up Vote Up Vote ×
Specializes in Hospice, Critical Care.

Yeah it's the same everywhere. We are never to say we are busy or give an implication that we are "too busy for you" to a patient for whatever reason (I once had a family member tell me he didn't care that I was in an emergency as I was flying down the hall for meds for a patient with chest pain--his mother needed care, too, and she was out of ice! At the time, i had 18 patients on a med-surg/renal floor.)

My lie: "I'm sorry, I was assisting a physician with a procedure..." Somehow it's ok for the DOCTOR to be busy but not the nurse

Up Vote Up Vote ×
+ Join the Discussion