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

[General E. Speaking, RN]

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?

[MAISY, RN-ER, BSN, RN]

That's BS! Can you tell I worked today....it was a BS day!

I can't stand when patients who are not acute whine about any nurses lack of "face time". I always get great reports, am mentioned often in PG reports and have never had a complaint written up by a patient-that being said.....I stop them dead when I start getting the complaint vibe, I refuse to put up with it.

It usually goes something like...if you stop breathing, your heart stops, or you have a brain attack I will be here with you until we fix you....meanwhile my other patients will wait! SO, if you are waiting for ice, blankets or a pillow.....it's because someone else needs me more! I then remind them, they were treated, minor inconveniences are just that MINOR!

I am getting really tired of entitled thinking...the only ones who can give patients a reality check is us! We'd better start doing it! We need to set limits, and realistic expectations for hospitalization and treatment, otherwise we will suffer for it!

JMO

Maisy----cranky today:no:

[RN1982]

If I am busy with a critical patient and my other patients complain because they are out of ice or need a blanket, I tell them I had an emergency. Some people like to use that "Well, I need care too!" excuse but sorry, your care didn't require me having to call anesthesia to stick a tube down your throat. Or take you for a CT scan because you are having a seizure.

Management likes us to pretend to our patients that our jobs are not as hard as they actually are. They want us to walk around with that "stepford wives" smile on our face and act as if we are not stressed from poor working conditions and outrageous patient ratios.

[locolorenzo22, BSN, RN]

I've had many patients try to say "oh, I had to wait FOREVER for someone to come answer my light"...when all they needed was ice/blanket, water, etc.....Some have tried to tell me that they've been waiting for 10 minutes...We have a call light system where after 3 minutes(yeah, heck of a response time, eh?) the light turns green and starts flashing....

So, if they go into that, I mention..."i'm sorry, the light was not green....did someone else come in before me?" usually shuts em up.

I always explain that when they are waiting for meds....that we are trying to pass meds on everyone...so we may be a little behind, but I'll make sure we have your stool softener.

I always say "well, if you feel there is something I NEED to address with you, please make sure to let whoever answers the light know and I'll be with you as soon as possible."

OP....when the patient would have started on the whole "not meeting my needs" spiel...I would have asked "And which needs are we not meeting? If you needed pain meds, or something vital...I would be here as soon as possible. However, right now, an emergency came up and I needed to take care of it. I'm here now, though. What can I help you with?"

[RNcDreams]

I think patients appreciate a truthful response.

My last shift consisted of 4 patients-- one with chest pain, one patient waiting for an ICU bed, one patient who was a DNR and rapidly decompensating, and the last one was someone who fell in the dirt and had scrapes/ a small wrist fx that didn't require admission.

Yes, you guessed it. Room #4 was on the light over and over for pain meds.

Yes, you bed I told them I was working with the family of a dying patient and that I'd be with them as soon as I could.

And yes, you bet I told the family of the dying patient that I'd be with them more continuously as soon as I made sure my ICU patient got upstairs without any events.

My feeling is that if patients and their families know what our workloads are like, they will talk about it outside of the hospital setting and enact some change, somehow... some way....

You did great!

[Cindy_A]

Don't bet on pts and families knowing what your workloads are like. That's why mgmt. doesn't want you to say your are busy with other pts. As long as nurses put up with this, nothing will change. We are always supposed to give in the to the whiney PITA pt, or get in trouble. Everything is the nurses fault - didn't you know?

[bethin]

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.

:yeahthat:

Just last week I had a pt who needed a sprite NOW when another pt was in resp. distress. It took me 15 mins to get to her light but I was running for the nurse, dr, RT, etc getting supplies so this guy could live (he was only in his 40's). When I did get to her light she rudely asked me what took me so long to get her coveted sprite. I told her point blank that this isn't a hotel and I was with a pt who was in trouble. That shut her up.

BTW, I rarely blow up at pt's but I could tell this one was going to be demanding and rude for the duration of her visit. I think pt's think we sit at the nurse's station sleeping, eating, and surfing the net. Heck, I'm not even a nurse and I get asked that question when I work nights.

[pagandeva2000, LPN]

I hate when I do go respond, they want to take up even more of my time complaining about why I didn't come fast enough, what they went through (thirst or hunger) while waiting for me. I told one once, that will all of this, I could have taken care of the need and moved on to someone else.

[bethin]

I hate when I do go respond, they want to take up even more of my time complaining about why I didn't come fast enough, what they went through (thirst or hunger) while waiting for me. I told one once, that will all of this, I could have taken care of the need and moved on to someone else.

I think the same thing as I listen to them complain for 5 mins. I've been tempted to say it, but I'm one of those people who when they do say something even slightly rude it comes out REALLY rude. Some can get away with saying stuff like that but not I.

I have two settings: really cold and so hot you'd wish you were dead.

[pagandeva2000, LPN]

I think the same thing as I listen to them complain for 5 mins. I've been tempted to say it, but I'm one of those people who when they do say something even slightly rude it comes out REALLY rude. Some can get away with saying stuff like that but not I.

I have two settings: really cold and so hot you'd wish you were dead.

Behavior like that drives me insane. I don't always know how it comes out, but at that moment, all I can care about is that I have to run on roller skates to people that have legitimate issues.

[Babs0512]

Let's face it, even on days where we are properly staffed, it you have a couple of critical patients and one walkie talkie, your priority is going to be on the most critical first. So I can see this happening even with proper staffing.

My response is typically, "Thank you for being so understand and patient, I was tied up with something, but I'm here now, what can I do for you?" Usually I make a point of sitting down when I say this, it gives the impression that your taking more time with them than you really are. Thanking them in advance, gives them little room to then be upset with you, as you've started with a compliment. It works for me, just a suggestion.

[RainDreamer, BSN, RN]

That would have left me flaming mad if my manager had said something like that :angryfire

I think that's why tele and med/surg floors continue to be understaffed (or not staffed properly for acuity) and will continue to be until stuff like this changes drastically.

[Ms.RN]

how about being bluntly honest and tell the patient "i"m sorry but i dont have two bodies" please give me a break one nurse cannot be i the same room with every patients at the same time!!!