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?
Specializes in Infusion Nursing, Home Health Infusion.
Yes the whole customer service thing!!!! I have been known to say that and I do not see any problem with it. What is wrong with gently reminding people they are not the only ones in the hospital. ( especially for non-urgent needs). I actually have said the same thing many many times I am here now how can I help you. I understand the staffing and all our patient issues are not the patients problems...I get that....but sometimes you have to draw the line with chronic complainers or they will walk all over you and subsequent nurses.
The majority of patients feel as though "they" are very important, and their illness is "just as important" as anyone else. Also, the general public often doesn't know what a real emergency is - so they panic and off goes the call light. Example: someone accidentally pulls out there IV, unless they are on heparin and coumadin, the IV site will bleed, but will clot with just a little pressure. Patient and family see "all this blood" and panic. This is an emergency to them. We know the site will eventually clot and the likelyhood of them bleeding to death from an IV is so remote as to be not worth discussing, but the average person doesn't know this.
In our hospital, we even have "oops" baskets. If a patient has come in for an outpatient procedure and has to wait hours past their time, we order small baskets of fruit from the kitchen for them. It's all about PR.
It would be nice to be able to say "sorry, your needing ice water had to wait because I had a guy in cardiac arrest a few rooms away". That would just scare the patient. Just best to stroke the patient and "make nice" to save yourself the hassle. That's just my opinion.
Happy patients recommend your hospital to others, and they themselves return, think of it as job security.
I always try to not say, "I was busy with another patient...." I've never been told not to say that by management. For the most part, I try to make all of my pts feel like their needs are my top priority, no matter how small and insignificant. I don't make excuses why I haven't "gotten their sprite" or anything like that. I apologize and move on with my day. If me apologizing isn't enough then screw it.
There have been times when I definitely feel your pain though.
A few weeks ago I was letting a patient vent about their care. A frequent flyer, complaining that the nurse on the shift before me was slow meeting some need, right? So I was standing their explaining that all the RNs are the "most popular people on the unit" when one of my coworkers popped in and said, "Hey, do we really need to insert that greenfield filter tonight? they're gonna have to call people in...the doc isn't happy!" I said, "Yea well otherwise the patient might have a heart attack and die!" Afterwards, the patient I was talking to gave me props for calling the physicians in. I told her I'd do the same thing for her if it came down to it.
I guess I just feel like when I'm assigned to a patient/room, that's my turf. I get all protective. But there are definitely times when I'd love to say, "I was busy with another pt" However, I just don't do it. Maybe I'm modest? I dunno...
No matter what, don't make excuses. There's no reason why you should make an excuse that you didn't meet some want. The patient wants sprite when they have a cup of water sitting in front of them? Well, tough crap that they had to wait an extra 30 mins....."I was busy with another patient" is a lame excuse. That's just my opinion.
We are in a no-win situation. I WILL tell a pt. I was delayed b/c an emergency came up, or I was with one of my other patients. I instruct my pts. to call for me for pain meds, nausea meds, SOB, etc. AND call the aide for drinks, snacks, extra pillow, etc.
I usually get, "oh, I didn't want to bother her, she is so busy, and you're here". If I have the time, I do it, but if it is a med pass or assessments for start of shift, well, they have to wait for the extras.
Then if I get a chewing out, I will document on nursing notes, and if necessary, fill out an incident report of pt. complaint and how I tried to deal with it, to cover myself. I have had roommates of a pt. tell me, "no, he hasn't been waiting for 30 min. he just called..." It is extra documentation, but I have it in writing when Dr. wants to know why his patient was kept waiting for 45 minutes.
Ask your manager what you should say. She told you what not to say so she can also tell you what you should say.
And, yes, do try to let it not get to you. Do keep telling the truth about how you and other staff were fully aware that she was safe because you were peeking in on her, even if she didn't know it, even if she could not get a non-essential need met right away.
I have spent so many years feeling so badly about myself but I am realizing more and more than I have been set up to fail by my idiot bosses and their unreasonable demands. I'm actually beginning to feel better about myself.
I remember a few years back when either the state or Joint Commission said that telling a patient you were short staffed was a form of intimidation. We were subsequently told not to say that. However, up until I left no one ever told us not to say we were with another patient. I know what is bothering you. You were doing such a great job of dealing with crisis after crisis and what you actually deserved was a pat on the back. How ever what you got was complaints. I guess that chaplin thinks he is such a great patient advocate. If he was really doing his job he would be there to give you a pat on the back also.
I used to work LTC 7p-7a. There would be 3 nurses on and 5 aides on nights for 80patients. One night one of the nurses couldn't get to work, she ran into a snow drift during a blizzard on her way to work. So that left 2 nurses. So for med pass, we did our own pts. first and then worked on the remaining pts. ( of course after checking insulin pts. for her halls).
When I got to one of the last patients for the missing nurse, I was chewed out by the patient/resident because I was so late. This is a pt. who had aides in and out of her room for bathroom help and/or snacks every night.
So I told her sweetly, "Yes, I am late and I apologise, but the nurse scheduled for your hallway had an accident on the way to work and with the blizzard no one else would come in. The other nurse and I are doing the best we can. Now that I am here, is there anything else you need before I go?
I didn't feel like I had to give her an "excuse", but I thought she deserved an explanation of what the hold up was. If a doctor is late to an appointment because of an emergency, does she/he get chewed out? Well, yes, sometimes, but you know, sometimes life gets into the way of our schedules.
....."I was busy with another patient" is a lame excuse.
I don't understand this statement. I was with you about making patients feel special and proctecting my turf (ask the 1st years). And apologizing and moving on if needed. But "I was busy with another patient" is honest and, if I truly make my patients feel like my top concern, they'll know and trust that I would put them first in an crisis.
The only time "I was busy with another patient" is lame (to me) is when it's abused by someone WHO is surfing the net, smoking or gossiping. Most of us are too busy for that nonsense.
Hey -- how about some of these managers who are sitting around on dayshift get out on the floor for a few minutes and answer some call lights???
Would that be too unreasonable? I've seen my manger do it occasionally. She will bring them coffee or ice chips or whatever -- but never often enough.
Hey, AMERICAN PUBLIC -- There is a nursing shortage. There are not enough of us. We're covering 4-8 to 10 of you a night. We can't humanly possibly get to all of your needs throughout the day and night. We're here to keep you safe, healthy, and alive -- not coddled and pampered like it's the Hilton. Why don't some of you ramp up your insurance or talk to the powers that be and get a personal assistant during your hospital stay to get you everything you need 24/7 -- because your NURSE can't do it. There is not enough staff for this in a hospital today. (actually, some of them do bring in their own "assistants" and sometimes even those assistants will get needy on us!
Nothiing chaps my butt more than this issue. There are way too many managers floating around for the job THEY need to get done, yet not enough of us. What is wrong with this picture?
It's an impossible task to get done what we are charged with, unless it's a 1:1 ratio. I wish SO badly this issue could be exposed somehow in the media or something for what it is -- it's just ridiculous.
I just wish that someone, ANYONE, would tell the TRUTH on this issue to the American Public and the Management and the powers that be. We nurses are not everyone's mules!! We are human beings ourselves and are going to leave everyone high and dry one of these days from this overwork and abuse that still goes on to this particular worker class in the 20th century!!
I also resent being told these canned phrases to use. My manager will walk in behind me and use them and I just want to roll my eyes. She sounds like a robot!!
To add another point, I've given explanations that I felt were very reasonable, and yet I've still gotten the angry glare from the patient or the family. For some of them, there is no excuse. They want you to themselves and that's it. They expect to get the service they want NOW and it just doesn't matter what else was going on.
And for some patients, they are highly understanding and reasonable people. Some will say, Oh, I'm fine -- I know your'e busy. And you feel even worse about that because you know they also deserve attention and are so sweet, you'll bust your hide to do it for them. I love these people with all my heart.
To me, there is NO other solution to this except a 1:1 ratio. Really.
Hey, managers -- you really want all those great "excellent" customer service ratings. Go 1:1. It's the only way. Good luck.
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iluvivt, BSN, RN
2,774 Posts
Yes the whole customer service thing!!!! I have been known to say that and I do not see any problem with it. What is wrong with gently reminding people they are not the only ones in the hospital. ( especially for non-urgent needs). I actually have said the same thing many many times I am here now how can I help you. I understand the staffing and all our patient issues are not the patients problems...I get that....but sometimes you have to draw the line with chronic complainers or they will walk all over you and subsequent nurses.