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

Nurses General Nursing

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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?

Specializes in Community Health Nurse.
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!

This totally cracked me up! Thanks for the early morning laugh! :rotfl::rotfl::rotfl:

I get to my patients as fast as the situation allows. I will apologize to them for the delay, and thank them for their patience and understanding while having to wait. That usually calms 95% of the patients. But...there's always always always that ONE that needs the sun to rise and set on him/her (usually a "her"). :bugeyes: No matter what you do for those patients, no matter how many trips you make into their room, no matter how many of their requests are filled by the staff, it is somehow never enough. THAT my nursing friends is categorized as "narcissistic personality"...it's alllllllllllllllll about them. :grn:So...just be the best nurse that you know you already are. We can't please every patient we are assigned for we serve imperfect human beings. They come in the hospital with that "flaw" in them. We didn't put it there, but we do have to acknowledge its presence and strategize around it when we're not able to please their every whine. :twocents:

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I see nothing wrong with being honest with that demanding patient. If you were keeping another patient from crashing, then I think it's perfectly acceptable to let the PITA patient know that this is a hospital, and if he/she were in a life-threatening situation, then you would do the same for him/her, but fetching ice is not the priority when the excrement hits the fan.

I work in home hospice, and if I have to reschedule patients due to another patient actively in the dying process, I will be honest with the ones I reschedule by saying "I have another patient who is having serious issues right now and needs me. Can I see you at another time?" Of course, I do this after I make sure that they are stable and ok for the moment.

I don't think it's a 'lame' excuse to tell another patient why you weren't in there the moment that light went off. Management would like you to think that. It keeps the managers from having to address the real needs (understaffing, PITA patients who need to be 'put' in their place). HOSPITAL, not HOTEL.........I think it IS good customer service to keep people alive....JMHO.

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Why does this continue to go on. Don't nurses ever band together and write letters to management? I mean -- why do they keep piling it on? Are they just out to lunch here?

I myself am ready to do it. I'll probably lose my job, but I dont' care. This situation is ridiculous and with the onslaught of baby boomers just around the corner, I don't know how this whole charade can be sustained.

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one time my nm overheard me explaining to a pt that i had been detained w/another pt.

i was very apologetic yet the nm pulled me aside and told me our pts didn't need to hear these "silly excuses".

the next time i was detained, i went into a pt's room, wiping my hands while telling the pt, "my goodness, i don't know WHAT they put in that lunch today, but i've been tied to the bathroom eversince."

my pt just looked at me, kind of wide-eyed and speechless.:rotfl:

THEN...my nm pulls me out of that room, letting me have it from both sides.

i re-entered this pt's room, again, apologizing for the delay, citing that my boss needed to have a word with me (w/awkward smile on my face).

since then, if i am with a critically ill pt and am detained, i continue to tell my other pts this.

afterall, it is an inpt hospice, and so, these pts know the nature of my delays.

leslie

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Specializes in neuro/ortho med surge 4.
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?

I am not a nurse yet as I take my boards on July 16th, but have worked as an aide on a cardiac floor. I seen the complaining first hand about how long it took to get them a drink, etc., etc., I agree that most patients and their families don't realize how busy the staff is and how their needs could be met better if there was more staff.

When I am out and about in a store and the subject would come up that I was in nursing school the conversation would steer towards how they or a family member had to wait forever to get their call light answered. I always told the person I was talking to that it wasn't because we were ignoring the light it was just that everyone was so busy running that we did not have a chance to get to it. I also told them to write their legislative representatives about unsafe staffing so things could change. I would never tell an actual patient in the hospital this though because it would create stress on them. I do spread the word to "civilians" to hopefully create awareness and change.

I will be joining the ranks soon and don't see anything wrong with telling a patient I was with another patient who was critical and could not be with them in a timely manner. I mean what are we suppose to tell them?

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You did exactly the right thing. You cared for the patient who needs were acute. I personally get very tired of fussy patients who want to be the center of attention, they want their need of ice water to be your top priority even though you have a patient with a BP in the 60's. If they don't get their way they complain , next thing you know your in the office having to explain yourself. It's so unfair.

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.......

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.

I am glad I am a member here, and understand how hard it can be to be a nurse. It helps me to understand where my nurses are coming from if they seem a little short with me at times.

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I find patients often ask for the nurse for needs that could be taken care of by the tech. They put their call lights on when the busy secretary ask what they need they say I need my nurse. When the nurse gets there they need a blanket or a glass of water. These needs could be easily met by the techs. I love the secretaries who triage the calls and send the right person for the job. They make a major contibution to the efficient running of the unit.

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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

Someone needs to have a "chat" with the chaplain. He doesn't do the patient any good by validating unrealistic expectations and is also putting himself in an adversarial role with the nurses. That does no one any good!

We have excellent customer service personnel at our hospital. They work closely with the nurses and understand our workload. They are also excellent with the patients and family and can sympathetically smooth over any minor issues. We couldn't get along without them!

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Specializes in Med Surg, LTC, Home Health.
"I was busy with another patient" is a lame excuse. That's just my opinion.

My goodness...I think the truth is the best explanation, and since this was the truth, then it is not an excuse at all. The only substitute for truth is indeed a lie, and i dont think you would believe that to be any less "lame". If i am going to look my patient in the eye and explain to them why they had to wait, i will be honest no matter what vague statements my management would like me to say. I dont need any excuses.

It sounds as if you're upset because I wasn't available when you needed me. How can I help you at this time?

Hehe. Now that is textbook therapeutic communication!

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I am 'justavolunteer' and I've even gotten occasional grief from pts. who thought I should be there 2 seconds after their light went on. Even though I can dodge most of the complaints, there are still some who are nasty to anyone who comes in range, even volunteers.

The point about sending the right person for the job is good, but some pts. even play games with that idea. I have had pts. say, "You can't help, I want the nurse". When the nurse comes, they say they want their food tray taken out or some similar nonsense. I have apologized to nurses more than once over that, just because I feel bad when it happens

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My goodness...I think the truth is the best explanation, and since this was the truth, then it is not an excuse at all. The only substitute for truth is indeed a lie, and i dont think you would believe that to be any less "lame". If i am going to look my patient in the eye and explain to them why they had to wait, i will be honest no matter what vague statements my management would like me to say. I dont need any excuses.

i agree with this.

pts need to realize that they don't have a private nurse:

and there are other pts who have needs, often urgent ones.

i would say most times, these pts need some perspective...

and that it's not all about them.

leslie:twocents:

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