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 Community Health, Med-Surg, Home Health.
Once, I heard from a friend that a patient chewed out the CNAs and nurses saying that she wanted her door closed and no one to come in to disturb her from 8p to 6a. It was explained to her that she gets medications, needs vitals taken at least every shift and rounds should be made, especially at night to see if she is even alive. Still balked about it. The AOD, doctors, nurses and supervisors decided that this woman did not want treatment, she wanted a hotel, and they found an 'excuse' to discharge her immediately. Thank goodness I wasn't there, I would have said good riddance.
I'm not a big fan of that phrase, but sometimes it's not what you say, but how you say it. "I was with another patient." isn't as bad as "you're not my only patient you know!". But even "I was with another patient" said with scorn and stress can come across as meaning "you're not important and how dare you complain because it should be obvious to you that you're not in a hotel and the world doesn't revolve around you." But if you say it with feeling "I was with another patient" can mean "I'm here now and you have my undivided attention as much as my last patient just did and I care about you."
edited to add: I hate scripts and being told what to say. I'm pretty good at communication and don't need a script thank you management very much.
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!
Be thankful about that!! At my hospital, the customer service personnel has been known to write up nurses without allowing the nurse to defend him/herself. I don't know how this is possible, but it happens.
I had a patient recently who was heavy on the call light for the non life threatening things: extra crackers, extra ice, extra blankets, extra crackers, yet more crackers....
I was able to get most of her calls, but the other nurse got a few. We are suppose to have a tech, but for the past few months, we have been working as everyone: RN, tech, secretary.
After the second time of going into her room to bring her more of something else, she said, "I didn't want to interrupt you! I wanted the tech, that other girl!" I told her that other girl was the other nurse.
"Where are the techs?"
"I'm here to help you."
"So, you don't have anyone helping you? Ya know, I have spent plenty of time in different hospitals and I have never, ever had the nurse bring me crackers. You should have people to help you."
"Is there anything else I can get you before I leave?"
"No honey, go get your important work done, I'm going to write a letter to the hospital telling them they need to make better use of their nurses and get you some help."
I gave her a whole load of crackers and Sprite after that!!
Maybe a patient's letter will make a difference because the hospital has had a deaf ear to our suggestions and recommendations for increased patient satisfaction.
There MUST be nurse managers or other administrative types that could chime in here. Surely they have worked bedside at some time; I would love to hear "their" side of this.
I would like to add to what I posted earlier with I also like when my nurses are straight with me. If you are busy with another patient, you were busy with another patient, just tell me.
i have also been told not to tell families or patients that we were working short or that some other patient was in crisis because we would 'scare' them because we were too busy to offer them proper care
if this patient was on telemetry explaining that someone was always watching the screen and that she was not in any danger just because someone was not at bedside
i myself believe that telling that you were busy is a valid way of informing patients that you are not neglecting them but i don't write the rules
i can understand that the chaplain might think that the patients c/o were valid and thought reporting was the right thing to do..maybe a little FRIENDLY chat would be in order
I'm not a big fan of that phrase, but sometimes it's not what you say, but how you say it. "I was with another patient." isn't as bad as "you're not my only patient you know!". But even "I was with another patient" said with scorn and stress can come across as meaning "you're not important and how dare you complain because it should be obvious to you that you're not in a hotel and the world doesn't revolve around you." But if you say it with feeling "I was with another patient" can mean "I'm here now and you have my undivided attention as much as my last patient just did and I care about you."
edited to add: I hate scripts and being told what to say. I'm pretty good at communication and don't need a script thank you management very much.
Yeah, to keep complaints down, I'm learning if when i go in a room that's called, if before they can complain I give a quick, "I'm sorry it took so long to get in here, I was busy with another one of my patients. What can I do for you?" along with making sure I check in on my patients even when they don't call (I refuse to call it the qhour rounding that's all the rage, but it's more or less what I do, do a round on everybody as often as I can.)
Anyway, if you let them complain, THEN tell them you were with another patient, it sounds like "just an excuse." If you preempt the complaint with the, "I'm sorry it took so long, I was busy in another room," then you're just keeping the patient in the loop and informed of what's going on.
I hate scripts and being told what to say. I'm pretty good at communication and don't need a script thank you management very much.
Would someone please tell me why management waste their time on so-called "scripts" and trying to "fix" customer "service" and not on ensuring that patients are safe and healthy??
I didn't go into nursing so I could mollycoddle patients or their families; I went into nursing because I wanted to give back, I wanted to empower patients and their families so that they could care for themselves and live good lives of quality, and I wanted to know, at the end of the day, I made a difference.
Now I no longer feel that way. I have had enough of management who don't understand their RNs, LPNs/LVNs, CNAs, MAs, or techs, or the difficult workloads we face day after day. Spend a week on the floor with us, and maybe you might just understand why the turnover rate is so high, or why there is a shortage.
This is managements way of shifting the blame and responsibility of short staffing to the nursng staff. I would never allow myself to take the fall for their **** poor staffing decisions. I say go ahead and tell patients that you are short staffed and if they are not getting the care that they need, to write a letter to management and tell them that they need more nursing and support staff. MANAGEMENT AND ADMINISTRATION ARE RESPONSIBILE FOR STAFFING NOT THE NURSING STAFF. And furthermore, nursing has no control over the staffing. Why are nurses taking the blame? Put the blame where it belongs!
Keep a record of complaints, and the staffing that was available that day. Staffing patterns are a factor in malpractice cases, so if you have no control or decision making on staffing, why are you taking the blame? also, if the hospital gets mad, call the senior partner of the law firm who defnds the hospital. I am sure that they would love to know. Let the individuals who do have control hear the patients complaints. You have enough to do. We enable them to get away with it. Like the spouses of alcoholics and abusers.
Would someone please tell me why management waste their time on so-called "scripts" and trying to "fix" customer "service" and not on ensuring that patients are safe and healthy??
I didn't go into nursing so I could mollycoddle patients or their families; I went into nursing because I wanted to give back, I wanted to empower patients and their families so that they could care for themselves and live good lives of quality, and I wanted to know, at the end of the day, I made a difference.
Now I no longer feel that way. I have had enough of management who don't understand their RNs, LPNs/LVNs, CNAs, MAs, or techs, or the difficult workloads we face day after day. Spend a week on the floor with us, and maybe you might just understand why the turnover rate is so high, or why there is a shortage.
As a patient if I was constantly hearing the same things over and over (the script if you will) I would get annoyed. I would feel like the nurse didnt care about me. That I am just a paycheck so it doesn't matter if she pays me personal attention or not. JMHO
pagandeva2000, LPN
7,984 Posts
Once, I heard from a friend that a patient chewed out the CNAs and nurses saying that she wanted her door closed and no one to come in to disturb her from 8p to 6a. It was explained to her that she gets medications, needs vitals taken at least every shift and rounds should be made, especially at night to see if she is even alive. Still balked about it. The AOD, doctors, nurses and supervisors decided that this woman did not want treatment, she wanted a hotel, and they found an 'excuse' to discharge her immediately. Thank goodness I wasn't there, I would have said good riddance.