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?

[Medic2RN, BSN, RN, EMT-P]

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?

Gosh, I really, really wish I thought about this some time back. I'll start doing it now though - thanks! I haven't had any logged complaints that I know of, but I think I'll record each work day in case something should happen.

[BradleyRN]

A lot of the posts in this thread make me wonder how threads such as this one....

https://allnurses.com/forums/f8/ban-together-change-nursing-312852.html

seem to get buried with very few responses.....

The unification of nurses in order to force change for the welfare of ourselves and the patients should never become an old idea until it is achieved.

[General E. Speaking, RN, RN]

Thanks for the support :) (except for the "lame excuse" comment)

As I said in original post, I was very diplomatic and tried to redirect my attention to her "I am here for you now, what can I do for you?" I said it very nicely and wasn't rude in anyway. I technically wasn't "understaffed" but you know how things change in a whim. You can have 8 walkie-talkies and get out on time but sometimes you can be busy as heck with three (or even one or two). It is a hospital, people are sick and Dukie happens!

I will continue to use my sound nursing judgment and prioritize according to needs. I think floor nurses do an amazing job and we somehow manage to have 4 or 5 boiling pots of water on the stove and still have a favorable outcomes. Every now and then this just simply is not possible.

[CrescentLuna]

Next time (or even as soon as you see them again!) ask them what the proper thing is to say! I'm curious! I've frequently told patients something along the lines of "I'm sorry, I had another patient who was having a crisis/needed my attention/just arrived and needed to be seen, what do you need?" Granted most times the techs are awesome and the other nurses will pitch in and get them a PRN med if they need it or something. Personally, if someone ignored my "why did it take so long?" question I'd think they were being rude. I did have one patient who was like this, actually, "Sorry it took awhile to get to your room, what do you need?" "What took you so long? Why do you people always take so long to do anything? Do the doctors only hire slow girls?" (they wanted the hat emptied in their bathroom, they'd gone back to bed)

I ignored this, emptied the hat, asked if there was anything else she needed. Her reply: "What, aren't you going to answer my question?"

My response: "I don't think that question deserves an answer." She sighed dramatically and waited until I was out the door to curse at me. Didn't bother me, she got really polite once her meds kicked in.

[iambrent]

That was the policy at the last hospital I worked for. Bye!!

I now work for a hospital with patient ratios that are excellent and I love my job again.

[cutebrnkze]

I've been in that situation several times. I work fulltime for one organization and prn at another. I was FT at the prn organization but I kept running into the same situation you went through. Management would only want us to kiss the pt's butts and never back up their nurses. My FT position backs up their nurses and they never put us in the place where we don't receive several pts or "all" pt's w/high acuities.

[inava]

This type of management double speak is one reason I am not practicing right now and may never again. What would have been said to you if you had catered to this lady and left your unstable patient unattended? Your manager should have gone to this lady and backed you up. You should have been given the leeway to prioritize your patient care according to each patient's acuity not their personality.

[Hospice RNCM]

Patients like the one you describe are not going to be happy, unless you stay at their side 24/7 and just forget that there are othert patients. Neither they or their families care about what is going on with Mr Smith or Mr Jones, who are both Code-Bluing. They are focused on ME ME ME, and expect that you will do the same. I had a patient that would call me in to giver her a glass of water every 15 minutes, and ut had to be just right, or she would throw it at me. It had to be ther right temperature, it had to have the right amount of ice, and the right amount of water in the glass, and I wasn't allowed to leave unless it was right, and then I had to go back and get her empty glass when she finished. Take people like that with a grain of salt and don't get bent out of shape; if your supervisor doesn't, why should you?

[jeffrey_rn]

The only necessary response to a patient who is upset with your lack of a timely response: "I apologize. How can I help you?" Anything else you say will be taken as "excuse making" and it won't make a difference either way. Just apologize for your delay and move on to the solution to the patient's problem(s). Ultimately, YOU know why you were delayed and that's all that matters. Save your excuses for your superiors in the event that they confront you about the problem. It will matter to them. But your patients don't need to be burdened by your burdens.

[nerdtonurse?, BSN, RN]

When you have management give you a BS order like that, look them dead in the eye and ask they what you should have told the patient. We've had frequent flyers who we draw straws for, loser get them, because they file complaints on everyone who comes thru the door. Unfortunately, you can't get a bed with a Tazer option for these folks....

[twistedpupchaser]

Two Pt's in a room, one a dying swan who had an excuse to ask for something if their room mate got any attention. The fact that the other Pt was in a seriously worse state did not seem to matter to the dying swan. The "sick" Pt was going downhill with a marked increase in pain and other symptoms. When asked why she hadn't called earlier for me to help her, "I didn't want ....... to get any sicker...."

Dying swan stopped the games after that, and I didn't have to say a word.

[wooh, BSN, RN]

Unfortunately, you can't get a bed with a Tazer option for these folks....

If we ever get beds with a Tazer option, I want them to come complete with chairs for the visitors that have the option as well!