Stopping patient care for another patient

Nurses Relations

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Ok I have a question....

Here's the scenario ... I was in the middle of patient care with one patient who was requesting pain medication. It was time for her scheduled meds so I was doing the whole nine. Checking her vitals, re-positioning, etc.

When I stepped out to grab something off my cart one of the techs on my other hall told me that a patient's family said that she wanted something for pain. I said I will come as soon as I finish.

When I finish I went to my other cart to prepare her meds when her family came up the hall and stated she needed more water so I said I will get it. I got some water then finished pulling her meds and walked with the family down to her room. Administered her meds and made sure she was comfy before I headed back down the hall.

2 days later my DON calls me and asked me to explain what happened because the family said she waited 45 mins(bogus) and they wanted to move her to a new facility. Now was I wrong for not interrupting my current patient care to go to another?

If I was then I will accept that for future reference. But I look at it as unfair to patients to put them on hold for another unless absolutely necessary. I took all of 10 mins at the most. I feel bad. Do you cut patient care short when someone requests something i.e. pain med, tx, water, snacks??

Specializes in Med/surg, Quality & Risk.
You know.. they were! Blood bank did not want to issue two units to me at the same time.

However, they realized it was an emergent situation for both patients .. knew me to be a professional and issued both units.

I see you are also an attorney.Therefore , herein.. and forthwith.. you are referring to my statement regarding pain control as an "exhibit".

I am most certainly aware that there are higher priorities in nursing care.

My statement was meant to point out that ... in the case of a patient experiencing pain.. that is indeed THEIR priority.

I am simply stating that the nurse needs to juggle the administration of pain medication...without her workflow foremost in mind.

Actually you said "Pain control is NUMBER ONE of all nursing priorities." That is why everyone is expressing that they think you are one off. If that's not what you meant, sorry but that's what you wrote.

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Specializes in Med/surg, Quality & Risk.
Unless the two patients you started a blood transfusion on were either in the same room or in a room right next to each other, this is not something to be proud of. If you start a transfusion on one patient, then walk down the hall to start one on another, the first pt. could be having the beginning symptoms of anaphalaxis before you make it back. With all your experience you should know this, as the pt. is supposed to be checked every 15 minutes for the first hour of starting a transfusion.

That is why I asked if they were in the same room, lol

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Wowsa...7 pages on this already? Getting back to the OP...

It comes down to nursing judgment. My 2 cents comes from a LTC/ heavy rehab experience. Some days when I'm on the cart it seems like all I do is prns. If you are in this setting, sometimes you can get a good bit of your res on the same-ish prn schedule so that you are not running in circles. Sounds like you were doing your assessments at the start of the shift? Those assessments usually include asking about pain. Great. If you can medicate at the start of the shift then middle then towards the end..it makes it easier. There are the ones that will ask for the PRNs..when someone asks for a PRN for pain I try to get it to them within 10 or 15 minutes if not quicker. Using nursing judgment in your above situation..could you have gotten your assessment and meds done on pt A done within that time frame then peeked your head into pt B and let them know you will be along asap?

Most will be satified with just being told I will be back in xyz minutes asap. Laying around in pain and not knowing the request was recognized is when you get and upset family etc.

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That is why I asked if they were in the same room, lol

Yup, soon as I posted I came across your comment...we were thinking the same thing. Even having them in the same room, if one starts to have a problem, goodness forbid going into anaphalaxis, the other patient will still get practically ignored and you will have to call in someone else to watch him/her...so it's an ok idea until the crap hits the fan, then everyones screwed.

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Specializes in Medsurg/ICU, Mental Health, Home Health.
I had one on IV pain med Q15min.

Why is this patient not in a higher level of care environment?

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Using nursing judgment in your above situation..could you have gotten your assessment and meds done on pt A done within that time frame then peeked your head into pt B and let them know you will be along asap?

Most will be satisfied with just being told I will be back in xyz minutes asap. Laying around in pain and not knowing the request was recognized is when you get and upset family etc.

Agreed. As I said earlier, I do NOT think the OP was wrong in finishing up with Patient A, and I think it's unfortunate that management did not have her back. However, I think the real issue was most likely not that Patient B had to wait, but that there was no acknowledgment of her request.

When I was working in the ED and would gripe to my partner about the unrealistic demands of some people and what I wish I could have said, he once asked me "Why didn't you? You know, you can say just about anything as long as you just say it right." I took that advice to heart and found out that it is true. It's amazing what you can say to people if you just phrase it right and deliver it in the right manner. Telling Patient B's family that she would have to wait her turn should not have been a problem, had it been handled well.

In this scenario, it sounds like there was no follow up with the family once the tech delivered the message to the RN. Even in my CNA days, I would have most certainly returned to the room and told the family that I had delivered the message, and that the RN would come to the room just as soon as she was finished with her current task.

It sounds to me like this did not happen, and the family felt they were left twisting in the wind, with no communication about whether or not their request was going to be seen to.

This is only partly the fault of the RN, for not instructing the tech to communicate with the family, but the tech really should know this and practice it, and bears some of the blame.

Of course, I could be inferring a lot. It's difficult to tell from a post on the internet what really happened, and often, details will come up during the course of the thread that weren't apparent in the original post. I could be so off base, I'm on a whole other planet!

It's interesting, having spent my entire nursing career in the hospital environment, and now being in the home environment, hearing what people have to say about the hospital. Even if they rave about the great care they received, every single one acknowledges that the communication in the hospital is the weakest element in their experience.

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Actually you said "Pain control is NUMBER ONE of all nursing priorities." That is why everyone is expressing that they think you are one off. If that's not what you meant, sorry but that's what you wrote.

I can see that the smaller minds are continuing to focus on that statement. How much would it cost me to retract that statement , on your current outrageous fee scale?

You can LOL all you want regarding my ability and liability in starting a transfusion for two patients at the same time. However , it can be done safely and legally . I have indeed been able to watch for transfusion reactions on two patients . No , I am not saying I am all that. I am saying. ..we do what needs to be done.

Thirty years of success, obviously means nothing here. Continue to munch on the old.

I would rather have a nurse at my bedside.. than a lawyer.

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Specializes in Med/surg, Quality & Risk.
I can see that the smaller minds are continuing to focus on that statement. How much would it cost me to retract that statement , on your current outrageous fee scale?

You can LOL all you want regarding my ability and liability in starting a transfusion for two patients at the same time. However , it can be done safely and legally . I have indeed been able to watch for transfusion reactions on two patients . No , I am not saying I am all that. I am saying. ..we do what needs to be done.

I am amused by how much you've read into my comments, while on the other hand, no one is allowed to dispute your EXACT WORDS about priorities.

Look, sorry you said something you didn't mean. Be more clear next time if you don't like being questioned. I guess you could say "30 years of nursing should do that for ya'."

And I guess I'll have to say it again: I asked if they were in the same room for the same reason someone else pointed out, about monitoring for reactions. I'm not the least bit concerned that you started two transfusions at once for patients in the same room. I wouldn't do it, but I don't work somewhere that I'm forced to do so.

Thirty years of success, obviously means nothing here. Continue to munch on the old.

I would rather have a nurse at my bedside.. than a lawyer.

Fortunately for you, I'm BOTH. And fortunately for me, I'll never have you as a patient. :D

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Is it possible there was a delay in the tech giving the message?

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