This is not a rant about staffing, we are horribly short staffed, but normally we are o.k. We're going through a rough, hopefully temporary time right now as some contracts have left.
I'm taking care of a patient who c/o of chest pain and was admitted, only to later refuse telemetry, leaves the floor to smoke. I see he's up at 5AM and ask him to reconsider the telemetry, as he told an aid, not me. I explained as a cardiac patient he needed to be on it.
"I don't like your attitude, just do what you got to do and leave me alone."
I'm tired, stressed, working overtime, caring for patients above and beyond the normal ratios.
So I say, "You're the one who came in here complaining of chest pain. I don't care if you wear the monitor or not. I'll go care for sick patients that need me. "
He said he didn't like my bedside manner. Well excuse me Mr. Customer I ain't in the mood for kissing ass today.
I DARE and DOUBLE and TRIPLE DARE anyone from management to say anything to me if he complains. Just dare them.
I occasionally do a shift staff relief at a hospital that has a script that the nurses have to adhere to. First contact with the patient you must go in ans say I am Barbara and I am your nurse today, write your name on a board and personal cell type phone number that the aptient can contact you directly, say I have not looked at your orders yet, is there any way I can meet your needs till then?
It continues from there as completely scripted. Is this common or isloated?
I too grow weary of patients who come to the hospital for some unknown reason. If they do not want to comply with the tx then please go home and let me take care of someone who is trying to get well.
We had a patient who was so noncomplient and begged to be d/c'd that I stamped up the AMA form for the doctors. She then refused to sign the form. Worst part about it- she was a nurse.
Let me just say this: I am tired of "disciplining " nurses because of complaints from patients that are foolish or unfounded- especially when the complaint was really generated by the doctor!
For example, there are 3 very nice and inexpensive motels within 3 miles of our hospital. we are located in a suburb of Detroit, and there is a very low crime rate . However, several doctors INSIST on making points with the patients' family by telling them they will write an order for visitors to have unlimited visitation PLus can stay all nite! This is a liability to the nurses. but I got a complaint that the "male nurse' was rough when he assisted a 27 y/o guy with a knee revision get onto a cart . I called her and she went on and on about how he should have been sweeter, and did not treat her boy gentler. Oh by the way-this 27 y/o pt was exposing himself to the female staff, and they wouldn't go into his room.
Bottom line? She felt the nurse should be suspended.
Case #2. a nurse was taking care of a pt in a stepdown unit who was confused and had been over- medicated. He was being monitored, but was essentially stable . His wife was allowed to stay 24/7 at the bedside. She was pleasant but wanted constant attention both for him and herself. She took notes, names and even pictures of the staff. They were intimidated by her, but tried to work with it.One day, the nurse had no relief for lunch and could not leave him unattended. She made sure he was resting and needed nothing, went to the desk, and took a "break" by (stilll within eye contact of the pt) going on the internet and surfing thru e-Bay. The wife c/o to me later (after her husband was transfered to Rehab) that she had mentioned this to the doctor who had also been her 1 st grade student, and they felt the nurses' incompetent behavior should result in her losing her job- and her lisence if possible!
Sorry y'all to rant on so....but I find this the perfect opportunity to get all my "customer service" nightmares out of my head...so that I can return to the workplace and "do the best I can to please folks". Ok.....this other lady that we have quite often decides she is having abdominal pain....( a documented drug seeker mind you)..and insists on being admitted. Well...the doc's give in and even order Morphine 4 to 10 mg's......every hour!!! Whoahh...anyways...she was there for a week and a half....getting pain meds on the hour....asking for Phenergan and the proceeding to ask for Sprite, toast, pudding, and a bowl of soup!!!! Errrrrrr...what do you do with people like this!!! Anyways...the doc's gradually , towards the end of her stay..started cutting down her pain meds...and bada-bing.....instantly...she is cured....by some divine intervention from up above no doubt. She then....insists on going home tomorrow...or else.. Errrrr...when does it end God?? I am so sick of caring for these system abusers...... I always get very high remarks on my bedside manner....but...it is soooo hard to clinch my teeth and carry on......I'd just like to give some of these folks the what for someday. I guess that's why I have this wonderful site to vent...thanks for listening...!!!
My husband works in a newly built hospital that was designed to cater to the rich. The place is gorgeous, it would put a 5 star hotel to shame. They have 1 floor with suites that has it's own personal chef that will make you what you want,a s gourmet as you want, whenever you want. The chef's kitchen has a wine cooler as well. The staffing ratio is 1:1 or 1:2 for stable floor patients. That would be a posh job but I can just imagine the nightmare patients that potentially would make you want to pull your hair out.
you can't get more PR customer service oriented than this. There is another new hospital opening up in the area that is offering the same type of "patient care". What kind of a precident are they setting here? They are perpetuating the idea that hospital=hotel=roomservice.........errr
How much do the nurses get paid? And only having to deal with one patient?!? Heaven!!!!! Even if that patient was a pain in the butt, at least you would only have that one or may one other to deal with. I don't know that I wouldn't get bored working someplace like that. At least you wouldn't have to deal with someone like that knowing that the hospital you work at will never see a dime of that person's bill paid, meanwhile dealing with several other patients at the same time.
Interesting thread, and all of us have been where 3rdShiftGuy has been at one time or another, to one degree or another.
I once spent WAY too much time on the phone with a doctor who was trying to get his patient NOT to sign out AMA. First I spoke to the doc, then he asked to talk to the patient, then to the husband. They were told to think about not leaving and when they'd made their decision, to call the doc again, which I did, and I had to get the husband back to talk to doc etc. etc. The patient ended up staying, but I lost nearly an hour of care for my other patients while we all took turns cajoling her to stay. (Not much cajoling done on my part, I'm afraid.)
Here's an oldie but goodie thread on customer service you might enjoy entitled, "welcome to the hilton...please dont forget to tip your waitress".
Let me just say this: I am tired of "disciplining " nurses because of complaints from patients that are foolish or unfounded- especially when the complaint was really generated by the doctor!
You sound like a savvy manager and one I would LOVE to work for!!! The examples you cited are frequent occurrences at my hospital; with patients, families (and doctors) being vindictive.
The other night in ICU:received an anxious , painridden pt with failure to wean from vent 1st day postop due to COPD. Family is at bedside, first off will not honor my request to step out so I can asess my patient. Their priority is to get my immediate promise I will NOT give her any pain meds tonite, because 'that night nurse last night did and the doctor said that's why she's still on the vent'. I smiled, took a deep breathe, looked at my tachycardic, struggling, grimacing patient and said sweetly "You will have to trust my best judgment on that, be assured I will minimize meds for a wean trial in am".
Well, that was not good enough, they immediately reported me to my supervisor. When they demanded a change in assignment I shrugged. While this attitude from families upsets and angers me, I also don't want their hostility all shift either. So the change in assignment is fine. 'Course my supervisors have had a complaint about me, and ANY complaint gets a nurse a black mark in my facility.
Thanks for validating the fact that it is the same all over!
My worst situation was when I walked into work nites in the Icu. The only pt in there was a 40ish male who had a back surgery that day that involved putting in a titanium cage around part of the spine. he had an art line, 2 ivs, a monitor, continuous pulse ox AND HIS WIFE IN BED WITH HIM!!! I nearly lost it! She said "well, the doctor said i could stay all nite, and he sleeps better if I'm in bed with him. I told her she could dislodge equipment, evn possibly move him in a way that could cause damage to his surgical site, add bacterial to an open wound,etc....she refused to get out of the bed. I called the doc-it was @ 1 am now, handed her the phone and let HIM dislodge her. She ended up sleeping in a chair next to him, and they both called me everything except "nurse". I still am shaking my head!
Thanks for validating the fact that it is the same all over!
My worst situation was when I walked into work nites in the Icu. The only pt in there was a 40ish male who had a back surgery that day that involved putting in a titanium cage around part of the spine. he had an art line, 2 ivs, a monitor, continuous pulse ox AND HIS WIFE IN BED WITH HIM!!! I nearly lost it! She said "well, the doctor said i could stay all nite, and he sleeps better if I'm in bed with him. I told her she could dislodge equipment, evn possibly move him in a way that could cause damage to his surgical site, add bacterial to an open wound,etc....she refused to get out of the bed. I called the doc-it was @ 1 am now, handed her the phone and let HIM dislodge her. She ended up sleeping in a chair next to him, and they both called me everything except "nurse". I still am shaking my head!
That reminds me of an incident i had when i first started working as a CA last year. Went into a pt.s room to find two people in bed very cuddled up, BOTH wearing hospital gowns. Two women, that were more than friends (the pt. listed the other woman as her spouse).
The problem was that neither one had an ID bracelet on, so how was i to know who the pt. was without asking (and then assuming i wasn't being lied to)?
Needless to say when the nurse said that only the pt. should be in the bed, they were beyond angry. But it's floor policy.
(Not much cajoling done on my part, I'm afraid.)
BarbPick
780 Posts
I occasionally do a shift staff relief at a hospital that has a script that the nurses have to adhere to. First contact with the patient you must go in ans say I am Barbara and I am your nurse today, write your name on a board and personal cell type phone number that the aptient can contact you directly, say I have not looked at your orders yet, is there any way I can meet your needs till then?
It continues from there as completely scripted. Is this common or isloated?