Patient and family priorities

[hiddencatRN]

Sometimes I find patient and family priorities frustrating. Had a patient in the other night, and as we were triaging the patient, the parent wanted to know "aren't we going to do anything for their pain" then "Can I have some water" and then "when can I feed them" and "Can I get some water?" This was all before we'd even gotten their names in to the system. I understand the concern about her child's discomfort, but she asked for water twice and we hadn't even completed triage. They'd literally just been dropped off by EMS, placed directly in a room, and there were two nurses and a doctor at bedside doing assessments and getting the patient's name, birthday and medical history.

"Ok mom, I'm in the middle of assessing your child's mental status post fall, but let me go grab you that water now."

[applewhitern, BSN, RN]

This is the kind of stuff that has made me hate nursing after 22 years. Our administration does not care what you thought was more important; patient satisfaction is all they care about and they will NOT stand up for the nurses whatsoever. If someone complains, no matter how silly the complaint is, the nurse gets "wrote up" and preached to.

[Crux1024]

I joined the Press-Ganey committee in our ER. Im anxiously awaiting some of the responses Im sure Ill see re: the "service" with a smile we're supposed to provide.

There was a family last week who arrived RIGHT after their mother did (via EMS) after a pretty bad car accident. First request: "She needs the CCollar off right now, shes uncomfortable.". As my preceptor put it "We need some scans of her neck before we do, if she has a fracture in her spine and she moves now, she'll never move again". Blunt and to the point, but the family got it and stopped asking.

[ktwlpn, LPN]

OMG-I just spewed my beer all over my 'puter-that's funny...

[locolorenzo22, BSN, RN]

Gravy is the base....potatos the middle, turkey the top....and stuffing fills the cracks....lol

[JDZ344]

Oops. I posted in the wrong thread. Again :/

[richardgleaton]

For you patient should be the first priority..No doubt that family also matters but you have to make difference between them..Professional and personal both are very different..

[Ruby Vee, BSN]

welcome to the er

welcome to nursing. those types of absurdities are not confined to the er.

[TeresaEDRN06]

I just said this same thing in a similar post...many people do not have the capacity to look beyond themselves. It is an EMERGENCY ROOM!!! There are emergencies. And those emergencies do NOT include food, pillows, or coke instead of the apple juice we gave her. Seriously.

[Guest219794]

I joined the Press-Ganey committee in our ER. Im anxiously awaiting some of the responses Im sure Ill see re: the "service" with a smile we're supposed to provide.

There was a family last week who arrived RIGHT after their mother did (via EMS) after a pretty bad car accident. First request: "She needs the CCollar off right now, shes uncomfortable.". As my preceptor put it "We need some scans of her neck before we do, if she has a fracture in her spine and she moves now, she'll never move again". Blunt and to the point, but the family got it and stopped asking.

I have always thought that ER satisfaction scores should factor in acuity. In addition to the average satisfaction, satisfaction should broken down by ESI.

My theory is that the level 2s would genrally rate higher than the level 5s. I think that many of the things one might do to improve the satisfaction of low acuity patients will be at the expense of high acuity patients. My time is a limited comoditiy, and 10 minutes on one task, is 10 minutes not spent on another.

So, when a department is looking to improve the scores of the level 5s. they would have to think about how it would affect the level 2 pts. While there are usually more low acuity than high acuity pt's, an ER should decide whether emergent or non-emergent patients are the priority.

I could, without a doubt, improve the scores from my non-acute patients. I would simply spend more time with them than the sick patients. This would improve scores in 2 ways:

1- The bulk of the patients, who are not especially sick, would be more satisfied.

2- The really sick patients would be less satisfied, but there are fewer of them, and some of them would die, so their negative scores won't drop the average.

A win-win situation. Unless you are having a medical emergency, and I am fluffing pillows and getting ice water for ambulatory level 4 and 5 patients.

[hiddencatRN, BSN, RN]

I LOVE the fact that we have no pillows in my ER. So whenever anyone asks for one I can smile and say "Sorry, we have no pillows!" and walk away.

[Lunah, MSN, RN]

I LOVE the fact that we have no pillows in my ER. So whenever anyone asks for one I can smile and say "Sorry, we have no pillows!" and walk away.

We don't have pillows either! We had one random pillow show up the other day, and I said, "OMG, hide that thing!!" LOL.

And get this ... we don't have call bells. I'm serious. I couldn't believe it either. Our ED is pretty small, though, with the nurses station right in the center of all our rooms, so we're never far from anyone.

[hiddencatRN, BSN, RN]

We don't have pillows either! We had one random pillow show up the other day, and I said, "OMG, hide that thing!!" LOL.

And get this ... we don't have call bells. I'm serious. I couldn't believe it either. Our ED is pretty small, though, with the nurses station right in the center of all our rooms, so we're never far from anyone.

Our call bell in some rooms is located immediately above the on button for the TV. I can't tell you how many times it gets hit accidentally. Design FAIL. The folks who hit it by mistake are usually pretty apologetic about it at least.

I have to admit, I generally do not advertise the existence of the call bell unless it is a patient I actually want buzzing me. Everyone else can figure it out on their own