Hello everyone!!! I hope this New Year has been a kind one to you all thus far.
Well, here i go again on one of my rants about the ever so intriguing world of nursing. Here's my pet peeve of the day:
Is is just me, or does it seem to you all that everytime you go into a patient's room to pass meds, do procedures, or simply check on the patient, they always have to ask you to bring them something.
I know for me, it never fails. If I go in there to just look in on my patient they always will stop you before you get out of the door and say, "Oh, nurse, could you get me some coffee," or "May I have something for pain?" or "Turn the lights off, will you". And it drives me crazy.
Now don't get me wrong, I have no problem doing anything for my patients. But it seems that patients look at nurses as nothing more than handmaids to wait on their every beckon and call. For example, I had this man to ring his call bell just to tell me that he wanted to sit up on the side of the bed. I wanted so badly to tell him, "Well, what are you waiting for?". This is because I know that this man is very capable of moving himself because I've seen him do it when he has a male nurse caring for him. But whenever a female steps in, the patients all of sudden become invalids.
I feel that too much of my time is taken up running up and down the halls getting water and coffee. I mean, as much as family members like to stay all day in night in these patients rooms, it would seem that they would get up off of their lazy bums and get these patients something every now and then. It wouldn't hurt them to do this. Oh no, they won't do this. But they can tell you and I how to do our jobs, can't they? (LOL!!).
I have gotten to the point that I actually like being pulled to the critical care units in the hospital because we have telemetry there and you don't have to go into the rooms quite as much as you do on the medical floor because the telemetry is evident.
Do you all feel the same way? Do you all feel that patients are too darn demanding and don't respect us as care providers but see us as handmaids instead? Male nurses, do you feel that patients tend to not bother you as much as your female colleagues? I welcome all input.
Now see, your situation was urgent. To prevent air from entering your veins in a life and death situation. The reason nobody came probably was because your nurse was tied up in the nourishment station making coffee for the blue-blood down the hall from you.
See, that's what I'm talking about. Small, non-medical request like that take away time for patients like you that really needed a nurse. I usually never get a call about an IV going dry because I stay on top of things like that. But if I do, I don't change a word, I got get it. If I have a pt. that is NPO and can have ice chips and they call for more; no problem!!! I can imagine what it's like to have a dry mouth and can't have water. But Miss Sally down the hall who wants coffee, I take my time and prioritize that as last on my list. Half the time, the patients will go to sleep and forget about things like that.
Well, as a fellow RN, I could pretty much size up how busy that floor was, so yeah, I just got the bag of saline myself. (Kept my own I&O, too). The staff certainly were not preoccupied with attending to "FMP/BMS" requests. ("Fluff my pillow/bend my straw.")
Ya know, pts don't know how good they've got it. My first child was born in a European hospital in the early 80's and after 10 hrs of labor during the hottest part of the year I was taken to a room where I was told to wash up in the sink, no shower, and given hot tea to drink! I had no tv, the other girl in the room didn't speak English, and after delivering an 8lb baby lady partslly with no complications the MD made me stay for FIVE DAYS!
Ugh! I was miserable!!! I was also very young and didn't know anything or else I would probably have taken my healthy baby and my sweaty, unshowered self and left AMA!!!
Believe me, after that experience I appreciate EVERYTHING anyone does for me while I'm a patient!
I hate when patients come the nurses station, too. When they just stand there, I just keep charting or whatever I'm doing. What's wrong with them saying, Excuse me, nurse,? I can't read minds, so if they just stand there, I let them stand. I don't look up, I keep doing what I'm doing because half the time I'm not paying attention to them standing there.
One of my co-workers told one them point blank when a family member cam to the desk, "That's what the call light is for, don't come to the desk"
We keep getting inservices on "customer service" and we are supposed to look them in the eye and help them, or at the very least acknowledge them and tell them we can help them "in a minute". We are told that this takes only a minute. I wonder where our superiors think all the minutes in the day for all the half a million things we do come from?
I feel guilty when I am truly way behind on my charting, and someone comes up to our desk area (which is wide open to the public) and I act as if I don't see them. Yet at the same time, I get irritated when I see my co-workers do that, and I end up being the "nice" one and getting the water, etc. We are all busy, and our little casper's (the CNA's who seem invisible once they clock in) are nowhere to be found.
Ya know, pts don't know how good they've got it. My first child was born in a European hospital in the early 80's and after 10 hrs of labor during the hottest part of the year I was taken to a room where I was told to wash up in the sink, no shower, and given hot tea to drink! I had no tv, the other girl in the room didn't speak English, and after delivering an 8lb baby lady partslly with no complications the MD made me stay for FIVE DAYS!
Ugh! I was miserable!!! I was also very young and didn't know anything or else I would probably have taken my healthy baby and my sweaty, unshowered self and left AMA!!!
Believe me, after that experience I appreciate EVERYTHING anyone does for me while I'm a patient!
That sounds like what I went through with my first birth but it was only 10 years ago in New York! I also had no shower in my room and no one to help me walk down the hall to the shower. I tried to go myself but started fainting along the way so the nurse made me go back to bed! I didn't get to shower until I went home 2 days later. And I was very sore from the birth and having a very hard time getting in and out of the bed. When I asked for help the nurse's aide said, do you think you're in a hotel? Really all she needed to do was adjust the bed to make it closer to the floor but she did not do that. It took me half-hour at a time to climb back into bed.
First off; I don't miss the call light. At my current job my patients use only their monitors and their screams to summon, and they don't get into emotional/power plays (they are infants). We won't go into their parents needs; thankfully I work nights and 90% of the parents are out of there by 10pm.
This may sound strange but I think the way I practiced med/surg/tele nursing was partly a by-product of my laziness. I wanted the patients happy (and therefore not calling) so I was pro-active in addressing their needs. I worked feverishly addressing any possible needs they might have in the first few hours of my shift so they would be satisfied and hopefully sleep for most of the rest of the shift. I made sure I could get them laxatives, sleepers, pain meds, extra bedding, ice & water, snacks, good IV sites to start with. It saved me work! Not only that but the patients will often start to trust you more and they relax a bit. Some of those calls are a product of anxiety, making sure someone is there and cares. Now I know not all will sleep and I know not every nurse here works nights but I still think it's a good practice and helpful even during daylight hours (I have worked dayshift and practised this way).
Was it Tweety who posted the link to the "hourly rounds" article? That was fantastic and that is my philosophy for time management in nursing. It saves you work! After I would get everyone their needs in the first few hours of the night (7-10pm), I would start hourly rounds and keep patients in that happy state if possible. Now I'm no super nurse and I had patients I couldn't satisfy but in general this tactic worked very well for me and I believe my patients also.
Does all this planning help when you have a critical patient about to code? Not so much, but honestly I was lucky enough I guess not to have that happen every night. And I wasn't afraid to say to patients "Can't get your ice cream right now, I have a very critical patient". Can't imagine that violates any HIPAA regs as long as I didn't elaborate beyond that.
And does this excuse the patient that calls to do something they can do? Well, sometimes they need education about what they are capable of doing, they honestly don't know! Others are just little trolls. When someone would call for me to change the channel or volume, I would stand by their bed and instruct them until they did it themselves, wouldn't do it for them.
It seems to me, that where I work anyway, from about late October until early April I cannot make "rounds". When I go in, I start my assessments...and nothing but chaos ensues for me, my shift manager, and my co-workers, until it's time to leave. We have agendas and they work in the summer when our census is low. Imagine an open unit where everyone in the hospital has to walk through to get from one part of the hospital to another, all the noise and people in your way. Imagine students, volunteers, xray techs, lab techs, PAc's, MD's, nurses, CNA's, Administration, Dietary, Parish nurses, the Chaplain, visitors, and other department personnel coming through your already too-small unit on their way to another part of the hospital, sometimes stopping to ask questions, directions, requests, or to just "chat" as if we had time. We have to move out of the way for them to pass as we are trying to get medications from our med carts. Oh wait, did I forget the numerous phone calls that the secretary doesn't screen because she too is behind on putting orders in the computer because of all the questions from people coming onto the unit? We have requested remodeling of the unit, and it is supposed to be done (hopefully as we helped outline) but until it is done, chaos. I'd love to make hourly rounds, but am too busy CONSTANTLY running.
I have a choice to leave, of course, but I like where I work, just not the design being so open to noise and confusion.
What I suppose I was trying to say is, even the best intentions don't always work everywhere.
So much of what I love about my job is my ability to do things for my patients, like take the time to explain cholecystitis, or educate a person who has just been devastated by a positive herpes diagnosis. It gives me a great feeling to alleviate pain, provide education, and supply information about the processes underway, from labs to CT to waiting for a bed.
What makes me nuts (and I know that this is not 100% fair as no one could possibly understand all we have to do except another nurse) are the people who will get nasty over things that any sane person would agree are not essential to one's survival. Less than a week ago I was hauling a$$ into a pt's room, pushing the EKG machine with one hand and balancing an armful of IV bags, tubing, chest pain forms with the other, plus a bottle of SL nitro in my teeth. A woman actually stepped in front of me and all my entourage, foricng me to a screeching halt, and stated firmly, "She needs a blanket!"
I was on serious stress overload. I longed to just snarl at this person who could observe such obvious urgency and believe that her family member's feeling cold should take immediate priority. I know that on the floors, often patients and families don't know where stuff is or if they can have it. But in an ER, this above incident just made me see red. I had no clue who this woman was, I was not the nurse for her family member, I had no idea even which room she was referring to. I could not imagine being on the other side of this situation, stepping out of a room in the ER and flagging down the first person I see with a demand both vague and haughty, assuming that my loved one's desire for a blanket was more important than whatever this harried individual was rushing to attend with such varied gadgetry. That the entire staff was there to serve my every desire, conveniently forgetting the very nature of an emergency room.
I will work overtime, go without lunch, and wait to pee till I get home to give my patients the care, attention, and information that they need. But I'll be da**ed if I'll accept responsibility for the whims of every person in the entire ER. This, I believe, is much of what the OP finds so frustrating.
I don't mind doing stuff... it just bugs me when people call you, you ask them what they need, they say "for the nurse to come to the room" and then you walk all the way in there and they say "I need a blanket." Usually, they don't care if the "nurse" is the NA or me, but some of them want the RN or LPN for everything (why, I do not know!).
I usually at that point tell them if they could be more specific, I could get them what they need faster (I could have gotten the blanket and then walked in the room - instead their wait time was doubled because I walked in their room, asked what they needed, went back to the other end of the hall to get the linens, and then back to thier room). Or, to not put them on the spot, the next time they call out I ask "is there something in particular that you need me to bring with me before I come down?" That is really the only thing that bugs me. Tell me what you need over the call light. Makes things better for you (the patient) and me.
I do want to say though that if a patient doesn't feel like they can do something, trust them. About ten days after I had my bab I came down with a major infection. I was admitted with a central line, IV antibiotics, and a MAJOR headache / syncope. That first morning, I was feeling so sick I was dizzy... and I needed help to the bathroom. I didn't have any family with me - they all left to go home and sleep and take care of the baby. When I finally got the NA in there, she helped me up and took me to the bathroom. I felt like I was going to pass out at any minute, and almost fell in the bathroom. She did stay beside the room and help me without me haivng to ask... but when she walked in, she was obviously PO'd that her supposedly "walkie talkie 17 year old" (thats what they always said about the young ones on that floor... I worked there 18 months later!) needed her assistance to go to the bathroom. Then, she made a smart comment about "wow, you have some major stretch marks!"
I was not happy, to say the least. Not only did I feel like crap, but I got an insensitive remark from the person was who was pretty much PO'd to be helping me because, I think, from my age she though I should be able to do it myself. I wasn't being over dramatic or demanding. After I got better, I did fine and did stuff myself. But I still felt badly asking for help when I needed it because of that NA.
One of my co-workers told one them point blank when a family member cam to the desk, "That's what the call light is for, don't come to the desk"
I get frustrated with having to get up from charting repeatedly too, but image how you would feel if someone was that rude to you! In my experience, the people who come to the desk believe that they are being helpful, they think using the call light is a burden. I realize that it was not OliveVines who said this to a family member, it was her co-worker. I hope that person is never my nurse. I had a co-worker once who spoke to pts and families like that, she also liked to make post-op patients wait for 30-45 minutes for pain meds until the oncoming nurse got out of report, because she had already taped, so she was "done" and sitting at the desk until it was time to clock out. A few times she even got up from her chair, walked to the pts room, and told them that the night shift nurse would bring the pain medicine when she made her rounds.
I just don't understand how anyone can treat a fellow human being with such a lack of respect and compassion.
Sorry, maybe I am missing something. Or maybe I have been away from bedside nursing too long. But isn't this a part of normal patient care? If we don't hear our pt's needs, how are we to determine what they are?
The best way for me to know what my patient needed was to have him/her ask me. If he asks for coffee, then his appetite must be good. Or he must be feeling better because he is attempting to get back in to some type of routine.
I don't know. I really don't see what is wrong with that. This may be your job, but your patient is in because he or she is ill. What more can I do to make him/her happy? I want to hear what he/she needs. Then I know I am doing my job.
I think what the op was getting at was, she doesnt like being treated like a maid, with the back and forth stuff. I agree with her, thats why I will never do any type of adult med surg, ever. I have no inclination to run around to get people cofee, worry about their diets, toileting schedule, etc. There are alot of areas of nursing that do not involve that. The op mentioned she kinda likes floating to tele... some people actually like doing the more skilled,critical part of our job, and tend to navigate towards those areas. Med surg is not for everyone!!!!
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I think it's very appropriate to vent here, if need be. This is a board of professionals just "shooting the bull" sometimes.....and Lord knows, we all get frustrated and tired of working under increasing pressure to "do more with less". Let's keep that in mind as we see people venting frustrations here, and perhaps, give the benefit of doubt------I know I consider myself a pretty darn good nurse, but I do get "fed up" oftentimes, and who else but other nurses would UNDERSTAND my vents? So I come here (grin). Does that make me a bad nurse? Think not...more appropriate to vent here than mistreat a patient or come off wrongly due to unexpressed and unrelieved anger/frustration. Try to go easy on each other, ok?
PANurseRN1
1,288 Posts
Well, as a fellow RN, I could pretty much size up how busy that floor was, so yeah, I just got the bag of saline myself. (Kept my own I&O, too). The staff certainly were not preoccupied with attending to "FMP/BMS" requests. ("Fluff my pillow/bend my straw.")