patients questions/concerns to an "aide"

[ava'smomRN]

hey guys, i was thinking about a situation i often get in at work, no big deal but here goes. i am a nurses aide and a lot of times pts ask me questions like: drug side effects, norms after surgery, discharge info, and things that sometimes i feel uncomfertable answering only because i dont know if i am supposed to answer these things because of my tittle. i never answer something if i dont absolutely know they truth rather i will direct them to their nurse, care coordinator, pt/ot, etc.but i am just wondering if it is ok to answer or if i am stepping out of line and in every case i should direct the question or concern to the proper person???........

[nursemike, ASN, RN]

I think the questions you mentioned should be referred to a nurse. These are things we cover in our various classes, and patient education is one of the things we can't delegate to an unlicensed person. I don't think I'd be comfortable discussing drug effects or side-effects without having taken Pharmacology, for example.

But I also think there's room for some common sense, too. I encounter similar situations in my present (unlicensed) job, too. Once had a patient ask, very earnestly, "Do you think I'm going to make it?" Now, even nurses aren't supposed to make medical prognoses--that's the doc's job--but this gentlement just wanted an honest answer from a regular person, so I told him truthfully that I didn't know enough to give him a definite answer, that he should discuss his concerns with his physician, and that he appeared to me to be a strong man in decent overall health, so if I were betting, I'd bet on him. He felt better, and I didn't feel I'd said anything unethical.

The thing you want to avoid like plague is saying something that goes beyond your scope of practice (which is basically everyday common sense) and saying something that a nurse or doctor is going to have to correct, or that undermines something they may have already said. It isn't just a matter of nurses protecting their "turf." In some cases, a normal, expected side-effect may be not all that different from a life-threatening crisis. I once transported a patient who was "warm and flushed" after IV contrast with a CT scan. By the time we reached her room, she was purple and unable to speak. Imagine if she had only been warm and flushed in her room and I had told her, "Oh, that's not uncommon..." without reporting it to a nurse.

It's a commendable impulse to want to give patients more than the minimum we are required to do, but I think it's a good instinct not to feel comfortable doing more than you are really qualified to do. That's a lesson we all need to heed.

[meownsmile, BSN, RN]

Thank you NurseMike,, well said.

[ava'smomRN]

thanks, i feel betterf now:)