I'm on a rant!! Add to my list if you feel so inclined!
A book/pamphlet/note card in the style of "What to Expect When You're Expecting" needs to be written and given to anyone who is going to be in the hospital for any length of time. It can be written collaboratively by nurses, doctors and ancillary staff.
THE TRUTH MUST BE TOLD:
The H sign on the side of the road doesn't stand for Hotel.
Your _____ is broken or your _____ was just cut into. You will be in pain. 0/10 at this juncture is not really expected but we will do everything within reason to keep you as comfortable as possible.
Your family being demanding, aggressive, passive-aggressive, haughty and demeaning to those taking care of you and you thinking they are protecting you so that you'll get better care in the form of more attention is usually dead wrong. We stay away from patients like that unless it's absolutely necessary to go in. If three call lights are going off, yours will be answered last since it is absolute torture to deal with you and/or your family.
It's 7:00 am and yes, I know where your surgeon is, She's performing surgery just like she was doing on you at this same time yesterday!
We have to prioritize and re prioritize our care constantly. That may mean that I have to take someone to the restroom and give another pain medication before I can refill your ice water. I will get to you as quick as I can but know if I am "late" that it is because I am with a patient who needs me more.
Well, regarding blood pressures and blood sugars for family members, I would do it if I have time and/or the person in question is symptomatic. I do not want visitor coding in my room and if they hypoglycemic because they simply forget to eat, one cup of OJ won't kill anyone if given in time and followed by trip down to cafeteria. Otherwise, it is crying to be made as nice gleaming booklet and handed down to every new admit. Read it, sign here for me, questions, sir?
Well some of these aren't the nicest of comments. We all have bad days and we all rant. I would certainly rather you rant on here than take out your frustration on a patient and/or family member. Pretty sure I've written down things about what I wish I could say to patients but can't...I KNOW everyone has thought of it so to say that you should re-evaluate your quality of care is just plain rude and unneccessary.
Health care is very frustrating. Patient's and family members can be difficult to deal with but that doesn't mean you aren't doing a good job. Some people are just plain difficult, end of story and no matter what you do they will stay that way. Nursing is an often thankless job, we hear that over and over again.
I'm all for ranting and writing out your feelings so you can get them out and not internalize them. Keep doing you and ignore those who say you aren't doing a good job because they obviously have no idea if you are or are not based on one single post.
Unqualified "nice" support is useless in terms of helping people to see their weaknesses and in helping people to improve their nursing practice.
The OP's post described her practice:
[COLOR=#000000]"Your family being demanding, aggressive, passive-aggressive, haughty and demeaning to those taking care of you and you thinking they are protecting you so that you'll get better care in the form of more attention is usually dead wrong. We stay away from patients like that unless it's absolutely necessary to go in. If three call lights are going off, yours will be answered last since it is absolute torture to deal with you and/or your family."[/COLOR]
As nurses it is not appropriate to stay away from patients or their families because we do not like them or find them difficult. We have a duty of care to all of our patients. It is not appropriate to ignore patients or their family members because we do not like them or find them difficult, or to prioritize our nursing care so that their needs are met last because we don't like them and/or find them difficult.
It's very true that doing rounding on demanding patients reduces their anxiety. There are many techniques to quickly update the patient and their proactive family member, giving them the impression that you care, and also subtly letting them know that you also have other sick patients. It really does work.
Well, regarding blood pressures and blood sugars for family members, I would do it if I have time and/or the person in question is symptomatic. I do not want visitor coding in my room and if they hypoglycemic because they simply forget to eat, one cup of OJ won't kill anyone if given in time and followed by trip down to cafeteria. Otherwise, it is crying to be made as nice gleaming booklet and handed down to every new admit. Read it, sign here for me, questions, sir?
Our policy is against this as it is viewed as providing medical care to a non-patient. You will get into a lot of trouble for even taking a non-patients blood pressure. We literally can't take their blood sugar either because they have no armband to scan. What if their BP is 200/115? You can advise them to go to the ED, but what if they don't? Then you know about the problem and can't do anything about it. What if they stroke out and the patient calls you out on how high their blood pressure was and says the nurse didn't do anything? You can say you advised them to go to the ED but it's their word vs yours. Then you have to answer to why you took their blood pressure in the first place. I am just saying, it does carry some liability to assess patients non-patients.
While I totally understand where you're coming from, prioritizing which patients you see first based on how annoying their family is is not very good nursing.
(But a pamphlet informing families that their complaining will not result in quicker service.... that I could get behind)
I agree with you - although ever notice it's usually the patients who are not that sick that are difficult or have the most difficult family members. Exception: oncology patients
I agree with you - although ever notice it's usually the patients who are not that sick that are difficult or have the most difficult family members. Exception: oncology patients
That's been my experience as well. Some of the nicest patients I've cared for have been terminally ill. Some of the nicest family members I've cared for have thanked me for caring for their just deceased family member. I've gotten a couple of thank you cards from patients' spouses after the patient died. Those people are my heroes--to be so kind and gracious in the midst of what had to be the hardest time of their lives. I hope I can be half as kind if/when I am in that situation.
Susie, I do agree that customer service is important in nursing. Any job that deals with the public does have a customer service component. I disagree that patients and their families shouldn't expect to have responsibilities and realistic expectations of health care providers. We're only human. We can only do so much and only be in one place at a time. My experience has been that when you are upfront with people, most of them understand. No, I'm not going to say that I have seven patients, because I don't want them to feel like they can't ask for things or that they're a bother, but I can easily tell them (within privacy constraints), I'm dealing with x situation now, I will get with you next." If we're upfront and follow through with promises, most people will work with us. Those that won't? I'll admit to being human and being only as attentive to nasty patients and families as required by my job. Whereas, those kind patients and families? I'll go out of my way to do extra for them, just because they're nice.
In our meters, it is possible to scan operator badge twice, then call and say what happened. At the worst, you always can scan the patient and explain later.
There were multiple topics here about nurses' obligations toward people who just happened to be around and suddenly got very sick. I was very much surprised that there were participants in discussions who allegedly refused to give a victim of anaphylaxis an Epipen shot or even start chest compressions just because "something might happen" later. Sorry, but my policies-kissing has certain limits and in situation with visitor complaining on chest pain I will check blood pressure and even start AHA algorithm if situation demands it, and let the chips fly and fall. Better that than a code.
I must be an awful nurse, because I totally got every single thing the OP wrote.
The pain thing, the pushy families, and the three call light nasty patient last example. I got it, and I don't disagree.
All things being equal, when three lights are going off, and they all need answered by me, I'll answer them in order of time spent. Or easy to hard. That way the person who only needs their IV pump silenced doesn't have to wait 10 minutes.
I was honestly shocked by the posts who blasted the OP.
We vent here folks. We vent and post things we'll never do. It just feels good saying we will.
In our meters, it is possible to scan operator badge twice, then call and say what happened. At the worst, you always can scan the patient and explain later.
There were multiple topics here about nurses' obligations toward people who just happened to be around and suddenly got very sick. I was very much surprised that there were participants in discussions who allegedly refused to give a victim of anaphylaxis an Epipen shot or even start chest compressions just because "something might happen" later. Sorry, but my policies-kissing has certain limits and in situation with visitor complaining on chest pain I will check blood pressure and even start AHA algorithm if situation demands it, and let the chips fly and fall. Better that than a code.
I'm sorry for derailing the thread some but...
Does your facility have a policy for what to do if a non-patient is in distress? Ours is to call a code blue and the code team will come and treat them and go from there. In a TRUE emergency, which I had happen, I did take the family members vital signs and prop her so that she was not aspirating. Code team came and took her to the ED then she was admitted to the hospital. In a true emergency while waiting for the team to arrive I will do what basics that I can.
So an emergency = call a code blue (regardless of if it is or not to get the code team asap). If a visitor is not having an emergency I will advise them to talk to their PCP or go to an urgent care/ED for their concerns.
Karou
700 Posts
Oh sorry, one more!
We have to prioritize and re prioritize our care constantly. That may mean that I have to take someone to the restroom and give another pain medication before I can refill your ice water. I will get to you as quick as I can but know if I am "late" that it is because I am with a patient who needs me more.