Refusing Patients' Requests: Can it be done?

[George4life]

Hello. I am a 24-year-old student considering beginning the pursuit of a career in nursing( R.N). I have read many threads about the life of a nurse- some claiming it to be pleasant, while others speak negatively about the profession. I am posting this new thread( which by the way is the first thread I have ever posted in my entire life lol) because I read a thread that wrote about how one nurse was annoyed that his patient repeatedly pushed the buzzer for trivial items such as a desire to have the light turned on, to have the phone handed to him, and so on and so forth. MY QUESTION FOR ALL OF YOU EXPERIENCED NURSES IS THIS.Can a nurse simply ignore a patient at times?Does the aforementioned nurse have to hand the telephone to the patient every time he asks for it? (keep in mind that the telephone is only inches away from his bed and the patient is perfectly capable of getting it himself.) ARE THERE TIMES WHEN A NURSE CAN REFUSE A PATIENTS' NON-MEDICAL RELATED REQUEST? SHARE YOUR STORIES.

[Daisy_08, BSN, RN]

It depends on the request. I'd say yes. often times its safety, scope of practice and common sense. "no, you cannot smoke in here" "no i will not take off your restraints" "No, I will not lift you on top of your wife and assist you in having sex"

[Aeterna, BSN, RN]

Like others, I've never ignored call bells or requests, per se. However, if they're calling so frequently that it's interfering with my work with my other patients, there's a point where I say, "I'm very busy right now, but when I have a moment, I'll get you a glass of water/help you with a phone call/etc." I have to prioritize. Obviously, giving out my meds, helping someone to the bathroom, and such, take priority over, say, getting someone their second glass of water in an hour.

MOST people understand and will wait once I tell them I'm busy, but I've had a couple of patients who will be on the call bell again in five minutes later *sigh*

There was one memorable lady, though, who rang for me to move her purse from one side of her bed to the other. She was in for a fractured foot. I did it because, at the time, she was new to me but little did I know that was just the beginning. On my second day with her, I told her very clearly that she could not ring ever five minutes because I could not be with her constantly (because she was literally on the call bell every 5-10 minutes).

[LouisVRN, RN]

yeah I think the other posters have pretty much covered the topic and the best options. You can't ever take a patient's call bell away in case they have a genuine need but at the same time limit setting is important in all relationships. The long-term care assisted living option will usually cure neediness.

[loriangel14, RN]

I work with a charming German lady that will not stand for any nonsense. She will march into their room and say "Show me your hands!!" Then she grabs their thumb and says "Just as I thought!! You've got a callus! Now stop ringing so much!!". She would laugh and leave. Sometimes people would get the message.

[vampiregirl, BSN, RN]

Gee, thanks for the referrals to LTC:)

I can't think of a single example when it's appropriate to ignore a call light. Even if it's someone who usually has trivial requests, the one time you ignore the call light, it will be for something urgent.

Having said that, being proactive seems to cut down on repeat call lights. Several other posters have offered suggestions.

I have several residents who choose to scream instead of using the call light or purposefully set off their pressure or seatbelt alarms because "staff comes faster". I have been known to ensure the resident is safe, ensure their request is non-urgent, and that that call light is truely within reach... and if so, have the resident active their call light and leave the room. I ensure that their call light is answered timely (sometimes by me in a minute or two).

On the other side of the coin... our call light system posts times that each call light is activated. I do pay attention to those times. I will answer call lights myself if times are getting long and the CNA's are busy. I also will not tolerate staff ignoring particular call lights:)

[TeleMeMore]

The answer is NO.

You cannot *ignore* a patient's request because to administration the patient=God.

The patient gets a survey after their stay and will fill it out if they are ******, for any reason. You wouldn't believe what people will complain about. i.e "The ice water tasted like tap and not bottled". THIS IS NOT A RESORT, IT IS A HOSPITAL!!!!! LOL.

Ergo, you have to answer to their requests no matter how small/silly/stupid.

BUT I won't let a patient take advantage of me and if they can do something on their own, while I won't ignore their request, I will go to their room and let them know they are capable of doing things on their own and they better start proving it if they want to get out of here (but in a much nicer way).

Never ignore your patient, after all you are responsible for taking care of them, being the kind, compassionate nurse that you are. I never ignore my patient, what if it is a true emergency? But if it isn't (most times it isn't), I'll help them if I deem it necessary, otherwise I'll help them help themselves.

AND there is a way to be proactive to cut down calls, make sure everything is in reach for them, ASK them if they need anything before leaving, NOT as you walk out the door, but stand near them, look at them, ask and wait. This way you are getting as much as you can done for them to make sure they are comfortable, they will be less likely to call you later on if they have everything they need. Ask them if they have any questions, etc.

[LoveMyBugs, BSN, CNA, RN]

I work on a long term vent unit so, many of my patients they stopped using their call lights and start bagging, and a couple of times they will discounect themselves from their vent so the alarms will sound and we will come running in there.

Usually it is for something trivial, like they want the TV channel changed, I have to remind them to please use their call light and not bang, and I tell my aides if they actually use the light, respond!

[Batman25]

Always answer your call light as it could be an emergency. I have denied requests and encouraged patients to be self sufficient. If they say they can't reach the water, phone, etc. I move it closer so they can. If they however want me to get it when their arms work and they are competent I don't always do it. We are to encourage patients to do what they can for themselves and I live by that. I always help those that really need it and have the others do what they can for themselves and help with what they can't.

I also think it is important to differentiate between why they need help. Are they lonely and just looking for company? If yes, encourage them to do what they can but tell them you will be back later to check on score of game, etc. Bring them a little snack when you get a moment or just say hi. If it is because they are spoiled set your boundaries and stick to them.

[JenniferSews]

Park of what I love about sub acute rehab is that it is completely appropriate to say "we encourage you to do as much as you can for yourself so we know you are can do it yourself at home." I do often give into the "can you move my water bottle 1/4" inch to the left?" I know they will be complaining in a day or so how much they want to leave and I will remind them how they need to be show their independence.

[3dayRN]

Had a twenty something year old patient that was giving everyone a hard time. He actually wasn't my patient but all us nurses and aides were taking turns answering his call light. He was on the call light continuously! So when I answered his call light he wanted me to hold his urinal in place for him and he was quite capable of doing it and had been doing it himself all night. I told him to do it himself and he said he would mess his bed. I told him if he did I would be back later to clean it up. He used the urinal HIMSELF the rest of the night. Some might say this was mean of me and not very professional but I would do it again in a minute.

[nerdtonurse?, BSN, RN]

What I do is tell them what I will and won't do, and then follow thru. A lot of people aren't used to being told "no." I spent a lot of my childhood as free farm help, and one thing I learned about animals is also true of 2 footed animals. Consistency is the key. Yes is always yes, no is always no. You don't let a dog get away with chasing chickens today, then be mad because he does it tomorrow. This is when you need to talk to the oncoming shifts and maintain consistency. If one shift lets the patient go out to smoke, to the cafeteria, leave the floor, etc., it's harder on the next shift if you try to follow the rules.

[nfdfiremedic, BSN, RN]

You can't ignore them but you can certainly tell them no if they're asking for something unreasonable.