Something bothered me today in the Emergency Dept.

happyinillinois · May 3, 2014

You were not using your time wisely. I am sure there is something else you could've been learning rather then sitting at 1 person's bedside for 2 1/2 hours. We aren't uncaring, it it just not possible to give a stable patient that much time. We do care, which is why we show up day after day, everyday seeing what we see. I am assuming it is your lack of experience that made this such a wonderful experience for you. Your role there wasn't a volunteer to keep the lonely company, it was to learn how to be an RN. ER is the one place where you can practice all your skills. December is going to come quickly, and you will wish you had spent more time doing assessments, starting IV's, dropping NG's and cathing people while you had someone to show you or be there which you. Everything gets easier with repetition, and this is the place where you will get the most opportunity to try those skills. You will be expected to pull your own weight once you are hired. You will not have an opportunity to sit with someone for 2 1/2 hours, you will need to prioritize. Seek out opportunities, don't wait for them to come to you. I see a missed opportunity. You can't tell me there wasn't anything else going on in the ER. We call this teamwork, and when you have a free minute, you help another RN.

amoLucia · May 3, 2014

I wanted to comment on this in my initial post but it was NOT what OP had asked about.

I thought what a nice opportunity OP had to just reach out to someone and make positive impact. We all know that that occurs so infrequently. I thought wasn't it a shame that this visit could not have been the basis for a PSYCHIATRIC clinical day. Some nice therapeutic interaction.

But that was not what OP asked.

Nor did she consider that the impromptu and extended visit could be setting up the pt for some emotional letdown and disappointment. The staff on the pt's new unit most likely will not have the time to devote to prolonged interaction while on duty. And nor will anyone stay two & half hours after work (ON THEIR OWN TIME) just to sit and talk with a lonely LOL.

An unrealistic precedent may have been set for pt and staff.

To OP - you'll find other pts that touch your emotions (good AND bad). What you do when you're working will be your decision, but you asked us for our opinions on your activity. You know, it's funny that even YOU seemed to think there might have been some questions. We answered.

Anna Flaxis, BSN, RN · May 3, 2014

Satrgazer, you have to understand that our ED yesterday was extremely slow nothing was going on. I have been down there a few time in my rotation and I am always in and out of rooms, starting IVs, floating around the trauma rooms etc. I do not want you to think that I am "one of those" students who do nothing but sit on their rear all day. This happened at the very end of my shift when all of our patient's were transferred elsewhere and there was nothing going on besides the usual gossip at the nurses station.

No, I didn't think of you as being lazy. I thought of you as sounding like a very caring person. It was nice of you to sit with her.

Nursing Is My Life · May 3, 2014

Personally I don't see anything wrong with going and visiting her, especially since she extended the invitation for you to do so. She may not have any family or friends that will come and visit her. Your visit would brighten her day.

I had a patient that was on my unit and I became somewhat attached to her, as I was the one that cared for her each shift I worked. She was trasferred down to another unit and I went and visited her. It made her day. I never got into trouble for doing this by my DON or anyone else. I say go for it, if you feel comfortable doing so. :yes:

Do what your heart tells you and good luck.

Wanda LPN, Nebraska

GodWatchesOver · May 9, 2014

I did that before, did not do me any good... you don't want to get attached to your pts, though you can always show them that you care.... I know you cared for her but you can only do so much... In ED, I try to talk to my patients and care for them as well, but 99% of the time, you always have something to do... As a student or orientee, you have a lot of time.. but if you are by yourself, you want to make sure you're not forgeting things like VS, charting/documenting, checking labs, attending to pt's needs, informing MD of pt's condition, giving meds/drips, helping coworkers and so on... You have to manage your time wisely even though you want to interact with them. The RN you are with that time most likely was prioritizing another patient that is more critical and knows that you were with that pt (unless she was critically gossiping in the nurses' station). I had a lot of patient with the same situation as hers.. lives alone, has chronic conditions (usually non compliant not because they want to, its because of their current situation), .. that's why I make sure that she'll get referred to case management. Aside from my team working on it, I also make sure my patient know how to get the resources she needs. Get the social worker involved... It's hard when you get attached to your patients... but it's not that you don't have a heart, you're just protecting yourself from being hurt. Goodluck and Godspeed :)

Happy Nurses' Week to everyone

psu_213, BSN, RN · May 9, 2014

To the original question--you are probably best not going up to visit this patient. What you did was very nice and it is obvious that care for her as a patient. However, that interaction is over, she has moved to a different unit, and you need to move on too--even if you have the best of intentions.

As for your time in the ER. Let's say I have 2 pts. One is this very nice lady, say her name is Mary, in A fib. The other can be whatever, we'll call him Joe. I get Mary stabilized. Make sure she is comfortable. I need to stay visible for Joe. I still need to go into his room, I still need to make sure his needs are met. If I spend a half hour or more with Mary, Joe or his family might tell me "hey, he was cold and thirsty and no one came in." If I say, "I was holding the hand of a scared elderly patient and providing her companionship," well, lets just say that Joe/his family might not appreciate my compassion toward Mary and only look at as ignoring Joe. Unfortunately, you can't use the "busy-ness" of the ER as a gauge for what nurses should have been doing--it is more complicated than that.

Keep you compassion high, learn the boundaries for a nurse, and try to be understanding of the ER staff and how things work.

OCNRN63, RN · May 9, 2014

Even if you're not busy, there may be another staff member who could use some help. I agree with other: the ED is not the place to sit and have a long chat with a patient, no matter how charming s/he may be.

I wouldn't go see the patient. You need to learn to develops boundaries, otherwise you'll get sucked in by every patient who is needy.

LadyFree28, BSN, LPN, RN · May 9, 2014

Personally I don't see anything wrong with going and visiting her, especially since she extended the invitation for you to do so. She may not have any family or friends that will come and visit her. Your visit would brighten her day.
I had a patient that was on my unit and I became somewhat attached to her, as I was the one that cared for her each shift I worked. She was trasferred down to another unit and I went and visited her. It made her day. I never got into trouble for doing this by my DON or anyone else. I say go for it, if you feel comfortable doing so.
Do what your heart tells you and good luck.
Wanda LPN, Nebraska

Ah, but going for it may land OP in hot water; better yet, it's best to know boundaries more than anything else; sometimes doing "what your heart tells you" may give you more of an issue than anything else...it's not about the OP and their heart, it's about maintaining and knowing when to break the nurse-patient relationship,

DayDreamin ER CRNP · May 10, 2014

I agree with so many of the other posters above. While me may not appear to be "warm and fuzzy," we have mastered the art off time management. It is an essential function of the ER nurse.

Two and half hours talking to a patient? That is precious time you could:

1. be catching up on your other patient (s)

2. anticipating the needs of your other patient

3. helping your co-workers / teammates with their patients

4. charting! In my facility, something must be charted on a patient at least every two hours. Vital signs and a reassessment are due every two hours at the very least.

5. stocking your rooms for the next shift

6. PEEING! Sheesh!

Yes! Some patients are more time consuming and require more attention than others. It is your duty to yourself, your co-wokers AND your other patients to manage your time and attention.

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