In the hospital where I used to work, family members would come up to the desk all the time to say "dad needs a _______ (blanket, cup, straw) and I developed a nasty habit of saying (in a perfectly innocent tone) "Does he know how to use the call light?" Gradually my tone started getting more and more sarcastic. Had to stop that one after a few nasty looks. oops.
Or "that's not real high on my priority list"
I know there's been plenty more....
At least I knew I had to leave the hospital setting for a bit before my mouth could get me in too much trouble. Feeling much better suited to home health, where you can throw whatever you like at me! I'll be out of your house in less than an hour!
If it's my patient's family I don't mind, but as a rule visitors:
1) can't detect that I'm in the middle of something more essential,
2) think my sitting at the desk 'talking' (handing over or discussing a patient with another member of the team), on the compuor (looking up results, paging someone or sending a referral) or writing means I'm free, and
1) seem to think we're all interchangable and all know everything about their family member's status. I don't know who you're dad is, let alone if he can have a glass of water. Please go back to his room and press his buzzer, so the nurse caring for him, who knows all about him, can attend to him. Thank you.
I was working ER at a pediatric hospital when parents brought in a screaming toddler who'd been scalded by hot coffee over his entire forearm. It was terrible for the parents and for us. The frantic young mom said, "Oh, I put Musterole on it and he cried harder. I guess I made it worse!" She was so distraught that my response was going to be something on the order of "Musterole is not for burns" and offer some better treatments in case of future need, when the nurse beside me said, "Yes, ma'am, you probably did." What she said was of course, true, but I could not have brought myself to be as blunt as that to this poor mom who was already beating herself up. It was such a blessing when the icy cold compresses we applied did the trick. (Now also a no-no!)
For those who don't know what Musterole was, it was an OTC cream that claimed it "heats the pain away" and was designed for muscle aches.
I cringed when I read this, then I tried to google Musterole to see what the heck is in it. What I see is mustard oil is the primary ingredient. Mustard is an old home remedy for burns, and knowing this I cannot fault the mother. She was desperate to help her child. She meant well, and was not prepared to treat or gauge the severity of a burn. How many patients have I hurt myself when packing wounds or applying things that hurt before they helped? How many treatments have I used that were accepted practice years ago but are not any longer (peroxide, betadine, icy cold compresses to wounds, heat lamps to dry decubiti). I think your response would have been better for a mother who was already suffering- hers was cruel. There is a difference between honesty and cruelty.
Honestly I wish I had know that when my mum was in and out of hospital. Now I completely "get it". But I used to bounce over to the nurses' desk and ask for things instead of using the call light -- I thought it was more polite than using the light.
Oh well live and learn.
I think it really depends on the individual hospital and unit. It wouldn't bother me a bit if you came up to me at the nurses' station to request something, just so long as you were aware that, if I'm in the middle of something more pressing, your request might have to wait a bit.
I was working ER at a pediatric hospital when parents brought in a screaming toddler who'd been scalded by hot coffee over his entire forearm. It was terrible for the parents and for us. The frantic young mom said, "Oh, I put Musterole on it and he cried harder. I guess I made it worse!" She was so distraught that my response was going to be something on the order of "Musterole is not for burns" and offer some better treatments in case of future need, when the nurse beside me said, "Yes, ma'am, you probably did." What she said was of course, true, but I could not have brought myself to be as blunt as that to this poor mom who was already beating herself up. It was such a blessing when the icy cold compresses we applied did the trick. (Now also a no-no!)
For those who don't know what Musterole was, it was an OTC cream that claimed it "heats the pain away" and was designed for muscle aches.
Poor baby, he probably felt like someone had set his little arm on fire!
A favorite line I have used a few times goes something like this:
(needy Pain In The Butt patients) - Can you move my tissues? Reposition me? Feed me? Open my mail?
Me - If you can wipe your own butt and go outside to smoke (which you've already done) you are more than capable of doing X, Y, and Z by yourself.
Another incident that stands out was a very hostile and demanding visitor. She was a middle aged WASP lady that DEMANDED a recliner.
Visitor: You are going to get me a recliner!
Me : In a few moments when I have time I will get you one.
Visitor : Are you deaf or just stupid? I said you WILL get me a recliner - Not when you have time - NOW!
Me: I have some other things I need to....
Visitor: YOUR AN IDIOT! GET THE F-ING RECLINER NOW! NOW! NOW!!!! I CAN MAKE YOUR LIFE A LIVING HELL - DO WHAT I WANT NOW!
Me: In A Moment - Hold on
Visitor - (in my face yelling and cursing)
Me: GET OFF MY BACK! Get the Gosh Darn (not the real words I used) chair yourself - Its down the hall in the storage room. Your attitude sucks sweetie. Your wants are not my first priority....I am here to care for the patient. Got it? Good!
What drives me crazy is when I'm triaging a patient (I work nights in ER, and we triage at the bedside) who obviously needs some interventions ASAP (in severe pain, for example, or vomiting), and the family member is asking for nonessentials: "Could you get her a drink of water?" "Don't you have a warmer blanket?" "Is there any way to turn down the heat in this room?" "Does she really have to put on a gown?" "Do we get a choice about which doctor sees her?"
I've probably mentioned it here before, but I was asked by a visitor to get coffee, while I was in the middle of starting an IV (as in, sticking and threading the cannula). Because don't all patients want the person sticking a needle in them to be distracted by their friends and family.
The majority of our patients have private insurance and the entitlement mentality to go along with it. They do not want inconvenience, pain, interruptions, etc. We are there to serve them. I would make a hell of a restaurant waitress; I've had great training for it. Was she crazy? No, just very, very special.
Another incident that stands out was a very hostile and demanding visitor. She was a middle aged WASP lady that DEMANDED a recliner.
Visitor: You are going to get me a recliner!
Me : In a few moments when I have time I will get you one.
Visitor : Are you deaf or just stupid? I said you WILL get me a recliner - Not when you have time - NOW!
Me: I have some other things I need to....
Visitor: YOUR AN IDIOT! GET THE F-ING RECLINER NOW! NOW! NOW!!!! I CAN MAKE YOUR LIFE A LIVING HELL - DO WHAT I WANT NOW!
Me: In A Moment - Hold on
Visitor - (in my face yelling and cursing)
Me: GET OFF MY BACK! Get the Gosh Darn (not the real words I used) chair yourself - Its down the hall in the storage room. Your attitude sucks sweetie. Your wants are not my first priority....I am here to care for the patient. Got it? Good!
I had a similar incident once, except it ended with -
Me: when you're my patient I'll prioritise your needs. You're not, so you have to wait until I've finished attending to my patients, including the person you're visiting. Any more of this [gesturing to indicate the carry on] and security will escort you from the grounds.
Then the person she was visiting told her to sit down, shut up and stop embarassing him :)
I'm usually pretty good about keeping my mouth shut. But two particular situations come to mind.
The first: We were having a really butt-kicking busy day in the ER. We were all running around like crazy, attempting to get stuff under control, when the greeter grabbed me and asked me to come talk to this woman. "She's been up to my desk 3 times, wanting to know why they haven't come back yet, and even though I told her why, she keeps coming back." I went to talk to the lady:
Me: "My name is KinshuKiba. What can I do for you"
Woman: "My daughter's throat is sore, and I want to know why we haven't come back." (At that point, she'd been waiting 45 minutes or so.)
Me: "Well, ma'am, we're pretty full in the back, and we don't have any rooms available. Unfortunately, we see patients based on how sick they are, and so we have to take back the people having heart attacks and trouble breathing before we can see your daughter. I promise, though, we will see you as soon as we can."
Woman: "Look, she just needs a presciption. Can't you just give us one?"
Me: "I'm sorry, but in order to get a prescription, you have to be seen by a doctor. We'll get you back as soon as we can."
Woman:"Well, then just give us a note for her school and my work saying we were here."
Me: "I'm sorry, but in order to get an excuse, you need to be seen by a doctor. If you wait, we'll see you as fast as possible. If you want to go, I can give the names of a few Urgent Care clinics."
Woman: "What are you talking about? We just need a prescription and a note. Why can't you just take us back?" (What was I suppose to do for here?"
Me: "I'm really, really sorry. But I can't take you back, I can't give you a note, and I can't give you a presciption. If you want to wait, we'll see you as soon as we can. If you want to go, you are more than welcome to. But I cannot do anything else for you."
I turned on me heel and started to walk away, when I heard her go, "Well, I don't know why you're being so rude, because I pay your salary."
And before I could stop myself, it can out of my mouth, "No ma'am, you do not pay my salary. In fact, you're on medicaid, which means I pay for YOUR healthcare!"
Yup. Sure did go there. I wanted to shovel the words back in my mouth as I was saying them. But it sure did feel good. I want and 'fessed up, and wound up not getting in much trouble at all. And the funny thing was, when she went to complain to management, that last comment wasn't even what she was mad about.
The second (Where I didn't actually say something but...): Another hectic day in the ER. Had a woman come in via EMS with a vague complaint of "just not feeling good." No pain, no injury. We put her in T6. Time passed, and we put a little old lady into T5, who promptly coded. Everyone made a bee-line for the code, so I stayed at the desk to watch things. The family of the woman in T6 came out, and said that his wife needed to use the bathroom. Before I got further, let me make a few things clear: 1) This woman was completely able-bodied; she could have gotten up herself. 2)T6 was the only room with its own bathroom, which was approximately 5 steps from her bed. 3) The only thing she was hooked to was her IV bag; no tele, no oxygen. 4) This wasn't my patient, but everyone else was busy. Anyway, I followed her husband into the room, and introduced myself and told her I would help her to the bathroom:
Woman: "I'm glad someone finally came. I can't believe it took so long."
Me: "I'm sorry you had to wait. Everyone is busy right now, but I'm here, so I can help."
Woman. "Someone should have come a lot sooner. I waited and waited."
Me: "I'm sorry. We didn't mean to make you wait. But I'm here now, so we can get you taken care of."
Woman: "You shouldn't have made me wait. I had to pee and y'all ignored me."
Me(starting to get frustrated):"I'm really sorry. There's something going on in one of the other rooms that needed everyone's attention right away. We didn't meant to ignore you. But I'm here and I can help you go to the bathroom."
Woman: "I just can't believe you made me wait."
Me(in a strained voice): "Ma'am, there's a woman down the hall whose heart has stopped beating. Everyone is in her room trying to save her, and that's why noone came at first. But let me help you now. I'm here now and you can go to the bathroom."
I turned around to get her IV bag, and heard her say, "It's because I'm black." And I turned and stared.
I wish, to this day, I had said something. Something, anything at all. "Yes, it's because you're black. It has nothing to do with a little old lady dying next door because her heart has stopped. No, we didn't come right away to take you to the bathroom, which you could have very well done by yourself, because of the color of your skin."
But I was , literally, speechless. I have never, in my entire life, been so angry. I gaped at her, unable to speak, to think, to breathe. And then I walked away. Because if I'd waited one more minute, I would have hit her.
When I was a student, I helped look after a lady who had unexplained per lady partsl bleeding. And it wasn't just big clots either. You know how you see big slices of liver in the butcher's - well, that is what was coming out of her. And did she ever BLEED. It was like she was giving birth to these huge slices of 'meat'! Me & an EN were changing her pads/bed constantly, & she was diaphoretic ++. In the shower she was sitting in a pool of blood on a chair, just balling her eyes out. Her poor hubby at the bedside was totally lost, didn't know what to do. I felt so sorry for both of them. Anyway we were giving her Vit K injections but I left after that. I asked one of the nurses what she might have & all she could think of was cancer. I often wonder if this lady survived, poor thing.
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talaxandra
3,037 Posts
If it's my patient's family I don't mind, but as a rule visitors:
1) can't detect that I'm in the middle of something more essential,
2) think my sitting at the desk 'talking' (handing over or discussing a patient with another member of the team), on the compuor (looking up results, paging someone or sending a referral) or writing means I'm free, and
1) seem to think we're all interchangable and all know everything about their family member's status. I don't know who you're dad is, let alone if he can have a glass of water. Please go back to his room and press his buzzer, so the nurse caring for him, who knows all about him, can attend to him. Thank you.