Time management with elderly patients

[witc]

Hi everyone!

I started my first job as an RN a week ago.

I am working half time in urgent care and the other half I do annual physicals with elderly patients. I am supposed to get everything done in 40 minutes. Basically, I do VS control, EKG, ABI, PFT, Bone density measurement, Draw blood for labs, take pt to xray, and conduct nursing interview. I can get all the studies and blood draw in time, but what is more difficult to me is the interview. Every time I ask a question, the patients give me a long story that barely relates to the question. Most pts have lost their spouses, so they keep referring to their lives back then when their spouses were alive.

I like listening to their stories :) however, because of the time limit, I know I have to interrupt them in the middle of a story tp get an appropriate answer and continue with the next question, and I can't help feeling rude and insensitive. I love listening to old people stories. My grandma has Alzheimer's and I can listen to the same story over and over and never get tired or frustrated.

So how do you think I could handle the interview? I mostly use open ended questions, should I used closed, yes/no questions instead? Any advices that would help me get through the interview process a little bit faster?

Thanks in advance!

[Orange Tree]

I try to set expectations where they need to be before I get started by saying things like, " I have a few quick questions for you." and "Don't worry, we'll make this go by fast." I also rely heavily on closed questions. I wish I had more time to chat, but that's just not the case.

[Flo., BSN, RN]

Closed questions. Elderly patients or those that have tangential thinking are hard to rein in but I find that simple yes/no help a lot.

[Good Morning, Gil]

This made me laugh since I had the same issue. I remember when I did my first admission with an elderly patient as a new grad, it took me 30 mins lol because when I asked if they ever have any GI issues? They started saying something like..."well, 20 years ago, I had this scope done, and I'll have to ask my wife", etc, etc after EVERY SINGLE QUESTION lol.

But, we had an admission nurse so I didn't have to worry about it haha. Don't know what advice to give you lol. I have to do admissions now at my job b/c we don't have an admissions nurse, but it's usually with the family member or if the patient is obtunded or something, I just get everything I can from the chart, and then ask the family later when they come in to visit (since its night shift).

I agree...I love talking with patients, too....but we don't have time for a 30 min conversation even though I wish we did lol. What I do now that helps, though...if I find its getting too off-topic, I just re-direct. Like say..."hmm..that's very interesting, and I'd love to talk to you more about that later, but I just have a few more questions that we need to finish since I want to be sure you get all of your important tests, meds, in, etc." That usually works...most people just don't realize the time constraints of a nurse (unless they are one...in which case, that can be a good or bad thing depending on the patient lol).

Best of luck to you!!

[croppyRN]

I think the above advice is very good. I needed it too, because I find myself in the same situation when dealing with my patients and residents. A lot of the time I have to interrupt them and apologize, explaining that I have to complete "X, Y & Z" before a certain time. This usually makes them all apologetic, which isn't my intention, but it is necessary. Otherwise I would be in their room forever. But this is still a work in progress for me. It's not that I want to be chatty and kill time, but sometimes I know they are lonely and just need someone to talk to. So, I give in, which causes me to fall behind, just like you.

I am sure if you work at this, things will go more smoothly with time. My goodness, you've only been at this for a week! Give yourself time, and don't be hard on yourself. Easier said then done, I know.

Good luck, and keep at it!