To tell or not to tell?

[freckles23]

Hi there, so I have a question regarding patient load since this will happen every so often. What do you do when you have a heavy patient load at a hospital and one or a few patients take up the most of your time? (Confused patients, unstable, pain seekers, dnr dni comfort care pts). im asking this because certain patients are a heavier load than others and if you have an unfair load in your assignment it is bound for trouble. The other night I was stuck with a patient for almost 2 hours trying to get her started on a drip and then she was confused and i had to deal with the family and it was just a mess and I was unable to attend to my dnr dni patient who was on comfort measures and felt so heartless because the dughter kept coming out and I had to keep telling her Ill be there when I can to give pain meds for her mother meanwhile Im dealing with a mess in the other room.

So my question is, is it okay to tell your other patients that you were caught up in another room due to an emergency in order for them to understand why you werent able to attend to their needs in a timely manner. I feel if you let them know that then maybe they will have some sympathy and understand that if it was them that needed the emergency I would be there right alongside with them. How do you approach this kind of situation? Especially if you are running a code or rapid and itll be awhile til you see your other patients. I am asking because its kind of like would you ever tell a patient you are short staffed nurses? no because then it looks bad and unsafe for them. So do you really tell them about other emergencies or just leave it alone that you were late and apologize.?

[mrsboots87]

I agree with others that this is the time you needed to utilize your team. This is exactly what a charge is there to help you with. Pain is a pretty high priority to me, and leaving a dying person in pain for 2 hours is rough. Even though it was your intent to do so. Since some of your problem was the confused patient getting up, watching them isn't only a nursing duty. You could have utilized a CNA to stay with the patient for a few minutes while you go medicate your other patient. Or you could have called another nurse or even the charge nurse to assess the pain and give the med to the other patient. You could have requested from the charge to have a sitter or call for restraint orders. Did you find the source of the confusion and was it treatable? It's so easy to get caught up in the hustle and bustle of things and not ask for help, but that's exactly what you needed. What would happen if the pain got so bad for the other patient that they became symptomatic and having other problems?

I work between med/surg and tele units. Besides the few outliers, there really is a great team between all the employees be it CNA, RT, RN, whatever. Usually if one of us sees another nurse struggling, any one of us will offer help. If no one asks a struggling nurse, if the nurse asks for help, we usually will. Just the other night I was working with a patient who was have uncontrolled pain and became very restless/agitated. My charge could see I was tied up at the moment and medicated another of my patients who began to have pain and assessed a patient with run of V-tach. In that same night, I answered a few call lights for another nurse and helped them to to the toilet and drew a lab because they were stuck doing something else. Team work makes the dream work because we can't all possibly meet every single patient need in a timely manner when things come up.

I hope ole you have similar teamwork and can next time use your resources to get all your patients cares for timely.