Vital Signs Taking at ER

[nursing_problem]

The patient was wheeled in ER via stretcher. Normally we get the data of the patient and her vital signs. After obtaining data, our resident doctor did his history taking. While doing it in the bedside of the patient, I told him the BP of his patient was 200/100. While transferring the data of the patient in an admitting chart, a relative went to me and asked for the BP of the patient. I told her in my usual voice that the patients BP is 200/100. She began to complain I'm a bit vulgar in saying the patients vital signs. She told me it may cause stress to her patient and cause elevated BP. So I told her ok, kowing inside me next time we will not divulge it in front of the patient. However, she get my name and have it written in a piece of paper. Unfortunately, one of my colleagues did not know the precaution that relative gave regarding the BP. Upon rechecking he told our resident doctor the lateat BP which was 190/110 which make the relative angrier. She told us is that the way we do it in ER? What if our Bp is high and hearing it doesn't it make it more elevated.. I told her that's the way we do it and communicate with the resident doctors in er and the nurse who rechecked it didn't know her precaution. After awhile, a co staff in the hospital told me, the relative told her If I was her daughter she would spank me. Is that how the nurses are in our hospital and we don't have etiquette. At the same time, she also told my co- ER staff that they will make certain actions regarding what I did in ER. She also told my colleague that I didn't apologize and answered back to her.I'm quite nervous of the possible things that may happen. Our chief nurse knows that relative for her manners. During previous hospitalization, our chief nurse started intravenous infusion to the granddaughter of the said relative. Since being a grandmother who doesn't want her relative getting hurt , she demands for the sharp shooter. One of the er nurse told her that our chief nurse is the sharp shooter in our hospital. She said to our chief nurse "so what if you're the chief nurse?"What do you think of my situation? My friends and I can't help but be sad because we were just doing our job. If certain precautions were told from the moment they brought in that patient, we will do it the way they want. But apparently, the relative just informed me after the second time I told the BP of her patient.

[CodeteamB]

My goodness. This woman sounds difficult, and it sounds like she has a history of being difficult. You work in an Emergency Room, you were communicating with another staff member important and accurate information, no-one should give a darn what this woman thinks about it. Her comment that she would spank you makes her seem like a crazy person at best and a threat to staff at worst, and the person who heard that comment should have called her on it. From what you have described of this scenario I can't imagine you getting in trouble for this.

Relax, you didn't do anything wrong.

[nursing_problem]

Thinking of the situation makes me nervous more and think I really did something wrong like not apologizing and answering back. But my point was to explain since she asked if that's how we do it in ER. What makes me nervous more is they're going to write a formal complaint letter to the superiors of our hospital. I always thought the pateint/ relative will always be right in situations like this since plainly speaking, they are customers. I already have spoken with our ER head nurse and chief nurse.

[CodeteamB]

I guess as a Canadian I have a different perspective. I have never in my career heard anyone say "the customer is always right" in regards to medicine, but I have seen it mentioned on this forum many times. I really can't believe that your boss would get on you for this, but that may be the reality of your workplace. In my ER this patient would have been directed that this is indeed how we do it in the ER, that if the pt does not want to hear his/her blood pressure they can request it and we will do our best to honor it, but we will be communicating in our workspace. She would be told that the bedside nurse will take a look for an IV an if this nurse doesn't feel confident she will ask a "sharp shooter" then. If a visitor made comments about spanking a co-worker I would advise her that this is inappropriate and will not be tolerated. If this continued she would be asked to leave.

The way I read this is that this person was extremely disrespectful to you, a trained health professional doing her job and trying to help the patient. In my opinion there is absolutely no reason that you shouldn't "answer back" and set limits.

Again, I don't know how it is where you work, and I don't want to belittle your concerns, but I maintain that you did nothing wrong and it would be crazy to discipline you for the scenario you described.

[nursing_problem]

t just happened this morning. A formal complaint will be filed maybe tomorrow or days to come. I haven't spoke to my the hospital administrator or medical director yet and they haven't reprimanded me.. YET. As I spoke to my chief nurse and head nurse the way I look at it, they understood the situation I'm into. I've already handled ptients whose relative requested not to tell the BP to the patient. And as requested, I tell the relatives the latest VS and if ever the patient asks I just say its quite high or low but we will give medications for it and rechecked it again.A

[corky1272RN]

Why was this relative being told anything to begin with? If they are within earshot when the VS are being communicated out loud then that is one thing, but to come and specifically ask... The patient stated he/she didn't want to know what the BP was or the fam member didn't want the pt to know? Unless designated by the pt to make medical decisions, that fam member can't direct the pt's care. I would like to say that that could be a problem versus the other

[Esme12, ASN, BSN, RN]

I am confused...I don't know why......I had a hard time understanding your post. Why is any information being released to the relative? If she over hears it that's one thing. A patient has every right to hear their vitals...it's the relative that doesn't when you think of HIPAA. Unless this relative is healthcare proxy....with a signed LEGAL healthcare proxy...she has no right to dictate anything about what is, or is not, told to the patient.

[CodeteamB]

I am confused...I don't know why......I had a hard time understanding your post. Why is any information being released to the relative? If she over hears it that's one thing. A patient has every right to hear their vitals...it's the relative that doesn't when you think of HIPAA. Unless this relative is healthcare proxy....with a signed LEGAL healthcare proxy...she has no right to dictate anything about what is or is not, told to the patient.[/quote']

^This! I don't care whether random visitors don't want the pt to hear their vitals, it is the patient's decision.

[Altra, BSN, RN]

I'm pretty sure that you're not in the USA. So that makes it really difficult for me to judge the situation and the behavior of the patient's family member, because I would be judging it by US standards, and your culture may be very different.

I wish you well.

[nursing_problem]

Definitely I'm not from US.. The patient was not really feeling well to give us any information so her sister,which is the closest relative, makes decisions for her. Upon arrival, the relative didn't inform us that she didn't want the patient to hear her BP. I understood that she doesn't want to cause any stress to her patient. It was only when she approached me and asked for the BP again that she informed me of what she wants. But she's already angry with us.

[nursing_problem]

And by the way, we are used in telling the doctor the VS of patients in a voice where everybody esp. The other er nurses are able to hear.

[Sassy5d]

Don't let it get you.. I always say, if you don't have a pt complaint, you don't have a pulse.

Especially if that lady likes to be difficult every time she comes in. Don't sweat it.