What to say when patients feel like they are wasting time

[Matt8700, RN, EMT-B]

Patient education question here.

How do you all approach the ER patient that is admitted and awaiting a bed on the floor, it has no active interventions taking place when they tell you that they "might as well just go home since nothing is being done?" It's one of the most frustrating things that a patient will say to me, and even after I explain to them that they have already been given fluids and antibiotics and that even if they were upstairs they would still just be sitting, they think that they are just wasting their time? I have tried to explain that there will be periods of time when there are no meds infusing and no tests being done, but they don't seem to accept that. It's like they think that unless they are hooked to some infusion or being taken for some test, then there is no reason for them to be in the hospital.

How do you all handle this? Especially when the family starts to get pushy too and feeds the fire? I have never been able to find an explanation that seems satisfactory to anyone. Ideas?

[JKL33]

This comes up a lot during something like a chest pain work-up too. In my overview of what we're going to be doing, I take a little time to elaborate on the fact that there will be a period of observation. I let them know things like we are continuing to monitor heart rhythm and that we have multiple monitors where the doctors and nurses are able to see what's going on with it. I tell them right up front that after the flurry of activity is over it's going to get pretty boring/quiet for awhile (HOPEFULLY!). When in the quiet phase, I check in periodically for comfort/needs and just let them know we're on the same plan we discussed earlier.

There are some people who won't accept it no matter what you say. And honestly, the ED (and ED stretchers) are sucky places to spend hours if your condition is such that it warrants admission. My only suggestion would be that you take everything you're already telling them and try to phrase it positively. The truth is that something IS being done - they are being observed in a setting that is much safer than being at home in their condition (most of the time). So instead of saying we've already done basically everything that needs to be done, tell them what you/we ARE doing now (it's not "nothing" or simply "waiting").

I know holding in the ED is frustrating for nurses, but we should be careful to not convey that to patients in order to try to make ourselves look better. It just causes them to lose confidence in their care. Try very hard not to feel personally offended about their patience wearing thin. YOU are not causing the situation and it doesn't reflect on you personally.

Providers can help with this too...they are so fond of telling patients how we're gonna "get you upstairs." If holding and disgruntled patients r/t holding are a frequent problem in your department, your manager should address patient communication about this with the medical staff too.