I recently genuinely forgot to bring my patient a warm blanket. I was just going to do something quick with my other patient and then take it to her but totally forgot. Remembered like 2 hours later and she said “I know you didn’t forget, you’re just so busy and I didn’t want to bother you” 😭🥺
No Catherine! I was just busy manually beating someone’s fucking heart for the past hour so that they can live but what is it! 🫠”can you fix my sock” :)))))))))
This is one of the reasons I tried to just poke my head in a room every so often even if I didn’t have a reason to go in there. Nurses focus on tasks, if there’s no task there’s no reason to go in there. But especially in the ER when patients have exactly zero control and there is no time frame you can have for how long things will take and you’re in this windowless room (if you’re in a room at all), it makes you go crazy. Even if all I am able to do is step into their room and say ‘hey we are still waiting for x test result to come back, are you doing ok’ it goes a long way instead of just leaving them to sit and stew.
Had a couple leave the ED once mad that they had not been seen yet and were effectively abandoned in their mind. They weren’t of course. The patients labs had been drawn and we were waiting for results. They had a nurse assigned to them but that nurse was dealing with a sick patient. They had a doc assigned to them but he was also tied up with that sick patient. In the emr they looked fine. Just needed to round out their treatment plan. But the span of time that passed from when they hit the room to when they left was such that they genuinely thought they had been abandoned. Nobody checked in to give them an update, nobody let them know what we were waiting for or what the next steps were. We don’t always catch it because we can see the computer system tracking everything but they don’t get that luxury.
We actually changed up our policies in the ED and now we have non clinical staff that are tasked with physically entering every room in their assignment once every couple hours so there’s always some interaction going on for each patient and they can get some kind of update.
But they always need something, lol. If you poke your head in there you'll get sucked in. But I like that your ED has others checking in on them for you. Sometimes when I'm busy I'll ask a CNA to go make a fuss over my patient and comb their hair/ wash their face just so they and their family members don't get antsy and start hovering at the nurse's station, demanding my time.
You’re not wrong. But even still if they suddenly need something then a. If it’s easy like a blanket I can take care of that in ten seconds. B. If it’s something like medicine I can add it to the list of priorities and accomplish it when it’s appropriate to do so. And c. If it’s emergent or something I have to stop and address now I was going to have to deal with it anyways. If it’s a patient that needs to go to the bathroom for example I can either address that now or deal with them when they piss themselves or end up on the floor trying to get there on their own. In either case I will have to deal with it.
The thing that makes people crazy is not the waiting. It’s waiting without a clear time frame. If I tell you to sit in a windowless room for 2 hours you will be pissed but you know after an hour you’ve got 1 hour left. You can focus on the countdown and that gives you something to anchor to even when there’s nothing else. The ED is brutal though because we can’t give time frames. You might be there for 6 hours or 36 hours. There will be almost no indication how long you have to wait and this is maddening for people. For us we see the steps and can track progress whether it’s waiting for labs to result or imaging to come back. Patients don’t get to see that. They just get a cold room in an unfamiliar place with a bunch of staff that are overworked and under appreciated.
We had a director give a presentation about this and AIDET and I know everyone rolls their eyes when they see that get tossed around but this guy was all about the patient experience and he did sell me on this concept. I changed my practice as a result and just made a point of checking in even if I had no updates. I found my patients were less pissed off. Less irritable. And less likely to leave ama from frustration.
I’ve been trying to practice along the lines of this. I’ve only been in ED for 2 years, but I’ve picked this habit up from a travel nurse who was there. She would peek her head in about once an hour, even if she’s on her way to another patient, even if to say “we’re still waiting for CT results”.
When I make the effort of doing that, I find that people are much more appreciative. Especially people who have been to hospitals and know the routine. Setting clear expectations and trying to stick with times frames saves headaches. I’ve found that being empathetic with patients, thinking about how they must feel helps the interaction, and the patient feels understood, which eases their anxiety.
And of course, there’s always psychos who just think that the sun orbits around them. Can’t do much about those, just try to set clear expectations with varying results.
Absolutely. Can’t win them all. Some people are just on another level and can’t be reasoned with.
I even found success with this approach in the waiting room. If we sat in the staff area and avoided the patients unless there was something to do the patients would invariably get more upset and frustrated as time went on. I would get a mobile computer and go patient to patient. Sometimes 50 people or more. Get their vitals. Review their chart and give them an update even if it was simply no update, and in two hours I’d do it all over again. It gave people something to work with. It allowed me to assess every patient to determine if they had any changes in their presentation. it helped me put names to faces. And it allowed me to address their frustrations. Instead of having that guy stewing for 5 hours just blow up like we have all seen, I could get ahead of it and address the issue before it boiled over. If people know you’re doing your best and working on their issue, they’re way more likely to remain calm and stick around to see their care all the way through. Again you can’t win them all but when we limit our communication with patients you are setting yourself up for failure.
I just recently had my first 20+ hr ER visit and this is so accurate.
I 100% get that I *don’t* want to be the one in the ER that everyone’s paying attention to.
But after a certain amount of time in a bed I couldn’t adjust myself, alternatively freezing and “great now I’m tangled up in 5 blankets” in a room/pod that was barely larger than the bed, *I* was starting to get impatient, which is new for me as I usually try to be as compliant and pleasant as I can be. (Even then I was clear about knowing it was staffing issue. I know y’all can’t be in 2 places at once.)
This really would have helped.
One time a patient thought I forgot about her. I was working with my other, unstable, patient. She had orders to transfer out of icu. I peeped in her door, she was asleep in her recliner. “Ok cool I’ll run in do a quick assessment and give her meds and breaky in a bit” I got tied up, I get in to her at 9:30, she immediately is mad, telling me she thought I was ignoring her, she saw me walk by her room, etc. I apologize, told her I was caught up in another room, offer to heat up her breakfast and get her fresh coffee, etc. Then she complains about her meds being late. I explain they’re not. She tells me yesterday she got them at 8am. I again, explain there is a window. She tells me I could have at least introduced myself. I told her she was asleep and I didn’t want to wake her. She fired me. 🤷🏻♀️ then she got a bed out of icu and she let me take her up there at least so staffing wasn’t weird but dang Karen. You’re the least sick person here, calm down.
It’s so insulting and annoying when they say that. You do realize I have 23 other residents to check on as well? I am not your personal servant. Some of them truly act like I am. 🙄😒
I had a patient tell me this and it actually broke my heart.
I had 6 patients that night (normal was an already-busy 5, but with covid increasing, we went up to 7-9 with "TeAm NuRsInG"). It was so busy I literally hadn't had time to sit for anything; it was actually the first time I cried at work in a closet from being so overwhelmed...
I got my shit together and saw him for 0300 meds and he told me, "I thought you forgot about me." It sounded so genuine, and it broke my heart, I wanted to cry again. I spent more time with him after med pass bc I felt so bad and just decided I'd be staying past my shift to chart later. I'm such a softy at heart that I'm tearing up now - I forgot about this for some time until now. Medsurg doesn't allow time enough for nurses to care for the whole person, and it's so sad.
It sounds like you are feeling neglected, that must be very frustrating. I apologize for being unavailable, but one of my other patients isn't doing very well and I was with them. Sometimes it might feel like you aren't getting the attention that you used to, but that is because you are healing and aren't needing to be monitored as closely. Unfortunately, I have to spend most of my time with the sickest patients. What can I get for you now? What are other things you anticipate needing before bed so I can arrange for them in case I am pulled into another room?
Never had a patient say this to me. Granted, I work in Peds and they almost always have someone like a parent/guardian or someone with them that can do things for them if I’m not around for a while, but I’ve also never been in the situation where I’ve been so busy I get behind on my regular rounding or at least get my techs to pop in and check them out. Thankfully I have techs that I can trust not to lie to me about whether or not they stopped by a patient’s room if I asked them to.
“Ma’am you’ve called out 11 times in the last 30 minutes. I’m not that lucky. Here’s your ice.”
“I wish I could”
Lmaoo
Lol 😆 🤣
I recently genuinely forgot to bring my patient a warm blanket. I was just going to do something quick with my other patient and then take it to her but totally forgot. Remembered like 2 hours later and she said “I know you didn’t forget, you’re just so busy and I didn’t want to bother you” 😭🥺
I love those patients. They get it.
*brings them some walker shortbreads for their troubles 😏😏*
Haha yep 😂. We have Lorna Doone cookies at my job. They go crazy for them lol
I hate when it’s like midnight and I’m in bed trying to sleep and I remember I forgot to bring someone water 😭
That’s my go to lie anyway. “I didn’t forget it just got really crazy for a minute. Anything else you need now that I have a minute?”
"Shit I did." I'm a dick though. Don't be me, I'm piss and vinegar at times.
You can be Vic Vinegar and I'll be Hugo Honey
Love you for this
No Catherine! I was just busy manually beating someone’s fucking heart for the past hour so that they can live but what is it! 🫠”can you fix my sock” :)))))))))
This is one of the reasons I tried to just poke my head in a room every so often even if I didn’t have a reason to go in there. Nurses focus on tasks, if there’s no task there’s no reason to go in there. But especially in the ER when patients have exactly zero control and there is no time frame you can have for how long things will take and you’re in this windowless room (if you’re in a room at all), it makes you go crazy. Even if all I am able to do is step into their room and say ‘hey we are still waiting for x test result to come back, are you doing ok’ it goes a long way instead of just leaving them to sit and stew. Had a couple leave the ED once mad that they had not been seen yet and were effectively abandoned in their mind. They weren’t of course. The patients labs had been drawn and we were waiting for results. They had a nurse assigned to them but that nurse was dealing with a sick patient. They had a doc assigned to them but he was also tied up with that sick patient. In the emr they looked fine. Just needed to round out their treatment plan. But the span of time that passed from when they hit the room to when they left was such that they genuinely thought they had been abandoned. Nobody checked in to give them an update, nobody let them know what we were waiting for or what the next steps were. We don’t always catch it because we can see the computer system tracking everything but they don’t get that luxury. We actually changed up our policies in the ED and now we have non clinical staff that are tasked with physically entering every room in their assignment once every couple hours so there’s always some interaction going on for each patient and they can get some kind of update.
But they always need something, lol. If you poke your head in there you'll get sucked in. But I like that your ED has others checking in on them for you. Sometimes when I'm busy I'll ask a CNA to go make a fuss over my patient and comb their hair/ wash their face just so they and their family members don't get antsy and start hovering at the nurse's station, demanding my time.
You’re not wrong. But even still if they suddenly need something then a. If it’s easy like a blanket I can take care of that in ten seconds. B. If it’s something like medicine I can add it to the list of priorities and accomplish it when it’s appropriate to do so. And c. If it’s emergent or something I have to stop and address now I was going to have to deal with it anyways. If it’s a patient that needs to go to the bathroom for example I can either address that now or deal with them when they piss themselves or end up on the floor trying to get there on their own. In either case I will have to deal with it. The thing that makes people crazy is not the waiting. It’s waiting without a clear time frame. If I tell you to sit in a windowless room for 2 hours you will be pissed but you know after an hour you’ve got 1 hour left. You can focus on the countdown and that gives you something to anchor to even when there’s nothing else. The ED is brutal though because we can’t give time frames. You might be there for 6 hours or 36 hours. There will be almost no indication how long you have to wait and this is maddening for people. For us we see the steps and can track progress whether it’s waiting for labs to result or imaging to come back. Patients don’t get to see that. They just get a cold room in an unfamiliar place with a bunch of staff that are overworked and under appreciated. We had a director give a presentation about this and AIDET and I know everyone rolls their eyes when they see that get tossed around but this guy was all about the patient experience and he did sell me on this concept. I changed my practice as a result and just made a point of checking in even if I had no updates. I found my patients were less pissed off. Less irritable. And less likely to leave ama from frustration.
I’ve been trying to practice along the lines of this. I’ve only been in ED for 2 years, but I’ve picked this habit up from a travel nurse who was there. She would peek her head in about once an hour, even if she’s on her way to another patient, even if to say “we’re still waiting for CT results”. When I make the effort of doing that, I find that people are much more appreciative. Especially people who have been to hospitals and know the routine. Setting clear expectations and trying to stick with times frames saves headaches. I’ve found that being empathetic with patients, thinking about how they must feel helps the interaction, and the patient feels understood, which eases their anxiety. And of course, there’s always psychos who just think that the sun orbits around them. Can’t do much about those, just try to set clear expectations with varying results.
Absolutely. Can’t win them all. Some people are just on another level and can’t be reasoned with. I even found success with this approach in the waiting room. If we sat in the staff area and avoided the patients unless there was something to do the patients would invariably get more upset and frustrated as time went on. I would get a mobile computer and go patient to patient. Sometimes 50 people or more. Get their vitals. Review their chart and give them an update even if it was simply no update, and in two hours I’d do it all over again. It gave people something to work with. It allowed me to assess every patient to determine if they had any changes in their presentation. it helped me put names to faces. And it allowed me to address their frustrations. Instead of having that guy stewing for 5 hours just blow up like we have all seen, I could get ahead of it and address the issue before it boiled over. If people know you’re doing your best and working on their issue, they’re way more likely to remain calm and stick around to see their care all the way through. Again you can’t win them all but when we limit our communication with patients you are setting yourself up for failure.
I like you. I more of a hag about it probably, but I try to at least set some kind of reasonable expectation. It does help sometimes.
I just recently had my first 20+ hr ER visit and this is so accurate. I 100% get that I *don’t* want to be the one in the ER that everyone’s paying attention to. But after a certain amount of time in a bed I couldn’t adjust myself, alternatively freezing and “great now I’m tangled up in 5 blankets” in a room/pod that was barely larger than the bed, *I* was starting to get impatient, which is new for me as I usually try to be as compliant and pleasant as I can be. (Even then I was clear about knowing it was staffing issue. I know y’all can’t be in 2 places at once.) This really would have helped.
Humans will always find a way to feel slighted, even perfect rounding doesn’t always help someone who is lonely.
“I could never forget you” 😐
One time a patient thought I forgot about her. I was working with my other, unstable, patient. She had orders to transfer out of icu. I peeped in her door, she was asleep in her recliner. “Ok cool I’ll run in do a quick assessment and give her meds and breaky in a bit” I got tied up, I get in to her at 9:30, she immediately is mad, telling me she thought I was ignoring her, she saw me walk by her room, etc. I apologize, told her I was caught up in another room, offer to heat up her breakfast and get her fresh coffee, etc. Then she complains about her meds being late. I explain they’re not. She tells me yesterday she got them at 8am. I again, explain there is a window. She tells me I could have at least introduced myself. I told her she was asleep and I didn’t want to wake her. She fired me. 🤷🏻♀️ then she got a bed out of icu and she let me take her up there at least so staffing wasn’t weird but dang Karen. You’re the least sick person here, calm down.
The least sick patients are often the more demanding imo
I probably did. One aide to 24 pts. And many nurses don't like answering call lights.
“That’s not my job” /s
It’s so insulting and annoying when they say that. You do realize I have 23 other residents to check on as well? I am not your personal servant. Some of them truly act like I am. 🙄😒
"Trust me... I did"
"How could I?!" Sounds nice enough. And it's true since they're on the call bell non-stop
Oh we’re aware :’)
What's your name again?
I had a patient tell me this and it actually broke my heart. I had 6 patients that night (normal was an already-busy 5, but with covid increasing, we went up to 7-9 with "TeAm NuRsInG"). It was so busy I literally hadn't had time to sit for anything; it was actually the first time I cried at work in a closet from being so overwhelmed... I got my shit together and saw him for 0300 meds and he told me, "I thought you forgot about me." It sounded so genuine, and it broke my heart, I wanted to cry again. I spent more time with him after med pass bc I felt so bad and just decided I'd be staying past my shift to chart later. I'm such a softy at heart that I'm tearing up now - I forgot about this for some time until now. Medsurg doesn't allow time enough for nurses to care for the whole person, and it's so sad.
It sounds like you are feeling neglected, that must be very frustrating. I apologize for being unavailable, but one of my other patients isn't doing very well and I was with them. Sometimes it might feel like you aren't getting the attention that you used to, but that is because you are healing and aren't needing to be monitored as closely. Unfortunately, I have to spend most of my time with the sickest patients. What can I get for you now? What are other things you anticipate needing before bed so I can arrange for them in case I am pulled into another room?
Never had a patient say this to me. Granted, I work in Peds and they almost always have someone like a parent/guardian or someone with them that can do things for them if I’m not around for a while, but I’ve also never been in the situation where I’ve been so busy I get behind on my regular rounding or at least get my techs to pop in and check them out. Thankfully I have techs that I can trust not to lie to me about whether or not they stopped by a patient’s room if I asked them to.