Gettin' Kicked Off The Carpet (Tales from the CCU)
added by geena on February 29, 2004 at 9:06 AM
I have a huge pet peeve at work. Well, I have several. First and foremost is hearing a patient call out, "Nurse! Oh Nurse!!" Grrrr. I would seriously prefer "Hey you!" over "Nuuuu-uuuurse!"
The other biggie is trespassing behind the nurse's station. This annoyed me even before HIPAA. It's like... it's like our sanctuary. Our space. Sure, we have to share it with the occasional doctor passing through :), but it's totally and completely off-limits to patients and family members. I have always found it so pretentious for someone to just march into our station like they own the place. No hesitation whatsoever. On my unit, the floor is all linoleum in the hallway and patient rooms. The nurse's station is carpeted. And when I say "station" I don't mean some kind of monolith in the center of the unit. It's not like we're walled off or anything. It's just a bunch of desks.
I'm not saying that people can't approach the desk; I'm saying that I don't like it when they come behind the desk. Even before I was a nurse, if I were in the hospital for some reason (visiting a family member, etc), I would have never dreamed of just crossing the boundary that is the nurse's station. Now, with HIPAA, it's practically illegal to do so. Take the situation that happened today:
Family member: (Coming up to carpet and looking like she wants to ask something) "Excuse me?"
Me: (Sitting in front of the monitors behind the desk) "Yes?"
FM: (Having gotten my attention, she assumes she can now cross the carpet and approach me behind "the desk" although we were less than 5 feet apart) "I wanted to ask about my father's belongings... I asked the nurse earlier about them, and was wondering if they'd been found yet."
Me: (Annoyed that she's behind the desk, but sense that this will be a brief convo and decide to let it slide) "I'm looking after your father for a nurse who is on break. Let me see if I can call the other unit he was on to find out if they have your father's belongings. Are you going in to visit with him? I can let you know if I find them."
FM: "Oh, that's okay. If it won't take too long, I can just wait. I've already been in to visit with him." (Proceeds to take a few steps back, still on carpet, still behind desk, and makes the I'm-waiting pose.)
Me: That's fine; it won't take me long, but I can't have you waiting back here behind the desk. Can you please wait in the hallway?" (Hallway that is less than 5 feet away)
FM: (Indignant look) "What? Am I not allowed on the carpet or something?"
Me: (Smiling, trying to be lighthearted because some people are just really that clueless and get embarrassed when they realize they've entered forbidden territory) "Actually, you aren't. I'm going to have to kick you off the carpet while I work on finding your father's belongings. There is a lot of patient information back here on the monitors and such, and for confidentiality reasons, I have to ask you to wait in the hallway."
She seemed okay with that. I found her dad's stuff, answered her other questions, and she was good to go. I don't mean to imply that visitors must shout to us if we're behind the desk. The unit has a very open floor plan and normal conversational tones are effective. I realize that sometimes visitors want to ask us about sensitive topics and don't wish to have any space between them and the nurse. In that case, most people come as far as the carpet and simply ask if they can talk to the nurse, and the nurse goes to them and conversation ensues.
It's just so ingrained in us to protect patient confidentiality at all times. We become very protective of our space because it contains such sensitive information. The chances of a visitor glancing at the monitors and happening to notice the name of someone they know are slim, but once we start letting everyone come back, it's only a matter of time before they start wearing out their welcome and sticking around long enough to notice such things.
Besides, it's just our space. We don't go barging into cubicles in offices, behind the registers in stores, or into the kitchens of restaurants. Our station is no different!
| Progress Notes (7) |
Progress Notes
Good on you for being able to stay light-hearted about it. I would bet a lot of people just don't think about the information that's available in the nurses' station. Or other patients' privacy. And of course, as a visitor, they're entitled to know everything about the patient who's in your unit, right?
added by Caryn on February 29, 2004 9:10 AM
The comments about the carpet make a lot of sense to me, though I think that coming 'in' might just mean a desire to be closer to the person I'm talking to. But the part about 'nurrrrsee' -- golly, I would have assumed thats what you'd want. I sure wouldn't call out 'hey you' -- doesn't sound at all right to me. But if thats what you want, how would you let someone know? Can't think of an easy way, short of an 'orientation sheet' (Don't step behind the counter; its a restricted area. If you want to call a nurse, 'hey you' or their name, if you know is, is the preferred method.' See? It starts sounding all awkward and lawyerly....
None of which should be taken to mean that you don't have the right to work as you wish, to control your area, and to be called the way you want. I just can't think of a graceful way to get the word out.
added by bill reith on February 29, 2004 9:12 AM
I wonder if signs on the desks that say something like, "Restricted area; only medical personnel allowed behind desk/in carpeted area/within ten feet of desk" would help.
I haven't been a CCU patient, but I can't imagine yelling, "Oh NUUURRRSSEE!" down the hallway, either. That's what the call button's for, right?
This strikes me the same way as the kids who only call their teachers, "Teacher." Your teacher is a whole human being who has a name. So is your nurse. So is your doctor, and your bus driver, and your UPS guy, and and and.
Huh. I guess it's also a pet peeve of mine. Use my name, dangit. Or if you forget it, which is totally understandable, ask again. I'll tell you.
When I was in the hospital, each nurse would introduce herself to me when she first came into my room. That was nice, but the one who wrote her name on the whiteboard right under the TV was absolutely brilliant. Then I didn't have to remember, "Is my nurse today Barbara or Virginia? They both were blond and had accents," when I was also freaked out about having had abdominal surgery and trying to figure out what to do with this insane little baby and on narcotics and being poked and prodded every ten minutes from 6 am to 6 pm.
added by Caryn on February 29, 2004 1:04 PM
Don't forget. Patients see many individuals in a hospital: Doctors (primary, Interns, Residents) Support person, technicians, Phelbotimists, Nurses aides, LPNs, RNs, volunteers, etc. They see these people for maybe 5 - 10 minutes max that cover multiple shifts. When you don't feel well, its hard to remember everyone's name. Typically they remember their primary doctor. But after that, its a fog of support people who come and go. Using the word "Nurse" is a well known and understood way to get help. And since patients do not understand the environment as healthcare workers, I see nothing wrong with using the word Nurse to get help or attention.
added by John on March 6, 2004 11:20 PM
Great blog! Well designed! Came upon it purely by accident but I intend to visit more often! I want to get the book "Complications" advertised on your site--I had never heard of it until now.
added by Stephanie Tate, RN on October 19, 2004 6:58 AM
I work in emergency and visitors are my number one pet peeve. I don't know why people think that when I call a patient to the door I want their whole extended family and entourage to come back too. You should see the looks of amazement and hurt when I tell them all to go have a seat in the waiting room. I wonder if they are all welcomed back to the examination room to hang out when they visit their PCP. (Silly me, assuming that people seek medical attention anyplace besides an ER.)
Another peeve is when people demand to know why "that person got called ahead of me". A lot of my coworkers explain that that person is being seen first because they're having an asthma attack or chest pain and you have a discharge from your penis/vagina or something else that can wait. This is all a violation of privacy and I don't offer any explanations other than to explain that people are seen in order of perceived seriousness, not arrival time.
It's always "that person got a sandwich, why can't I eat?" (as if it's a restaurant). I'm often tempted to show them someone on a ventilator and ask "do you want one of these too?".
added by Pedro on October 19, 2004 10:42 AM
I'm a nurse too and have to agree with you on both counts. I don't scream "Attorney" when I enter his office. Use the call bell.
Also the privacy issues, I cannot barely take a break so I generally try to eat and document at the same time (in an outpatient clinic now)--yet people still try and come up behind me and look at my computer screen. Doesn't anyone know how to say "excuse me?" anymore?
Just to add a pet peeve, nurses on other floors who will not take report for a transfer or admission. What do they think? that the admitting doc will change his mind?
added by Kathy on October 20, 2004 12:15 AM
So, what brought you to the hospital today?