Prioritizing multiple important needs happening simultaneously is one of the most challenging and stressful aspect of nursing in my experience. Let me give the following common example: Prioritizing the priorities.
If one Patient is having surgical pain, a second patient is requesting ice water, a third needs to go to the bathroom, a fourth is having chest pain, a fifth has an IV beeping, and a doctor is waiting to speak to you on the phone, what do you do first? All are considered a priority, even ice water, especially for customer satisfaction which is top priority for hospitals.
To answer the question, I would have the secretary tell the doctor on the phone I have an emergency (or even specifically tell them I'm treating a patient with chest pain so they know I'm in a legitmate situation that keeps me from talking with them, because of course what they have to say is very important too).
I would first go see the most potentially life-threatening patient situation, the one with chest pain and intervene (which could take a significant amount of time--assessing the potential cause of the chest pain and other assessments, possible EKG's, medication, calling the doctor, labwork, etc.) In the process of all of this I would attempt to have someone else assist the third patient to the bathroom and have another nurse give pain med to the surgical patient. If no one was available to help, the patients would have to wait. Ice water definitely needs to wait unless any employee is available and willing to assist (at least this task doesn't require a license and can be potentially delegated to more people.)
Hopefully another nurse would check on the IV beeping down the hall or I could ask someone if they could check explaining I have someone with chest pain. After intervention for chest pain, I may find that no one was able to help the third patient to the bathroom and they wet themselves and are upset. Also, the patient requesting ice water is also angry that they've had to wait 30 minutes or more for the water as they are very thirsty. Since I can't share details with them about the other patients, I apologize and explain I had a life-threatening situation in another room that delayed me. Sometimes that satisfies them, and sometimes it doesn't. "I'm important too!" some say, and I agree with them. Like I said, everything is a priority, and we have to prioritize the priorities and do our best. It can often feel like a 2-3 person job for one person.
Healthcare workers are very aware that while we are delayed in a room, we are not readily available for our other patients. If needed, we hope a staff member will let us know they called or find someone else to help them until we're available. Honestly, if the other nurses and bedside workers are just as busy, the patients will have delayed care which is a safety issue and customer service issue.
Various nursing groups are taking action for better staffing ratios and safety issues. I am fortunate to be part of a strong nursing union in California (California Nurses Association) that is very active in taking a stand for safer healthcare. Surprisingly there is resistance to this from hospital systems and is a chronic issue in healthcare. We have hope for change by taking a stand. Will you join us? Leave comments below sharing your experiences of patient safety, staffing issues, and more.
For more reading, I highly recommend this article (I've felt most of these!): 10 Reasons Why Nurses Want To Leave Hospitals
Next Blog: 5 Things I Love Most About Being A Nurse
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