How do you politely walk away or say no?

2 I'm a new nurse and have found it hard to turn down or say no to some patient requests even when I'm too busy, frustrated, or creeped out to do it. A few examples:
--It was close to Christmas time, and one of my patient's family members was trying to decorate the patient's room and wanted me to help her. That would be fun and all if I didn't have any other patients or a million other priorities, but I didn't really know how to say that nicely. When I tried to help her, she sat back and started commanding me how to decorate. "Untangle those lights...wow, you went to school for how many years and you are having trouble untangling that string of lights? () Hang those decorations on the tree but make sure they are spaced out well...No, no, that's no good, do it like this/like that." I felt like just walking out of the room and getting to my truly important tasks. Of course, I didn't...
--Another example: There was a patient (not my patient) who needed help to the bathroom. I was alone at the nurse's station, so I ran over and helped him out of bed, to the bathroom, and back to bed. That's fine, except when I was leaving, he asked me to massage his neck. I needed to get back to the nurses' station to watch the phones and call lights, but I thought "What the heck, 10 seconds won't hurt". But when I tried to stop and leave the room, he told me not to stop and to keep massaging his neck and to also start massaging his head. I was a little creeped out, but I didn't really want to say that, so I did it for several minutes. Later that night, I went to the room for some reason, and he asked for another massage. He already had me in the room, so I felt bad just leaving, so there I was giving him another long neck and head massage. He wouldn't ask anyone else for massages, just me. I was really creeped out by then and tried to avoid walking by that room.
--My patient wanted me to hand her her purse so she could get something out of it. I gave it to her and asked if there was anything else I could do for her before leaving. She wanted me to stay in the room and wait while she looked through her purse. So I stood there while she went through everything till she finally found what she wanted. I didn't see the point of this since it's not like she wanted me to put her purse away when she was done. She just wanted me to stand there. She did this several times throughout the night. I grew more and more frustrated and eventually asked if there was something she needed help finding. Nope...no reason for me to stand there as she looked through her purse. But didn't really know how to say "Yeeeah I've got stuff to do. Bye."

All of these were young, capable people.
Yeah yeah, I need a backbone. So, how do y'all handle similar situations at work?
After making sure their needs are taken care of, if someone makes an over-the top request how about saying, "I'm sorry, I need to check on my other patients now. I'll be back to see how you're doing at such-and-such time. Use the call bell if you need anything before then."

You are going to need to learn to set boundaries...a tough thing to do as a new nurse. I've no qualms telling patients that while they are important to me, I also have two other patients who also need me to do things for them and since we do not have a CNA in our unit, it's just me and another nurse for up to 6 patients. So if another one of my pt's is trying to die on me...a neck rub is NOT at the top of my priority list at that exact moment in time. To the lady who asked help in setting up Christmas decorations(first of all, did they get clearance from maintenance to string those lights??), you tell her although you'd love to help, time doesn't permit you to do so as you have x additional pt's to care for.To the patient who needed to go to the BR and then wanted a neck massage, Id have said, I'm sorry but I must get back to the desk to watch the monitors but I'll tell your nurse when she returns from dinner break.To the patient who wanted you to stand there and watch her look through her purse, I'd hand it to her, ask if there is anything else they need right now and unless it's something dire like needing a pain pill or going to the BR, you tell them you need to go check on your other patients.Good luck to you in your career.

Unfortunately, this just comes with time. (sounds kinda funny coming from a 20 y/o, huh? lol)It took me about a year to be able to turn down unimportant requests from pts/family members. You'll get there. In my experience, using the "I need to check on my other pts…" line works pretty well. Unless the pt/family member is a complete self-centered jerk, they won't argue with the fact that you have to take care of someone else….

It is tough to say no, isn't it?Patients by and large want to feel like they are the only patient you have. When I first started out, I had a very high maintenance medical student who acted like a princess (partly because her parents treated her like one). I mention the fact that she was a medical student because SHE KNEW how busy our unit was, but still acted as if the nurses had nothing better to do than brush her hair, massage her feet and rub a cool cloth on her face and neck "to help her calm down". I finally had it with the requests and set boundaries with her. I told her that although I would love to be able to have the time to do all of these things for her, there were so many tasks that I had to accomplish-"you know the routine," I said. "Administration loves to generate more paperwork for us! Perhaps you can call a friend or have your Mom come and visit for a while with you to help you control your anxiety." She left me alone after that. Don't feel like a jackwagon for setting boundaries. You are not going to be accused of being an awful person if you tell someone no. You are protecting your own sanity! What is the worst thing that would happen if you said no? The world will not end, but your shift will and you want to make sure you aren't behind the 8 ball when you have to finish the plethora of work before you leave.

You have to learn to say I will check back on you later.I had a stressful day today and I had one family member who kept wanting to pull me back into the patients room, I had already been in the room 3 times, and I had 18 patients. I finally told him that while your family member is important to me and I will be in the room again at X time tonight, I currently have patients that I have not seen yet today (this was 3 hours into my shift) It is not fair to the rest of my patients when 2-3 will try to take all of my time and keep calling me in the room.

I always say, "Please excuse me. I have to check on other patients."But at first it wasn't easy. Once I walked to the ER parking lot on the other side of the hospital to take this patients' purse out of her car. -_- It wasn't until I got fed up with it then I would say, Sorry I can't help you with that right now. You will get there. Slowly but surely.

You have to get your job/tasks done, because honestly, the patient can't do it for you. Simple things like that, I simply do what I can. The decoration request? Seriously? I would have sincerly replied "A) I'll be happy to help you if I have time. I have to check in on all the patients still and I'll see if I can find 5 or 10 minutes to help later." Also, I would have said that I must have been absent the day they went over light untangling. I wonder if that was between my cardiac and IV therapy lectures?B. The massage guy? May have been doing something there. If he's claiming stiffness/pain, 5 minutes is usually enough. Flat out refuse when a patient asks you to do something you are not comfortable with. If he's still having pain, offer or get orders for a pain med.C. Purse lady? here's your purse, call me if you need anything before I come back. You don't need to stand there.You'll find your boundries. But start now before you get so worn out with the petty C$$P some families comeup with that you think you hate nursing when it's really just the people.

Just give a quick "Sorry but I have to get a patient off the bedpan". Works every time. Try to avoid what I recently did when a patient asked for a massage. I couldn't help it ,I burst out laughing.

It was hard at first for me too. I still have trouble sometimes. But just remember that you have other patients and that your time is best spent doing patient care- that's what you're there for. The extra stuff is just....extra.

Thank you so much for posting this! I'm doing my CNA clinicals after next week, and hoping to work as a PCT in July, and I have a huge problem with being too nice for my own good! When I worked in a pharmacy, we would have customers that would hold up the whole line (and only line) telling me their whole life stories, showing me the blisters on their feet, crying about what their daughter said, on and on and on. They didn't bother anyone else. It got to the point where the managers had to work out a code word to call me to the office to let me escape. (And sometimes they followed me). Also, I can't get patients to stop talking when I'm doing blood pressures and pulses!! In school they teach you to talk, look at pictures, and do puzzles with patients, but in the real world they give you 18 patients and leave you no time for this kind of stuff. I feel your pain!

Quote from pixiedrink348--It was close to Christmas time, and one of my patient's family members was trying to decorate the patient's room and wanted me to help her. That would be fun and all if I didn't have any other patients or a million other priorities, but I didn't really know how to say that nicely. When I tried to help her, she sat back and started commanding me how to decorate. "Untangle those lights...wow, you went to school for how many years and you are having trouble untangling that string of lights? () Hang those decorations on the tree but make sure they are spaced out well...No, no, that's no good, do it like this/like that."

It's all about following policy, setting limits, and being firm but polite when people become a little overly demanding. I would have told the lights lady that maintenance would have to come in and approve those decorations (which in most hospitals, is usually the policy). And if she was making snide comments while I was helping I would have said, "well you seem to have a better idea of what you want, so I think it would be better if you placed them" and left the room saying "I'll check back in later." As for the massage guy...I would have said I am not licensed to give massages and if I hurt him or made him worse (which can happen if you massage incorrectly) I could be liable. Then I would offer pain medication, heating pad, or to reposition him. As for the purse, I would have been upfront and just explained that I had other patients to round on and would check back in. It's hard to say no at first...when I first started I thought if I said no it would make me a bad nurse or I would somehow get written up. It's important to set limits though because some patients do think you are there to SERVE them. I have actually had a patient's daughter tell on me because I would not stay in the room and give a foot massage to their mom, I put venous flow foot pumps on her instead. The daughter complained because 15 minutes later she came out to the nurse's station and saw me "playing on the computer", when in reality I was trying to chart. My supervisor came to my rescue and told her that with 9 patients she was surprised I managed to put the foot pumps on her so fast. And then she asked the daughter why she could not do a foot massage for HER mother if she was going to stay the night...that shut her up!