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Accommodating Patients - International Nurses Association

How far do you go as a nurse to accommodate you patients?  Do you go far enough?  How much is too far? The number one reason that there is often difficulty in this particular area is that not all nurses interact the same way with patients.

Scenario
Mr X is a patient that has been admitted for some time. He is unable to do some things for himself, and will occasionally ask for assistance. He spoke with his nurse regarding his toenails, and said that they needed to be clipped. The nurse did as he requested, and clipped his nails. Several days later he mentioned wanting to shave, however his hand was unsteady.  Again, his nurse assisted him. A couple weeks later Mr X had a different nurse, and requested that she cut his toenails and help him shave. This nurse knew all hospital rules and regulations, and she knew that nurses were not to cut nails or assist with shaving. There was in fact specialty staff to do this. When she advised the patient of this, he was very upset, saying, the other nurse did it. Essentially, the first nurse set the second nurse up to have a problem. The first nurse was being accommodating to the patient, however in the end it was not a good thing. We all bend the rules at times, however when you bend the rules, you are setting standards for the next nurse working with the patient. That nurse could potentially be under observation by a supervisor, and they are now either going to bend/break rules, or have an upset patient. What seemed like a small accommodation could have very bad results in the long run.
When a patient has a nurse that does x,y, and z for them, and the next nurse won't, well, you can see that is a problem. Some people have a nurturing personality; however that needs to be put into perspective on the job. The solution is, all nurses should be on the same page for pretty much everything.

Related: History of Nursing in the United States

Setting Guidelines
Saying to a patient, can I get you anything? may lead to a polite no thank you, or it could lead to a long list of accommodations. You may need to come up with a professional and polite speech that essentially reminds the patient, it's a hospital and not a spa resort. You want to provide the patient with everything medically necessary for their care and comfort. It's also great to provide a few little extras, within reason. An extra blanket or pillow is within reason, but stay away from requests that are beyond what you or any other nurses would normally do. Keep in mind if you do it, the next nurse will also be expected to do do it. Make a suggestion to the patient that a family member or friend will need to help them with requests that are not related to their medical condition. Boundaries are very important for nurses, and doing too much for a patient crosses those boundaries and sets up the next nurse working with the patient.

Medical facilities are now very focused on patient care and satisfaction. They want patients to be comfortable and have a good experience. They often do surveys to determine what areas may need improvement. Since the implementing of the patient satisfaction programs, some medical centers have offered specialty programs to assist patients. There are staff that can wash hair for bed-ridden patients, trim nails and provide a mini manicure/pedicure, offer massages, and apply lotions for dry skin. In addition to personal needs staff, there are social workers to help with financial needs and future placement needs. There are actually a number of accommodations afforded to hospitalized patients, in fact more in the United States than in any other country. It's always nice to do a little something for your patient, provided it's not more than what the nurse on the next shift would do. A few pleasantries, some fresh ice, a soda, a warm blanket is all great, just watch the boundaries, and think of your coworkers that may not have time to provide what you do. Remember, it is a hospital with excellent care and nurses, but it's not a resort.

Related:  International Nurses Association
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