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Question
How should nurses (and supervisors) respond when patients say, "I don't want this nurse taking care of me"?
 | Response from Carolyn Buppert, MSN, JD
Healthcare attorney |
This question, about not wanting a particular nurse assigned, leads to an intriguing idea if we were to flip the question to "I want this nurse to take care of me/my child." Given that the trend in healthcare is toward a "medical home" and designated primary care provider, the nursing application of medical home would be an option for an individual or family to have a "family nurse" who would follow the family or patient over time and provide community-based, hospital, and/or nursing home care as needed. The patient could select the family nurse just as patients select their family doctor -- from profiles on the company Website, through interviews, or through word of mouth.
Such an option would require some system changes, in that the company or subsidiary that offered the nurses would need to have those nurses credentialed by the facilities. And "family nurses" may need to be proficient in various specialties within nursing, which might be daunting for the nurses. One major benefit would be that individuals or families who had a "family nurse" would avoid the uncomfortable and frightening experience of being in a strange environment (the hospital, nursing home, or rehabilitation facility) with strangers providing care. The family nurse would serve as the patient's ombudsman or patient advocate, and, because the nurse isn't employed by the hospital, might be in a better position to negotiate with management than a hospital-employed nurse.
Now I'll answer the question you posed. Hospitalized patients very quickly develop preferences among their caregivers. Patients don't have a legal right to select their nurse. However, they do have a right under a "Patient's Bill of Rights," often posted by a facility or health plan, to safe care; to be treated without consideration of race, gender, sexual orientation, and religion; and to have their complaints addressed promptly.
If a patient complains that any of those rights -- safe care and freedom from discrimination -- are an issue, the manager definitely should replace the assigned nurse. If none of those issues are at stake and the patient just doesn't like or doesn't want a specific individual providing care, then the matter is one of public relations, marketing, and risk management and is not a legal issue.
It is important to a hospital's financial bottom line to keep patients satisfied. Dissatisfied patients are more likely to sue, and bad word-of-mouth is negative marketing. Managers can reduce the risk for patient dissatisfaction by switching assignments if a patient requests that he not be assigned to a specific nurse. Sometimes managers won't be able to make the accommodation because a replacement nurse isn't available. In that case, mediation between the nurse and the patient, conducted by a manager, might smooth the situation.
FAQs
Patients don't have a legal right to select their nurse. However, they do have a right under a "Patient's Bill of Rights," often posted by a facility or health plan, to safe care; to be treated without consideration of race, gender, sexual orientation, and religion; and to have their complaints addressed promptly.
Can patients choose their nurse? ›
Yes, patients can request specific nurses during their stay at the hospital. However, it is important to note that while hospitals strive to accommodate patient preferences whenever possible, it may not always be feasible due to various factors such as nurse availability or workload distribution.
Why should nurses be involved in decision-making? ›
Optimal outcomes and greater job satisfaction are more likely when nurses actively influence decisions that impact the quality of patient care.
Why is it important to include patients in decision-making? ›
By recognising patients as experts in their own health and by providing support to develop understanding and confidence, self-management leads to improved health outcomes, improved patient experience, reductions in unplanned hospital admissions and improved adherence to treatment and medication 6.
Why is patient preference important? ›
The role of patient preferences in healthcare outcomes
Involving patients in their healthcare decision-making contributes to positive results. When providers suggest medical care that matches patients' desires, they're more willing to initiate and engage in the treatment.
Can you choose what nurse you want to be? ›
One of the great things about the nursing profession is that you can enter many specialties without additional formal education beyond what was required to become an RN. In fact, changing specialties can simply be a matter of being trained and precepted on a unit within the specialty.
Can a patient refuse a specific nurse? ›
Yes you can, you don't really need a particular reason but it helps us understand why, for example a lot of our elderly patient prefer to have same sex nurses deliver their personal care. How do nurses refuse and say no?
What is an example of nurse decision-making? ›
An example is patient triage: when a nurse must decide which of several needy patients requires immediate attention. That decision may depend on where the nurse can do the most good, or where the need is greatest, depending on the nurse's determination of the most just course of action.
Why do nurses choose nursing? ›
If you love working with people, and you want a rewarding career where you can impact the health and well-being of your patients and your community, nursing could be a great fit for you.
What is effective decision-making nursing? ›
Clinical decision making is a balance of experience, awareness, knowledge and information gathering, using appropriate assessment tools, your colleagues and evidence-based practice to guide you. Good decisions = safe care.
A patient has the right to make informed decisions regarding his or her care and has the right to include family members in those decisions. A patient has the right to information from his or her doctor in order to make informed decisions about his or her care.
Can patients make their own decision? ›
Decision-Making Capacity and Competence
Generally, patients are free to exercise their autonomy in making decisions about their own health care.
Who makes decisions for patients? ›
If a person lacks the capacity to make decisions, the physician and health care team will usually turn to the most appropriate decision-maker from close family or friends of the person.
What is patient preferences in nursing? ›
Patient preferences mean the choices of individuals to make decisions about health and medical treatment by using their own experiences, beliefs, and values.
What is patient preference and values? ›
Patient values and preferences are the unique understandings, preferences, concerns, expectations and life circ*mstances of each patient. 6. Values are defined as a patient's attitudes and perceptions about certain healthcare options, and preferences are their preferred choices after accounting for their values. 7.
What is respect for patients preferences? ›
Respect for patients' values, preferences and expressed needs. Involve patients in decision-making, recognizing they are individuals with their own unique values and preferences. Treat patients with dignity, respect and sensitivity to his/her cultural values and autonomy.
Can a male patient refuse a female nurse? ›
But it is also a patient's right to ask or prefer to receive care from a gender specific nurse. Absolutely, they should be able to unless there are not any male nurses working on the shift that particular day. This may be something that management may need to be aware of if the patient is long term.
Can patients decide their own care? ›
Generally, patients are free to exercise their autonomy in making decisions about their own health care.
Does patient have the right to choose providers? ›
A patient has the right to have a role in accepting or refusing referrals to certain specialists and home treatment plans. This is in the patient's best interest (beneficence) because it empowers the patient to make decisions over his or her own treatment (autonomy).
Who assigns nurses to patients? ›
Patient assignments are typically made by the charge nurse (or nurse supervisor) from the previous shift.
