017 患者可以自己选护士吗？ - 医护前沿 - 奥医教育-奥医资讯-厦门奥医教育咨询有限公司

有时，患者对为其服务的护士不满意，因此要求更换护士，“让XX护士来护理……”。那么，患者有这个权利吗？护士又该如何答复这位患者呢？

Should Patients Be Able to Choose Their Nurses?
Carolyn Buppert, MSN, JD

Question

How should nurses (and supervisors) respond when patients say, "I don't want this nurse taking care of me"?

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.

原文链接：http://www.medscape.com/viewarticle/825720

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