the patient who drives you CRAZY!

Nursing Students CNA/MA

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okay, first of all - i'm a CNA who is also a nursing student and i really like my job. i actually do this job because i WANT to. i have a degree in another field and i could make more money, but i really WANT to be a nurse so i chose to be a CNA to get some experience. for the most part, i LOVE my patients! i go out of my way to do things for them. i pretty much have to hide on my 30 minute (unpaid) break just to get a break bc if i don't hide i'll end up answering call lights because nobody else will!

but last week i had a patient who absolutely drove me NUTS! when i had to go in this lady's room or saw her call light, i dreaded it! usually i ask, "is there anything else you need?" and i really mean it, but i didn't ask this woman because she'd say umm...can you pick up that gown and put it in the linen? can you plug up my cell phone? could you straighten up that counter? can i have a snack? (okay - i go to the galley, get a snack, bring it back) could i have a drink? (okay, i go to the galley, get a drink, bring it back) could i get a straw? could i get some more peanut butter? could i get some ice? let's forget this patient is in isolation so i have to dress out/undress each time. this patient could turn herSELF - she was able to walk (with someone there "just incase") but would hit her call light to have someone come and turn her!

bottom line - she drove me nuts. i usually have patients thanking me and even telling me they're going to write notes to my manager about how great i am, but it just took everything i had to tolerate this woman. have you ever had a patient like that? how do you deal with it? i know i screwed up royally with her. i wasn't "mean" but i definitely didn't have my poker face on and i'm sure she could tell.

Been there, done that. I always try to take a balanced approach to my patients. Don't offer too much or too little. Only because sometimes those you think will flatter you with kindness only later to take advantage of you will probably be those you least expect. I for one am not afraid to speak my mind. Sometimes you just have to tell a patient that they will have to be patient, and perhaps even ask for all their needs at once. Hard thing to do sometimes, but we all have those difficult patients that stick in our craw. Part of the profession. Best of luck with the resolution!

I don't think you "screwed up royally" at all with her.

You are not going to like every patient you ever take care of. I know I don't.

If someone is a problem patient like that, I'm not going to walk in their room with a 20-foot smile plastered on my face. I'm not mean, but I'm not going to be submissive and walked all over and cater to their every need. I don't usually talk more than necessary when I'm in those rooms. If they can see I'm not at my best, I can only hope it will be part of a wake-up call that they are a needy, pain-in-the-butt person.

You need to have a heart-to-heart with these people: don't be afraid to tell them that they are not your only person to take care of and basically they need to stop with the "small stuff" crap. I've even told some people to make a list of things that they want done (I'm not talking about nursing care -- the dumb stuff like organizing clothes in closets) and we will pick 1-2 per hour and that I'm not coming back to do non-nursing relate things until such-and-such time. I'm only one person, and not everything on that list is going to get done and they will just have to live with it. You could spend forever in these people's rooms doing the most asinine, worthless things.

Of course, management gets all upset about this because they want everyone to be 100% satisfied and return like we're some kind of fancy beachside condo that you can stay at for the weekend whenever the heck you feel like it. You can either deal with one negative survey from a needy patient (which is completely subjective anyways) or deal with an entire floor of them when you neglect all of your patients and spend every second of your shift trying to please one person.

Be assertive. Take charge. This may be your first problem patient, but I can guarantee you that it certainly won't be your last!

Specializes in LTC.

I think the word "patent" needs an S at the end of it. lol

The patient I can't stand the most is actually a family member, but I feel like I do a lot more attending to HER needs than I do the actual patient! This family is there 24-7 and for some reason (*cough* private pay) they are allowed to RUN THE FLOOR. Seriously. They hoard all the supplies in their room so none of the other residents can have anything, they monopolize the staff, make requests that waste the staff's time (I think it's on purpose- I swear they actually get jealous of the other residents and this is their way of dealing with it), and they are not happy unless they're in a power struggle with at least one staff member at any given time. They act like we work for them and not the facility. I could go on and on but I won't.

The residents who are obsessed with pooping annoy me too. I get tired of having to take them to the bathroom every half hour all day long and having to hear them whine that they didn't poop yet or it wasn't big enough. It's all they think about, so it's all they talk about. It's such a drain on your time. You try to talk about something else and they bring it right back to poop. If they go they want to inspect the contents of the toilet bowl and if they don't, then dragging them off the toilet is a herculean task. Everyone on my floor is a fall risk so we can't leave anyone on the toilet alone.

Oh yeah. We have a lady who weighs 300 lb, abuses her husband in front of staff, abuses other residents if she gets a chance, and recently used the trapeze bar over her bed to bash in the forehead of one of the aides on night shift. She kicks and punches staff who try to change her when she's soaking wet. Recently her roommate was put on comfort care as she was dying of cancer, and they had to move Ms. Moose out of the room completely because she'd yell obscenities at the hospice resident's family members. We're forced to keep this resident here because the facility we're trying to move her to, one that is specially designed for people like this -- at this time they have no openings. So we endure, and that's about it.

"The residents who are obsessed with pooping annoy me too. I get tired of having to take them to the bathroom every half hour all day long and having to hear them whine that they didn't poop yet or it wasn't big enough. It's all they think about, so it's all they talk about. It's such a drain on your time. You try to talk about something else and they bring it right back to poop. If they go they want to inspect the contents of the toilet bowl and if they don't, then dragging them off the toilet is a herculean task. Everyone on my floor is a fall risk so we can't leave anyone on the toilet alone."

Uh-huh. We recently had a resident who cannot defecate at all unless she attaches an enema hose and bucket to her hind-end, which is her routine every night before bed. I had to take over for one of our younger aides who came out of her bathroom, her face a pasty white because she just was too grossed out to continue assisting the lady. I'm a mother of 4 including a disabled child on whom I've had to perform manual de-impaction many times, so nothing much bothers me in this regard. But yeah, pooping is always a problem for the elderly and disabled, any way you slice it.

Specializes in 6 yrs LTC, 1 yr MedSurg, Wound Care.

I have 2 of these on my hall. I am a nice person, I listen when people talk ALL the time, smile when I'm just passing someone in the hall, do whatever I can to help, etc. I can understand where you're coming from.

I've been a CNA for just over a year now, and I can see that I have become more jaded. I don't mind helping still, but I have started to do what they put their light on for and get out. I do ask the ones that aren't as troublesome if they need anything else while I'm in there, but the ones that will come up with about a thousand things and take up 20 minutes of your time, I'm not as "nice" to. Not rude or anything, I just know that their light will be on again in 5 minutes.

We are not there to be their friend, we are there to take care of them. And not just them, but most likely 10 or more. If you can do for yourself and are in your right frame of mind, then you can spray your own perfume on your hair like you did the rest of your body and put on your own clip-on earrings. Yes, that happened to me this week.

To the lady that talks your ear off for 45 minutes, I would love to be able to sit and talk with like I thought I'd be able to in CNA school, but I have 3 people that have to be turned every 2 hours and I haven't had a chance to in about 3. That makes me feel like a bad aide, but I don't know how to do better than get in and get out.

Off of my rant now. :) My advice to you, try to anticipate what they are going to need ahead of time and work with their "routine". If they are going to ask you to put linen/clothing in the laundry, grab a trash bag or your linen barel (or whatever you have) on the way and do that while they are trying to "remember" what it is they turned their light on for in the first place. Don't get on a personal level and start calling them "Grandma" or whatever, call them Mrs. Whatsyourname instead. Stay professional. You can NOT neglect your other patients. You have to protect them and your certification. If it is becoming a real issue, tell your nurse and have her talk to your troublemaker. Sometimes it helps and sometimes it doesn't, but it's worth a shot.

I have one resident who has been a pain in my ass from day one. The main problem is that she expects everything done a certain way, and expects everyone who takes care of her to do things this certain way. If something isnt done exactly to her liking, she wont tell you directly, but you can be sure she will tell everyone and anyone else, sometimes for days on end. She is continually lobbying to get whatever CNA is on her bad side at the moment fired, and isnt above embellishing the truth, or simply making things up in order to achieve this.

This was of course especially challenging when first starting out as a CNA, before memorizing her exact routine and preferences, as you were apparently expected to be psychic. This particular resident, who is total dependance and extremely difficult to take care of to begin with, even without the extra demands and expectations, has certainly helped drive more than a few new CNAs to quit.

Specializes in 6 yrs LTC, 1 yr MedSurg, Wound Care.
This particular resident, who is total dependance and extremely difficult to take care of to begin with, even without the extra demands and expectations, has certainly helped drive more than a few new CNAs to quit.

With residents like these, we use the buddy system. NO ONE goes into their rooms alone. I don't know if it does any good, but we also have a few blank pages in the ADL book that we chart in throughout the day, stating the time they turned their call light on and what we did for them. Basically, witnesses and documentation. Tell the nurse what is going on so she can chart it also.

Yeah, there is a patient who I dread dealing with. One night she got really snippy with me and I flat out told her that there was no reason for her to talk to me that way. I told her that she is NOT the only patient in the entire place and to not get so upset when her call light is not answered in record time. She apologized to me but was back to her manipulative self 10 minutes later.

She calls for stupid stuff like to get her a bag of ice, pick up the remote on the floor, turn off her light and then turn it back on. There are days when I feel like disconnecting her call light but my orifice would be grass (hey nothing wrong with dreaming, yes?).

Some patients need a reality check. If I have a fall risk patient is getting someone a bag of ice going to take precedence? Insert eye roll here...So yes, there are patient who I do not like and I do not feel bad for feeling that way. No wonder why some families do not like to visit 'em.

Specializes in LTC.

We have one lady that everyone hates. She's totally "with it" but she's mean and plays games, tries to pit the CNAs against one another, keeps you in the room as long as possible, and insults you in any way she can (you're fat, you're a moron, your ass is huge, you're incompetent, and don't you know I pay your check, so you have to wait on me hand and foot, etc). She is physically aggressive sometimes too. She will have you looking for, say, a blanket that doesn't exist. The whole time you're looking for this alleged blanket she insults you. You go through every single one of the 20 blankets on her bed and she shoots them all down. When you finally can't take it anymore and leave she just puts her light on again and starts accusing people of stealing the blanket she made up, telling the next CNA that the last one said this or that, and insulting them too. She is such a waste of time.

Specializes in Public Health.

Haha there is one patient who hasn't understood yet that he has "lost his marbles" and believes that he owns the place and basically freaks the hell out whenever anybody tries to give him care and believe me there are countless more like this because our facility is "high-end" and the residents pay top dollar to live there. Everyone thinks they are the only person in the place and thinks they own you. But its rather funny and me and my colleagues have to find the humor in it or else we would cry ourselves to sleep every night. But truly I love my job and my residents.

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