[quezen]

I love it QueenJean, comments like that give people like me the will to go on!
You know the old VA nurses used to tell me that they used to call on patient PA,"everyone (who could walk) with nine O'clock meds report to the desk and line up". I bet people got well and went home under those 'house rules' also.

[BlueRidgeHomeRN]

Originally Posted by quezen

I love it QueenJean, comments like that give people like me the will to go on!
You know the old VA nurses used to tell me that they used to call on patient PA,"everyone (who could walk) with nine O'clock meds report to the desk and line up". I bet people got well and went home under those 'house rules' also.

Because back then they were "patients" who were in a hospital because they were sick and needed to get better..

Now they are "customers" who do not see the difference between their "need" for a low-fat decaf mochachino and their roomate's "need" for pressors and suctioning!!

[Altra]

Originally Posted by queenjean

That's when it's nice to have vent threads, so I can say something like: did you SERIOUSLY just walk up to the desk to inform me that you are suing me for abuse because I won't let you eat because you are NPO with a diagnosis of dehydration secondary to pancreatitis? Well, you just go right ahead with your little lawsuit AND your noncompliance--eat that cheeseburger and fries your girlfriend just brought you. But guess what, your pain meds and antiemetic are only ordered every 4 hours, and the doc left a specific order that we were NOT to call him for any additional orders if you experienced nausea and pain due to your noncompliance. See, the last few (oh, maybe 10) times you were here you pulled his, and DrY is sick of it; so are we. Maybe you'll just FINALLY leave AMA and drive your puking self to another hospital. Please, be my guest. When your name was called up for admission, we drew straws; and when I lost, I cussed like a sailor at the unluck of it all and then pulled the AMA paperwork to have ready for you, all before you even got to the floor.

That was great - thanks!

[neonatal3]

queenjean "you rock" with your real world comments about some patients who insist on being noncompliant! I had a patient who was NPO after abdominal intestine surgery and who was "reading me the riot act" about his "right" to have food right away! No amount of kind patient education about the dangers of eating too soon after this surgery would convince this patient that the purpose for the NPO order was about safety for his condition. This patient said to me "if you do not give me food right now, I am checking out of this hospital this morning!"

I called this patient's surgeon to inform him of the situation. This great realist doc came right over to the hospital, went with me to the patient's room, kindly explained again the potential risk if the patient ate, and then bluntly said something like: "you can follow my order not to eat to protect your health, or I can discharge you right now". Then this know it all patient actually shouted at this doc and me and said something like "ok, send me home now because I am going to eat no matter what!"--patient was discharged and ended right back in the hospital emergency room and to our floor the next day with major abdominal complications! Go figure?

[KyPinkRN]

Originally Posted by BlueRidgeHomeRN

Because back then they were "patients" who were in a hospital because they were sick and needed to get better..

Now they are "customers" who do not see the difference between their "need" for a low-fat decaf mochachino and their roomate's "need" for pressors and suctioning!!

Bravo! you hit the nail right on the head! Now, what are we going to do about it? Who knows?

[wooh]

Originally Posted by queenjean

Of course, I make sure they know where it is. Sometimes I think family and pts need to know that they *can* do those things--I've had family call to ask for the nurse to give mom a sip of water--but I think honestly they think that they might get in trouble, because they aren't sure if mom is supposed to be having water, or maybe we are measuring it and they don't understand that we do that at the end of the shift, etc.

Last week I had a family member call me to raise the head of the bed, but she honestly didn't know if she was allowed to do that.

I find the "I'm going to let you do that." typically works.

I do something similar. "Oh, let me show you how to do that," in a friendly non-confrontational way. If they simply don't know, they know now. If they're being manipulative and/or demanding, then they get the point that I'm not going to do it for them. A lot of times people want to do for themselves, they just don't know they can. I show them the family room, where they can get ice water, "So you don't have to wait on us, I know that can be annoying!"
I think working in peds has helped me a lot, I've grown more forgiving of demanding family members, more understanding of the stress they're under. But I'm still not going to be walked on. I think the big difference for me is I've learned over the last couple years how to demand respect without having to "demand" it. If I assume they're just stressed (even if I suspect they're just rude and manipulative), and treat them with understanding but not being walked over, then I make the truly stressed happy, but the manipulative ones, well, they can quit being so manipulative without having to feel like they've been "shown up," which isn't going to make the behavior stop, just usually get worse. Everybody wins.

[wooh]

Originally Posted by elthia

The most annoying things to me is the 50-60 year old man who has perfect control over his arms and hands. He can cut up his own food, eat and drink from a cup no problem. But his wants his female nurse to hold his urinal for him while he pees. That just reeks of some disgusting misogynist sexual fantasy and I will always refuse to play along.

If you are old and weak and have Parkinson's tremor, I will discreetly help you with your bodily functions that's different. But I refuse to assist any perverted fantasies creepos. It still amazes me how many there are that try to insist on this.

It's amazing how quick the calls to help with the urinal end when you start sending in one of the male nurses or techs EVERY time they call for help.

[jmgrn65]

Originally Posted by lamazeteacher

It is a "given" that sick people, while not exonerated of their extremely negative behavior, are nevertheless expressing their individual reality. The nurses contributing to this "vent" thread, hopefully vent here instead of acting out their negative feelings toward patients. It is useful to discharge feelings in this manner. However, I am unsure of what constitutes a "vent" thread, rather than one contributing to other nurses' information.

It would be good when feeling angry about the patients we care for, to "journal" them. Then, a few days later, when the anger has diminished, read what we've written and see if those feelings have changed. If they have not, then venting them has not been useful, in that it hasn't changed the negativity expressed, for that person. There are many ways to deal with anger. Reading the "Dance of Anger" may be helpful.

I was horrified to hear from my brother-in-law, George about the treatment received one evening by the young man sharing his semi-private room, whose call button wasn't answered for over an hour, other than someone yelling through the intercom to say it wasn't time fror his pain medication. George telephoned the hospital and asked for the nursing supervisor. Another hour passed, without any nursing intervention for the roomate. Finally the unit nurse showed up with the pain medication, as the newly post-op patient in need of it was writhing and crying; and said that it hadn't been given sooner, as the young man hadn't said "please" and "thank you" when it was given before!

George again called the hospital requesting that administration call him (he is known in our family for his strong reaction to wrongdoings. A half hour later, the physician who operated on George to replace his knee, came into the room with a great flourish, followed by the unit nurse and the supervisor. He told George in no uncertain terms, that he would not tolerate any disturbance to "his" nurses. Then his roomate, finally relieved of his pain was taken to another room and George never saw him again.

The family discussed with their daughter-in-law, a pain management physician, what should be done. She said "nothing", as any more attention to the nurses' behavior would result in more patients suffering. When I heard about this, I practically leapt over the 3000 miles distance to the site of such a travesty, vowing to have that doctor's license revoked, the nurses disciplined, etc. Then I realized that I had no right to act upon a situation in which I personally was not involved. That was a hard lesson, and it seems that I still have more to learn about butting out of scenes in which I have no part. Sorry, colleagues.

I just wonder do you still work the bedside?
And do you think it is possible george didn't know the whole story.
you can't just get on the phone and demand the hospital administrator, they are not going to come on the floor and talk to a patient thats what patient relations is for.
Yes sometimes doctors and nurses act like that, but we are all human, well maybe not all.

[facetiousgoddess]

Originally Posted by Recuerdo

This thread is making me so, so sad.

The person who was a nurse during the '50's....conditions were bad then and nobody complained. No one would dare.

The nurses of the 21st century....conditions are bad and now, much of the time, still nobody complains. Why not? Corporate management intimidation. Now, hospitals are a competitive business and the customer is always right. Different reasons...same result.

Nursing is the way it is because we have allowed it to be that way. IMO, that is nothing to self-righteously chirp about so proudly. I think it stinks for both the nursing profession, and the patients.

I have done this job since 1974 and I am still doing it.

By behaving like idiots, we have created the nursing shortage. Maybe if we lived in a society where personal responsibility was valued more than it is, people would take better care of themselves, care more about others, recognize real and necessary boundaries, and not treat those who try to help them like garbage.

Under no circumstances should a nurse ever take physical or verbal abuse from anyone. All working people are, by law, entitled to the proper breaks, and to reasonably clean and ergonomic working conditions. I don't care if they're nurses or not...it is both romantic and naive to believe and hold on to the old idea of sacrificing your life and your health because you think you are giving "service".

In a moral society, which we do not have, each person is responsible for his own life and health. Doctors and nurses can help, but they are not ultimately responsible. WE ALONE as individuals determine the outcome of our treatment. Health care professionals are just there to help.

There is nothing more destructive than that "Look how tough I am and how much I have done" attitude. It has been like a cancer in both the nursing and the medical profession for far too long. It's insane and violent in a subtly and sneaky and manipulative way. It still exists, even in corporate medicine. It is useless, egoic, immature behavior and it needs to stop.

I will celebrate its death, which I hope comes soon.

I just have this urge to jump up and down screaming "RIGHT ON!!!!" or in this case....write on....


I agree with you whole heartedly and wanted to say "Thank You."

Tres
Who is taking the summer off, so I don't go the martyr route.

[lamazeteacher]

JMGRN65:

No, I haven't worked on a med-surg unit in ages, as I'm an OB Nurse. We have a healthy respect for pain, especially when it's accompanied by "Aaaaarughhh", as that's the call of the pushing laboring woman.

I've never wanted a patient to say "please" or "thank you" when receiving medication - analgesic or otherwise. However in Canada a lot of Jamaican trained Nurses work, using ancient British practises to which they were subjected. Come to think of it, my exposure there to the Brtitish ways, have me saying it when I've been as patient asking for same. I was very pleased to have the PCA button last time, so I could give myself the analgesic after surgery.

George is not a person who would think twice about going to the top of any organization, as he was a vice president of a Canadian style Fortune 500 company (think Trump). The only rooms available in Canadian Rehab hospitals are 2 bedded, and he had to put up with a roommate in pain, and thought he had to do something about that.
However, his physician (and the staff, I'm sure) viewed his arrogance
negatively and thought they had him on their terms (vis a vis the splenda thing). He still has my sister buttering his toast for him. Once he asked me to do that, and I said, "I'm not my sister!"

It's not their routine to have motorized stretching equipment go home with patients, as that wastes money, so they keep them in facilities for 2 weeks after joint replacement surgery, sharing the equipment, and no HH PT visits are needed afterward. Let me tell you those facilities aren't pretty, as money isn't spent on decor, color coordinated lobbies and corridors....,..,. Essentials and necessary equipment, yes, extras, no.