Do you ever put your foot down with difficult patients?

  1. I rarely do, but once I had one of our frequent flyers who is in his 20s and a pathetic alcoholic who comes in with abdominal pain and wants narcotics. He has had pancreatitis several times, but often his amylase is WNL and he still presents with this manipulative clock watching neediness.

    So one night he got the unassigned doctor who has the most old-fashioned views about pain control. For the needy types he always orders it IM and definately doesn't buy into the current thinking on the subject. My patient was whining and wheedling. The doctor wouldn't up his pain med.

    Finally, I put my foot down and chewed him out. I told him he should be ashamed of himself for drinking again, that he was self-centered and thoughtless for the well-being of his two young children. I told him that the doctor was not going to give him more pain medicine so he might as well stop ringing his bell because I was busy with other patients who hadn't gone on a drinking binge to land themselves in the hospital.

    Didn't hear a peep from him all night, and he's always on his best behavior when he sees me.
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  2. 25 Comments

  3. by   jojotoo
    Sounds right on the money to me. Perhaps if we had more "truth sayers" in our ranks we would have fewer of these "voluntary" medical problems.
  4. by   EmmaG
    I initially mis-read your thread title.

    I thought it said "Do you ever put your foot down ON difficult patients?"
  5. by   jojotoo
    Quote from Emmanuel Goldstein
    I initially mis-read your thread title.

    I thought it said "Do you ever put your foot down ON difficult patients?"


  6. by   UM Review RN
    Yes, sometimes I feel that we pussyfoot around a little too much with some of these patients. I had a wheezing COPDer come in with a great deal of respiratory distress who said, "I'll quit smoking next year," and --I swear it just burst out -- I said, "Oh honey, you won't have a next year if you don't quit smoking."
  7. by   bethin
    A few times.

    I think, at least where I work, that a nurse or aide isn't supposed to tell it how it is. We're just supposed to be nice all the time even when pt's and family members are rude to us. We are expected to be angels.

    I remember one pt, mid 20's, admitted after a bar fight, observation who was still quite drunk when he made it to our floor. He needed help making it to the br. I helped steady him and he whipped it out and peed on my leg. I was furious! And he had the nerve to giggle like a schoolgirl about it. I told him to put the damn thing back in his pants and I wasn't some tree he could pee on.

    I'd like to see someone off the street try to smile through that.
  8. by   FireStarterRN
    Quote from Angie O'Plasty, RN
    Yes, sometimes I feel that we pussyfoot around a little too much with some of these patients. I had a wheezing COPDer come in with a great deal of respiratory distress who said, "I'll quit smoking next year," and --I swear it just burst out -- I said, "Oh honey, you won't have a next year if you don't quit smoking."
    Pussyfoot around is a good way of putting it. All that nicey, nicey stuff gets old, it's nice to call a spade a spade and tell it like it is, people need to hear the unsugar-coated truth now and then.
  9. by   FireStarterRN
    Quote from bethin
    A few times.

    I think, at least where I work, that a nurse or aide isn't supposed to tell it how it is. We're just supposed to be nice all the time even when pt's and family members are rude to us. We are expected to be angels.

    I remember one pt, mid 20's, admitted after a bar fight, observation who was still quite drunk when he made it to our floor. He needed help making it to the br. I helped steady him and he whipped it out and peed on my leg. I was furious! And he had the nerve to giggle like a schoolgirl about it. I told him to put the damn thing back in his pants and I wasn't some tree he could pee on.

    I'd like to see someone off the street try to smile through that.
    What a gross jerk.
  10. by   Diary/Dairy
    Wow, bethin, I never met anyone who had that done to them....on purpose!! How gross.... BLECH!!!!!!!!!!!!!!!!!!!!!!!!!!!1
  11. by   Altra
    Daily.
  12. by   TazziRN
    Quote from angie o'plasty, rn
    yes, sometimes i feel that we pussyfoot around a little too much with some of these patients. i had a wheezing copder come in with a great deal of respiratory distress who said, "i'll quit smoking next year," and --i swear it just burst out -- i said, "oh honey, you won't have a next year if you don't quit smoking."
    oh my.......very good!!

    the only part about the op i disagree with is the "you should be ashamed of yourself."
  13. by   CyndieRN2007
    Im with MLOS. On a daily basis...it feels good to tell them too. Someone has got to snap those types of people into reality.

    I have many asthmatics/copders that STILL SMOKE! Diabetics that walk into my office eating snickers, the list goes on. Arrrgghghgh!
  14. by   rita359
    Quote from Angie O'Plasty, RN
    Yes, sometimes I feel that we pussyfoot around a little too much with some of these patients. I had a wheezing COPDer come in with a great deal of respiratory distress who said, "I'll quit smoking next year," and --I swear it just burst out -- I said, "Oh honey, you won't have a next year if you don't quit smoking."
    It just came out, I know. Way to go girl! I know more of us would like to say these things but hold our tongue.

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