Hello Mr. VIP! I'm your servant nurse for the night! - page 2
So, yeah... VIP patients. I had one for the last two nights and let me tell you how much I wanted to pull my hair out. Old dude, post exp. lap. w/ lysis of adhesions, stable to the point of taking... Read More
Apr 12, '07We have a VIP policy and a special overhead code for VIP patients. It's absolutely ridiculous.
Apr 12, '07I remember right out of, I worked on this med surg floor. I was already a nervous wreck, and my assignment was this doc. I didn't know who he was, but was totally freaked out by the though of taking care of a Doctor!!!
The charge nurse must have seen my color drain..." Honey, what's the matter with you?" I was embarrassed but admitted I was nervous about taking care of the Doc..." Honey!! Don't you worry about him... this morning he peed in his denture cup!!"
I love that story... We're all the same, and if we're prudent nurses, we treat them all like VIP's. Even if they pee in their denture cup!!
Apr 12, '07HOW!?!?! did I know you were working in New Orleans? I am not even a nurse yet but I work in the ER where we get "VIP" patients all the time. It is annoying and not fair to the patients at all. Are we the only city with VIP's?
Apr 12, '07This is the time I love to pull out all the post op routine procedures. Yes I will pull your blanket up but lets turn first. Lets get up and walk to the bathroom just in case your bowles have to move again. Time to get oob and to the chair again. Here is your incentive spirometer, this time when you get it to 1000 hold it there for 2 minutes...can't hold it that long? Thats why they call it an incentive spirometer. O.K. I'll give you an ice chip if you cough and deep breathe 10 times. You want to go back to bed well let's take two more trips around the unit. Pretty soon you are the last person the patient wants to see.
I know just what to do. I cant believe I did not think of it myself. Its PERFECT!!!
Apr 12, '07Quote from ELKMNin06Also a few from med/surg ICU -
1. can you scratch my head-pt totally intact and able to do himself
2. Can you feed me a sip of water-totally intact 15yo
3.I want to go smoke by the window, if you just open the window ill just have two puffs
4.My SVNs are making my teeth hurt
just a few
5. what is my BP RIGHT NOW?
6. I hear something funny (BP cuff pumping up)
7. I'm in pain but don't want any meds for it
8. Where does your husband work?
And 15 other reasons why this one pt pressed her call light one night last week. If you are well enough to push the call light 20 times a shift and can ask me where my husband works, well you don't belong here :trout:
Apr 12, '07My first week off orientation, I was assigned the hospital CEO for two nights :uhoh21:
Credit to him - he was genuinely nice and he even remembered me from orientation (CEO comes down to talk to each new employee).
Apr 12, '07VIP's drive me insane when I have them in the ICU...Usually they do not need to be there and are usually A&OX3, MAE, etc...
I had a VIP from the hospital last summer who literally treated me like a his personal hired help. Wanted the temperature adjusted up then down, Blinds open then closed, blankets on then off, sips of water, ice cream, sherbert, change the channel, etc...
He became angry with me after I started sending the CNA in when ever his light came on. I received a new CABG directly from the OR and needed to be in the room for a while. Well, Mr. VIP was irritated because I was not coming in. So, now he kept pushing his call bell and asking anyone and everyone that answered "Who is the new Patient?"..."What did she have done?"..."Where is my nurse?"..."Why is my nurse ignoring me?"...
I finally found someone to cover for me for a few minutes and I had a talk with this VIP. I told him in a very nice, professional and somewhat stern way that he was asking questions that we were not allowed to answer due to HIPPA laws, and that because he was stable the CNA was perfectly capable of assisting him with whatever he needed. I also explained to him that he was making several people uncomfortable with his questions regarding another patient. I was so fed up with him that my mouth became possessed and I could not control what came out. I asked him if he was trying to test us by asking questions like that? I valued and respected my patients privacy and would never give information to a stranger. I also assured him that I valued his privacy as well. I asked him to try to understand that I was needed in another room at that time, but I was also there if he needed pain medication, did not feel well, etc...I even went as far as to ask him why he was calling us to change his channel, give him his water, and so on....He looked embarassed. When I was done I felt like I had just reprimanded a little boy.
I expected a lashing the next day, but it never happened. He actually told my boss that I was a really good nurse who really cared about her patients. I took that as "I was a complete Butt-Head to your nurse, and this is my way of apologizing".
Apr 12, '07NurseyPoo and burnout have it down to a science. I'll also chat with them about how since they contributed to/chose this hospital they must support our philosophy of treating everyone with top quality care no matter who they are, and use that as a bit of a lever if they hate my prioritizing skills. I'll also talk up my coworkers, "the CNA is so smart she could easily get through an RN course, but sadly hasn't been able to take the time, we are so lucky to have her... I trust her judgement totally" Try to find out what their pet peeves are, temp, sherbet, etc and take the initiative each time you go to te room, do they want more? temp OK? any other questions or concerns? OK then. Then when the call light rings 3 times in the next 15 minutes we've discussed prioritization, and hospital mission, and ALL his comfort needs, and I need an hour to straighten away patient Y, and then I'll be all yours again for a few minutes....
I really need a heads up on these type of patients in report, so I can start my routine before I actually feel like killing them. Just can't let them know
Apr 12, '07Document, ADLs for each time you clean up diarrhea, ADLs for each time the patient is unable to pick up cup to drink, suggest or order PT/OT for this patient so he can return to normal life. Educate and patient on need to do for self, sit up and deep breath and go get an incentive spirometer so he can use that to enhance his lung capacity. He is awake and breathing at 2am. If patient gets nasty and stated he dosent need to get better or something along those lines, document that too.
Everyone comes from a different lifestyle and some react in a very weird manner to fear. Just talking to this person, as a person not some VIP to find out what those fears are and helping them to resolve the fears can make a world of difference. Being in the hospital is frightening for many even if they have lots of money or are arrogant or psychotic or just plain old mean.
Apr 12, '07I've had many patients in the hospital who demanded VIP treatment whether they were VIP's or not. Sometimes I feel like a waitress more than a nurse.
I'm now trying corrections nursing part time. While the security issues can be nerve wracking the upside is they're inmates so ... no customer service crap, no call lights and you have a lot more control over the situation. It's more like a doctor's office. You see each patient one at a time and, if you don't have time to see them ... they just have come back the next day.
There's more stress with the security issues but, less stress with routine day to day care.
Apr 12, '07I have had VIP patients like that. Also have had VIPs that were really quiet patients. They were loath to ask for something for fear someone would think they were throwing their weight around. I think it has more to do with kind of person they were. I think the the demanding ones would still be demanding even if they were nobodies.
Apr 12, '07VIPs run the spectrum. I have had some "important" patients who were the least demanding folks ever. Others made me scream. I have had societal "losers" who were MUCH more demanding and entitled than any VIP could ever be. Setting limits so important, but IMPOSSIBLE when management/administration and their doctors refuse to back you up. NO WIN.
Apr 12, '07i second (or third) the advice given about "yes, you can have an ice chip just as soon as you do your incentive spirometer 10 times," and "certainly, i can get you a drink of water. you have four pills to take," etc. until you're the last person they want to make demands of. "oh, you want me to get chairs for your visitors? you have ten visitors, and unfortunately our policy allows two. but you have two chairs, so let me show the rest of these folks where our waiting room is." it works really well.
i've also been known to take it a step further.
"don't you know who i am?"
"yes sir. do you know where you are today? do you know the date today?"
or, a favorite of mine: "i'm a close personal friend of dr. jones." (the ceo).
my reply: "oh, that's nice. who is he?"
i don't believe in "vip status." i treat everyone the same, regardless of who they are. i must be doing ok, because i was asked to take care of our manager's father-in-law, the medical director's father and another cardiologist's father-in-law. the cardiologist's father-in-law told me that he didn't need to cough and deep breath (after his cabg) because he had an in with dr. smith. dr. smith, bless his little heart, happened to overhear this particular tirade and stepped up to the bed, handed the guy his incentive spirometer and bellowed "suck, dad. and don't let me ever hear about you telling this nurse "no" again. believe me, she'll tell me!" it worked!