Mamma's Boys (vent) - page 3

Hey - is anyone else seeing this trend? We have had a run of late 30's males who still live at home with "Mommy" -their words not mine - who dote on them hand and foot and expect us to do the same.... Read More

  1. by   scherzo
    I used to live in Europe many years ago and met plenty of adults that lived with their parents. Then (20 years ago), it was harder to live on your own as a young person. Jobs paid so little and the cost of living was outrageous. But, even with enough resources, most of the adults I knew had good relationships with their parents and adult-level boundaries.

    I do sympathize with the RN that has to care for a dependent personality. I find, though, in my own practice that setting limits early and consistently with all patients can avert many problems. It doesn't solve them all, but it helps avoid many of them.

    The fellow with the Foley catheter dilemma: As long as it was medically necessary to measure I/O...like it would be with someone with a facial fracture...you want to know immediately if he develops diabetes insipidus (DI)...I would place a condom catheter on him and measure it that way. The MDs do not want an invasive foley...for infection reasons...and you NEED to KNOW his urine output to give safe care. This man's problems are deep and will not go away by making him pee in a urinal. This is also the kind of patient that often sues over the smallest infraction...or his mother will. I would just get through my shift with as few problems as possible...and help the physicians get him safely out of the hospital...whatever it takes. I would ensure that he got a psych consult...and that this was documented. I would document ever single refusal for care...and write that the patient refuses to pee in a urinal (using quotes from him) and that a condom catheter had to be placed in order to assess for risk of developing DI. All language in the document needs to be descriptive and contain no judgements about the person. For example, "Patient urinated in his bed. Amount unknown. Entire bed was soaked. Due to risk for DI secondary to facial injuries and the patient stating "I don't want that urinal, I want a Foley," Drs. Smith and Jones were consulted. A condom catheter was placed and an emotional care consult was requested. Patient talking with his mother on the telephone. No observable distress."

    These patients can be like road rage participants. They can really make you mad...and engage you in their need for attention. I have learned that letting them have the road as much as safely possible will let me avoid a collision with them. This issue has been going on for this patient long before I got his assignment...and I will not be able to fix him. I do not have the training, for one thing.

    I had a patient once who was VERY difficult...a man in his 40's. He had a massive heart attack and was in heart failure and needed a ventricular assist device to keep him alive and possibly get him on the transplant list. The night nurses were fed up with him because he was refusing to speak. I read in his notes that he had survived a code which prompted an emergent VAD placement. I spoke to the attending MD right away and got a neuro consult as well as a psych consult. The man was angry enough to throw things across the room, so he would also need emotional care. The two MDs arrived together to assess him. It was discovered that this man had expressive aphasia from a small stroke...and he was a physics professor...someone used to talking eloquently to many people all the time. He was extemely frustrated that he could not communicate...thus the anger expressed by throwing things. For a week, he was getting lectures from his doctors and nurses about how his lack of cooperation was hurting him and that he needs to talk to us. The night nurses were laughing at his strange behavior...and afraid of his rage. Getting him a piece of paper...and eventually a lap top...and some antidepressant medications altered the course of his treatment for the better.
  2. by   teeituptom
    Oh god yes you see an increasing trend of mommas boy who still live at home, girls also.

    Had a guy a few weeks ago. 36 yo male tall handsome worked out every day. kind of looked liked a younger Tom Selleck. But his mother supported him. And she was a total B when it came to his care. Just as well he was such a whiner.

    I dont know where these severely dependent people come from. or why it happens.

    disgusting though
  3. by   northwest20
    Quote from scherzo
    I had a patient once who was VERY difficult...a man in his 40's. He had a massive heart attack and was in heart failure and needed a ventricular assist device to keep him alive and possibly get him on the transplant list. The night nurses were fed up with him because he was refusing to speak. I read in his notes that he had survived a code which prompted an emergent VAD placement. I spoke to the attending MD right away and got a neuro consult as well as a psych consult. The man was angry enough to throw things across the room, so he would also need emotional care. The two MDs arrived together to assess him. It was discovered that this man had expressive aphasia from a small stroke...and he was a physics professor...someone used to talking eloquently to many people all the time. He was extemely frustrated that he could not communicate...thus the anger expressed by throwing things. For a week, he was getting lectures from his doctors and nurses about how his lack of cooperation was hurting him and that he needs to talk to us. The night nurses were laughing at his strange behavior...and afraid of his rage. Getting him a piece of paper...and eventually a lap top...and some antidepressant medications altered the course of his treatment for the better.

    WOW, this was a very poignant story, thank you so much for sharing and thinking outside the box.
    :angel2:
  4. by   northwest20
    Quote from teeituptom
    Oh god yes you see an increasing trend of mommas boy who still live at home, girls also.

    Had a guy a few weeks ago. 36 yo male tall handsome worked out every day. kind of looked liked a younger Tom Selleck. But his mother supported him. And she was a total B when it came to his care. Just as well he was such a whiner.

    I dont know where these severely dependent people come from. or why it happens.

    disgusting though

    ive learned about why this type of behavior happens in pscyhology courses, particularily developmental psychology.
  5. by   EarthAngel
    Quote from Krissy NY
    A story that is...not a momma's boy

    I worked with a girl who dated a guy who lived with his mother at 33 years old. She was an RN and was always convincing him he was sick and should stay home instead of seeing Jill. She said she was there to meet him for dinner and his mother gave him two teaspoons of cough medicine in front of her and was ironing his shirt for their date.

    She stopped returning his calls when he casually mentioned that she gives him enemas to "clean him out" and he thought it was ok because she was a nurse
    *Shudder*
    Thats...just.. sick..
    I cant even begin to imagine the years of mental abuse he must have gone through to reach the conclusion as an adult that this was anywhere NEAR "ok because shes a nurse"!! It sickens me that "nurses" like that slip through the cracks and end up with a license.
  6. by   moia
    Because I work with cardiac patients we see alot of this..also because we are increasingly multicultural we have patients that are culturally dependant and speak absolutely no english.
    I have had patients that have lived in Canada for twenty years and have never ever made an effort to learn english.
    I let one family member stick around for translation and reassurance but I am pretty strict about the huge mob of family.
    I also take the family member aside and bluntly tell them they have made a potentially fatal error in not demanding that the patient learn some basic english...I give them a list of emergency words and a few comfort words...PAIN is always the first word I teach...the family gets" I need to pee" and" I am hungry" simple things that gives the patient some control when family is not there....I cannot tell you how frightening it is for me to think of my patient on the ward with no english and no family there. Recipe for disaster.

    Culturally there are some patients that are a nightmare but I just let the family deal with it...in the limited time I am the patients nurse I won't make any difference...I just make sure the family is completely involved, especially with physio...On the whole I find family to be really effective if they are involved right from the start...if they know why they are good bullies and I don't have to fight with the patient.

    I let the sucks be sucks as long as they are following the recovery plan...any attempts to subvert that plan will not be tolerated. I am completely blunt..I tell my patients why they must cough, deep breath, get up and walk and look after their personal hygiene when they are capable..I tell them all about pneumonia and blood clots and every potentially fatal side effect of sitting in bed...I don't take no for an anwer and more than one patient has found themselves assisted to a chair all the while complaing bitterly.
    I have an obligation to explain why I do what I do and explain the risks if I don't , I premedicate for pain and I move right on.
    We call it the bumsrush...it works...the patient never admits it but once they do it once they always ask to do it again..usually when you are way too busy....


    My problem lately is the completely independant guy...he is always shocked by is limitations and he is always the one using the call bell in the bathroom after you told him not to get out of bed without calling you first....I just want to shake them because they scare the hell out of me.
  7. by   chris_at_lucas_RN
    I don't think we are talking about cultural situations here, where it is common historically and economically for multiple generations to live together. There's nothing wrong with that.

    What we are talking about are some "fringe" behaviors (as in, out in the fringes), that are weird enough to make you go "ew" or feel strange in the gut (the old "gut feeling").

    These are "personality disorders" rather than "personalities."

    And this pair here....

    She stopped returning his calls when he casually mentioned that she [his mother] gives him enemas to "clean him out" and he thought it was ok because she was a nurse
    This would be rather sexual in nature and therefore incestuous. There are lots of reasons we keep our bottoms covered and protected around certain people who are either too close or too distant, relationship-wise.

    Personally, I've never run into any of these guys (gender generic), and I'm not sure what I'd do. Glad I'm married to a nice, normal guy though--I can see myself falling prey to one of these yahoos! (It's a forest for the trees thing with me.)
  8. by   Tony35NYC
    Notwithstanding the male bashing in this thread, what are you refering to as a "trend"? One patient? Two? And, compared to what?

    You are describing your patient as a mama's boy, but isn't that an assumption? Seriously, what do you really know about the nature of the relationship between the man and his mother? There's a big difference between a person who has strong attachment and affinity for his or her mother and one who is needy and socially inept. I don't think its fair for some of you to use the bad experiences you've had with the men in your lives as examples because that doesn't prove anything. There are women who do the same thing with their mothers, fathers, and husbands, too. What's so bizarre about people using their close family and friends as an emotional crutch when they're facing serious health problems?

    I was surprised by the nurse who made the comment about men in prison. Since you actually work in a prison you should know that that is an entirely different situation, contrived for political expediency and most often out of fear than weakness. The guys who end up being "owned" are the ones who choose that over the alternative of repeatedly being severely beaten or being murdered. And as for those nurses who were laughing at the patient because of his "strange" behavior...well, that was just unprofessional. There's nothing "strange" about a patient who displays anger and frustration about his debilitated condition. You've made examples out of male patients who were dependent, combative, and who refused to cooperate with prescribed therapy. Am I to believe that you never get this from any of your female patients?

    You have a right to talk about your observations, but it is also important to consider that people come from all different types of familial and cultural situations that won't always fit our ideals. That doesn't make us or our standards any more or less "normal" than they are.

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