Patients Rights vs. overly demanding patients

chris_at_lucas_RN, RN · Jun 16, 2004

The social worker is wrong.

Patients do not dictate standards of care.

If patient demands interfere with providing care to other patients, the care of those other patients comes first.

Some social workers are just not too bright, and I'm pretty sure none of them are nurses.

As they say out here, "go get 'em!"

Farkinott, RN · Jun 17, 2004

Social workers and dietitians are like annoying little brothers that won't go away!

Cheap shot I know!

Destinystar · Jun 17, 2004

Unfortuantely whenever a pt. complains you have to assess him. If it turns out that he has a pattern of unfounded complaints have to get a psych consult. Have to care plan it. Have to try interventions such as pt. teaching, etc. Find an electronic BP cuff and teach him how to use it. Social Worker is practicing out of her scope if she is giving you a nursing directive and possibly harassing you. But this sounds like something that could have been delegated to a CNA. You can even teach a family member how to take a pts. vital signs and ask one if they would not mind coming in and taking the BP every time the pt. demands one. Sounded like he needed a private duty nurse. No matter how you look at it these types of pts. are OBNOXIOUS AND THE SOCIAL WORKER IS EVEN MORE SO. The pts. dont have a right to get there blood pressure taken within one second of demanding it if the pt. is not in any acute distress. If you cant take the BP on the spot tell the pt. when you can then f/u as promised.:uhoh21:

Destinystar · Jun 17, 2004

most of those "social workers" are designees that have nothing more than a short course and a certificate. they are wanna be nurses. most of them don't know or do their jobs cause their so busy interfering with our job. just give them a title and a way they go.

agnus said:

for a while they used a fruitcake social worker like you described at one facility where I worked as the case manager. when she left they did the right thing and used an RN and the new social worker they hired was relegated to part-time social work period.
the fruit cake thought it was her duty to "advocate" for every patient. not a bad thing but she saw nursing as the enemy so to speak. what ever rediciouls thing a patient said or wanted was gold to her and we were all monsters. it was even like she went out of her way to find some "heinous crime" we were committing.

social worker have no clue about nursing or health care and should not pretend they do.

fortunately for the most part they are great but then there are others....

Destinystar · Jun 17, 2004

WAS THIS PATIENT IN A NURSING HOME OR A HOSPITAL?????

Angela Mac said:

Where do you draw the line? I had a very demanding patient who would sit at the nurse's station and holler out that he wanted his BP taken while I was scrambling to get all the fingersticks done. This patient wanted constant attention. The Social Worker told me- "Residents Rights- if he wants his BP taken every hour you must do it". You can imagine how upset I became. Where do you draw the line?

nursemike, ASN, RN · Jun 17, 2004

I am occassionally appalled at the lengths we go to placate patients and their families on my unit, and at the abuse we are expected to endure. Generally, I like my management, but I wish they would do more to stick up for us. Frankly, I have a real problem with the whole "customer service" versus "healthcare" and "client" versus "patient" paradigm. Not that I object to putting the patient first, but to my thinking a patient is more than a customer, and what we provide is more than a product or service. Very often we're dealing with their very lives. That's a solemn responsibility, and we shouldn't be distracted from it by the girl who wants a regular Sprite NOW and all we have on the floor is diet, and she doesn't like waiting for dietary to bring up a regular one.

On the other hand, God help the patient who needs a bedpan at change of shift, when the two nurses and two aides on the clock assigned to him are in report. (Not all nurses or aides, of course, but enough to make us look pretty bad pretty regularly).

Fortunately, it isn't out of my scope of practice to help someone to the restroom if they are up with assist, and I haven't yet gotten in trouble for putting someone on or off a bedpan (orderlies don't get report--but that also means I have to be pretty careful about who I help, since I don't know a new pts activity level, etc.)

It's a big problem all around. One nice thing in acute care is that the docs are sometimes around, and some of them aren't shy about looking out for nursing staff.

Had a pt once who demanded to be taken outside to smoke, now, or allowed to smoke in his room. Vasc doc told him you can go home and smoke if you want, but you'll probably lose your foot. Not diplomatic, but it got the job done.

Perhaps it's just as well no one asked me to write our patients' rights handbook, because I would almost certainly have included a line to the effect that: Hotel workers won't wipe your butt, and we won't put a mint on your pillow.

Angela Mac · Jun 17, 2004

GREAT, THUMBS UP TO NURSE MIKE.........I really got a chuckle out of "hotel workers won't wipe your butt, and we will not put a mint on your pillow." WELL PUT....

This patient is in a nursing home, a young adult in his late 50s, without dementia. Perhaps angry with the world that he abused his body, but nonetheless, expects servants instead of nurses and cnas. And my heartfelt thanks go out to all of you who endure the FLUFF MY PILLOW, BEND MY STRAW types.........love, Angela

SCRN1 · Jun 17, 2004

LOL, I liked your comments too, Mike. :rotfl:

This is one reason I like working nights...don't have to deal with social workers.

If I have a patient who is asking for something that doesn't take priority over what other patients NEED, I will let them know that (in a nice way) I DO have a few other things I MUST do first and will get to him as soon as I can. Usually, this works.

nursemike, ASN, RN · Jun 18, 2004

Angela Mac said:

GREAT, THUMBS UP TO NURSE MIKE.........I really got a chuckle out of "hotel workers won't wipe your butt, and we will not put a mint on your pillow." WELL PUT....
This patient is in a nursing home, a young adult in his late 50s, without dementia. Perhaps angry with the world that he abused his body, but nonetheless, expects servants instead of nurses and cnas. And my heartfelt thanks go out to all of you who endure the FLUFF MY PILLOW, BEND MY STRAW types.........love, Angela

It's funny...a few nurses I work with will call a UAP to pick up a piece of paper they dropped on the floor, while others run themselves ragged getting water, fluffing pillows, etc., and trying to be good nurses at the same time. I'm going to have to try being more proactive with the latest round of newbies, letting them know that I or an aide can do some of this stuff, too. Of course, a few of my fellow UAP's (You apes?) have a bad case of notmyjobitis, but even among those not in nursing school, plenty would help if we knew what needed done. It's actually a pleasure to work with a nurse who knows when and how to delegate.

On the other side of the problem patient coin, you also have those whose families are always bringing in cookies, candy, donuts, etc., and the patients themselves who are just so damned pleasant that you hate to leave them, or the ones in airborne isolation who you can tell are so lonely that you have to hang out awhile, even in a mask and gown.

I shoulda learned to drive big rigs.

Hellllllo Nurse, BSN, RN · Jun 18, 2004

Farkinott said:

Social workers and dietitians are like annoying little brothers that won't go away!
Cheap shot I know!

LOL!

But I have to say that the dietitians and social workers are great and work WITH nursing where I work!

However, I have worked where this was not the case.

I.e. SW(sneering) "Those nurses never get Mrs. Jones up. They just leave her in bed all day." SW then goes into pt room, and plays guitar for her. Says things like "You poor thing. You must be so alone." and pats pt's hand.

Comes out looking at us like we are all devils. "She's so lonely all by herself."

SW acts like a martyr, and like he is the only person who gives a crap about the pts.

"Mrs. Jones" had a stg IV coccycx decub, caused by an inoperable tumor, which is occluding blood flow. She was on a $600. a day low-air-loss, automated pt turning bed, and receiving excellent care.

Pt has lots of family visiting daily, and has verbalized wanting more time alone to rest!

Another example:

Nurse writes a pt care plan (different pt), and uses "Body Image Disturbance" as one of the NDX. Social Worker has a fit- saying that nursing is overstepping their boundaries, and getting into social work territory.

Hellllllo Nurse, BSN, RN · Jun 18, 2004

nursemike? said:

....... Hotel workers won't wipe your butt, and we won't put a mint on your pillow.

I think you've created a classis, Mike.

chris_at_lucas_RN, RN · Jun 18, 2004

Quote

I shoulda learned to drive big rigs.

They have lots of venous stasis problems--like DVT's, varicose veins and, so very pleasant on the long hauls, 'roids....