Son of a bad patient

  1. My father, whom I dearly love, is in the hospital tonight, should come home this morning. Had a femoral artery stent, which I'm hoping will relieve some of his ischemic leg pain, improve his quality of life, and help him keep his leg. He had the other side done a month ago, and is showing significant improvement. Not miraculous, but significant.
    Of course I'm profoundly grateful to God, the doctors, and the nursing and support staff who've cared for them. I've made a point of thanking everyone I've seen, although it occurs to me I need to take a moment to add a thank you to the Almighty, although presumably he knows I'm grateful.
    Anyway, the one discouraging aspect of this whole business has been Dad. I'm sorry to say, he's acting a lot like one of those patients. Rude, uncooperative, demanding, and impatient. Frankly, I've been embarrassed for him a number of times in the past day or so. And it doesn't help a bit that he's in the hospital where I work--except that I know my colleagues are used to it, just as I am. Like everyone here, we understand that pain, discomfort, and probably some anxiety, don't tend to always bring out the best in people. But, still...
    I'm thinking I am going to send a note to the director of the cath lab to praise the nurses and others who treated him so well, and to express my regret at some of his behavior, and a similar one to the cardiology unit where he is recovering.
    Okay, enough venting. We've all seen the receiving end of this enough to know the score, and I do take a little comfort in my own experience that it's hardly ever the sickest patients who give me a hard time. The 80 y.o on her third hip replacement is a trouper while the 19 y.o. with a broken wrist screams all night. I'm glad Dad's well enough to be a nuisance. But I do think I need to discuss this with him, because I don't think he has any idea how out of line he has been. Like calling the NP who put some towels under his heels an idiot because she didn't get them just where he wanted them.
    Yes, I believe it did hurt worse where she put them, but she's a capable intelligent woman who was just trying to help, and all he had to do was say where he needed them put. Eh--I'm starting to vent, again.
    Anyway, I clearly need to take some time to get some perspective, first, but I do want to make the points that need to be made, not least of which is that acting like a jerk doesn't always get you the best care. But if there are any cooler heads out there--especially if you've been through a similar situation--I wouldn't mind some advice. I don't suppose this will be his last trip to the hospital, and I would hate to see him get pillow therapy.
    •  
  2. 12 Comments

  3. by   Tweety
    I wish your dad well. It does sound like an awkward situation for you. The note the to the nurses sounds like a very good idea.
  4. by   EmerNurse
    NurseMike, best wishes for your dad's recovery. As you stated, your co-workers know how some folks can be when they're sick. It's NOT a reflection on you, please remember that.

    Sure, when you're dad's feeling better, perhaps you could share some of your own experiences and talk about how "some patient" could have been easier if only they'd....<whatever>. Maybe he'll get the picture. Really depends on your dad. You know him better than I do. If my mom were to get onery, I'd tell her to give it a rest already LOL. But I can get away with that.

    Absolutely, send a note if you want to commend his medical care. No need to apologize for your dad's oneriness, you didn't do it. But nurses get little enough in the way of thank you's, so one in writing is always welcome.

    Good luck to you and your family. You can always bring donuts on your next shift if you want to, say they're from your dad. We're always nibbling, aren't we?
  5. by   clemmm78
    It's hard, isn't it? When my mother was in the hospital three years ago, something happened and she became one of "those patients." She was confused, disoriented and a danger to herself by trying to get out of bed when she couldn't. She was rude and nasty in English and in Dutch, but she didn't make any sense in either language either. I remember one day, she was babbling in Dutch and the nurses were glad to see me so I could tell them what she was saying. Unfortunately, it was total nonsense - until she got mad at me for looking like her sister when she really told me off.

    Anyway, at first I was embarassed but then I realized that there really wasn't anything I could do as a daughter. Luckily, whatever sent her into that loopy state stopped as quickly as it started and she was back to normal in about two weeks. We still don't know what happened.

    All that to say, I know where you're coming from. I think words of praise would go a long way, but most hospital personnel would be pretty understanding.
  6. by   santhony44
    I think "thank yous" to the staff would be really appreciated. As to whether or not talking to your dad about his behavior would help, you know him better than we do. If it was truly out of character for him, and he does not remember it at all, it might just be an embarassment to him to tell him.

    Would it help to ask how he'd feel if someone were talking to you the way he talked to his nurses?
  7. by   TachyBrady
    We see this happen all too often, don't we? Cute nice little old things on admission but a few days later, confused, aggitated, and demanding. I have compassion for these folks because I know it is not their real selves but the medical procedures, meds, strange environment, lack of rest, illness, night time, that are causing these changes.

    Shortly before my Dad died, he was one of these patients... sitting up all night at the nurses station. It broke my heart that he was so ill and in this situation. I hoped that the night nurses understood and were kind to him. (I wish they would have called me because I would have come to sit with him. I didn't find out until after the fact.)

    Please do write your letters of thanks and satisfaction with his care. It is always nice to be appreciated. Don't feel bad or imbarassed. These things happen frequently. Any good healthcare worker expects this while continuing to deliver respectful and compassionate care.

    I hope your Dad recovers well.
  8. by   MALE*RN*777
    Wish your dad well and know where you are coming from... I was the son of a mother who had a knee replacement and would not think to ask for all things needed when the RN/CNA/LPN was in the room. 5-10 mins later she would be on the call light. I explained things to her and tried to be there as much as I could or have other family members there, so not to burden the floor staff.
  9. by   rehab nurse
    Awww, nursemike...(((hugs)))) to you and your dad.

    Don't feel bad about your dad's behavior. I know you may cringe because you recognize that the workers your dad may be cranky at are giving good care. I know it's easy to feel embarassed at times.

    I know because my own dad was in the hospital s/p CABG a year and a half ago and became quite irritated with a lot of the nurses and aides. However, a COUPLE of those workers were too busy with other patients to give adequate care. It was a very busy CVICU and stepdown unit and a few times, they were simply slammed. Even with the ratios they had there, when they have half their unit circling the drain/crashing, they simply don't have time to wash my dad's hair. He did remarkably well after the 5 bypass graft surgery. I know some of those times he was cranky that his blood sugar was quite low (for him anyway). He really feels horrible when his blood sugar is lower than 70, and they were really trying to keep tight glucose control. Tighter than he's used to.

    I guess the worst is my grandma in the NH, who is getting more and more demented by the day. She's also legally blind, nearly deaf, and she is having more episodes of anxiety and paranoia. My family doesn't understand dementia quite well, and they don't understand why grandma calls her kids and tells them someone's in her room and trying to break in the window, or trying to kill her. She's scared out of her mind because she was finally placed in a nursing home after months of me trying to stop by before work to care for her...clean her up, change her badly wounded legs, etc. She was devastated when we had to close her apartment and give away her belongings. She has now become very bitter, very demanding, and her friends in the NH have mostly stopped talking to her. Mostly because she never thanks anybody for anything. Yes, it can be a sore spot when you hear from the staff/roommates/etc that she is very rude sometimes and just not thankful. I know the NH she is at is very short staffed. I think this has all been aggravated by her conditions, her refusal to take meds (and at times, the facilities refusal to give certain meds...they kept d/c'ing them), etc.

    Gosh, I realize I've just been chatting away here. Sorry about that. Just wanted to chime in, tell you that there ARE others out there going through similar issues. I feel for you. Definately send the hospital a thank you letter if you want to. I know I did, and I specifically sent some letters to a couple of nurses (as well as to their bosses) who really went above and beyond. I know they appreciated it. And I try to bring stuff in to the staff at grandma's NH. They work their tails off for her, and I know from experience it's not easy. But like other posters said, the staff is used to it, and we know it's not something they (usually) do on purpose.

    Hang in there. Hopefully dad gets back home and feels better very soon.
  10. by   TrudyRN
    Quote from clemmm78
    It's hard, isn't it? When my mother was in the hospital three years ago, something happened and she became one of "those patients." She was confused, disoriented and a danger to herself by trying to get out of bed when she couldn't. She was rude and nasty in English and in Dutch, but she didn't make any sense in either language either. I remember one day, she was babbling in Dutch and the nurses were glad to see me so I could tell them what she was saying. Unfortunately, it was total nonsense - until she got mad at me for looking like her sister when she really told me off.

    Anyway, at first I was embarassed but then I realized that there really wasn't anything I could do as a daughter. Luckily, whatever sent her into that loopy state stopped as quickly as it started and she was back to normal in about two weeks. We still don't know what happened.

    .
    'lytes off? Rx side effects?
  11. by   TrudyRN
    Quote from rehab nurse
    Awww, nursemike...(((hugs)))) to you and your dad.

    Don't feel bad about your dad's behavior. I know you may cringe because you recognize that the workers your dad may be cranky at are giving good care. I know it's easy to feel embarassed at times.

    I know because my own dad was in the hospital s/p CABG a year and a half ago and became quite irritated with a lot of the nurses and aides. However, a COUPLE of those workers were too busy with other patients to give adequate care. It was a very busy CVICU and stepdown unit and a few times, they were simply slammed. Even with the ratios they had there, when they have half their unit circling the drain/crashing, they simply don't have time to wash my dad's hair. He did remarkably well after the 5 bypass graft surgery. I know some of those times he was cranky that his blood sugar was quite low (for him anyway). He really feels horrible when his blood sugar is lower than 70, and they were really trying to keep tight glucose control. Tighter than he's used to.

    I guess the worst is my grandma in the NH, who is getting more and more demented by the day. She's also legally blind, nearly deaf, and she is having more episodes of anxiety and paranoia. My family doesn't understand dementia quite well, and they don't understand why grandma calls her kids and tells them someone's in her room and trying to break in the window, or trying to kill her. She's scared out of her mind because she was finally placed in a nursing home after months of me trying to stop by before work to care for her...clean her up, change her badly wounded legs, etc. She was devastated when we had to close her apartment and give away her belongings. She has now become very bitter, very demanding, and her friends in the NH have mostly stopped talking to her. Mostly because she never thanks anybody for anything. Yes, it can be a sore spot when you hear from the staff/roommates/etc that she is very rude sometimes and just not thankful. I know the NH she is at is very short staffed. I think this has all been aggravated by her conditions, her refusal to take meds (and at times, the facilities refusal to give certain meds...they kept d/c'ing them), etc.

    Gosh, I realize I've just been chatting away here. Sorry about that. Just wanted to chime in, tell you that there ARE others out there going through similar issues. I feel for you. Definately send the hospital a thank you letter if you want to. I know I did, and I specifically sent some letters to a couple of nurses (as well as to their bosses) who really went above and beyond. I know they appreciated it. And I try to bring stuff in to the staff at grandma's NH. They work their tails off for her, and I know from experience it's not easy. But like other posters said, the staff is used to it, and we know it's not something they (usually) do on purpose.

    Hang in there. Hopefully dad gets back home and feels better very soon.
    If you can possibly afford to get a part-time companion for her, it would go a long way toward helping her adjust to being uprooted. If you have a large family, maybe you could all take turns being with her for an hour or so at a time. Make a schedule and just try to frequently have a family member with her. It's got to be ten kinds of hell being forced to radically alter one's lifestyle, + being blind, deaf, etc.

    Why do they keep stopping her meds.
  12. by   rudopal
    I had a similiar experience when my dad went to the hospital. His baseline temperment is calm and good natured, but, under the circumstances, he became surly and passive-aggressive. Eventually, he pulled out his IV and went AMA. Yeah, he was one of those! Luckily, he went on to recover without further complications, but the whole experience was really an eye opener for a brand new nurse (me-at the time). Patients are not always who they appear to be or, maybe, you only see a small side of them and it's sometimes the worst. I consciously made an effort to be more tolerant of my patients after that. I also didn't work at the hospital where this happened, so that was nice!
    Last edit by rudopal on Jan 31, '07
  13. by   clemmm78
    Quote from TrudyRN
    'lytes off? Rx side effects?
    I think it was a med error that was not detected. Or was but covered up. She literally woke up completely lucid one morning - she said it was like there was a switch. It was very odd.

    Also, when she was in, they wanted to do an LP but I was the only one who had consent privileges (father was also in the hospital having a knee replacement) and I never signed a consent. First I was told she had one. I asked for the results, and asked how they did it without permission. Then they said that they didn;t do it. Yet, when I spoke with the dr on call that day, she said she had the results. I never found out if she did or didn't have the test.
  14. by   nursemike
    Thanks for all the advice and support. Dad's home and fine and in a much better mood, and a little sleep did help my outlook, too. He wasn't demented--just very grumpy.
    I guess there's a good reason we don't treat our families. I can have a lot of empathy for strangers, but it's tough to see my lifelong hero vulnerable and not at his best.
    Dad has chronic pain, especially in his feet and legs. Peripheral neuropathy, ischemia, and arthritis. On a prior stay, for CHF, the only bed he could get was on an oncology unit, where pain control is a high priority, and he had a much better stay. Unfortunately, a fair amount of discomfort is hard to avoid with catheterization--flat bed rest, tethered to a monitor, frequent labs and assessments.
    On the ride home, Dad did voice his view that patient comfort ought to be the top priority, and I countered with my perspective, that it's a high priority, but not the top. Told him about a patient I recently had on a PCA with dilaudid for severe pain who stopped breathing. Stopped the PCA, got her back without narcan, and called the doctor. We reduced the PCA, which increased her pain, and worked on titrating through the rest of the shift. Not a direct analogy with his situation, but I'm trying to show him that the things we do aren't arbitrary.
    Predictably, the staff who were taking care of my father weren't nearly as bothered as I was. Still, I do think a thank you card and some doughnuts may be in order.

close