Things you'd LOVE to be able to tell patients, and get away with it.

Um, a pro? Is that a good thing?

Here's my two cents:

"No, I will not close the door for you, since obviously you could open it by yourself."

"Please stop screaming my name........IT DOES NOT MAKE ME MOVE FASTER, SINCE IT"S THE FIFTH TIME I"VE BEEN DOWN THERE TO ASSIST YOU!"

1. Yes, you are on a lot of medications. Yes, I want you to take all of them. No, none of them are poison. We are not trying to make you sick so we can keep you here longer. Yes, I understand that you were perfectly healthy before you called 911 before you nearly fell over dead. I understand that you weren't taking ANY medications before coming here, but YOU'RE IN THE HOSPITAL, HOW WAS THAT WORKING FOR YA?

2. If you're capable of reaching your mouth to eat, then you should be capable of reaching your own rear end to clean it.

3. Just because I am wearing the same uniform as your nurse, that doesn't mean I am YOUR nurse. I don't know you. I have no idea where your pain medication is. I had no idea mama was even on the bedpan, let alone that she had been calling for 3 hours (there must be some sort of time warp in the hospital) to get off it.

4. No, I don't mind coming in RIGHT NOW to pull the cover up on your loved one (because it surely requires an RN for that type of "procedure")...that is if you don't mind running to the other end of the hall to tell me why that patient isn't breathing. I should be done here by the time you get back.

5. Yes, I know the food here is crap. Sure...go on and bring your diabetic renal family member that fried chicken, chocolate cake and orange juice that they love so much and while you're at it, why don't you come on back tonight, we'll probably need the help while we're coding their @$$.

6. Yes, you figured out our secret. We draw labs every day so that eventually you'll lose enough blood that we can charge you for putting it back in.

7. No, of course we're not trying to wean your loved one off that ventilator. He just looks so comfortable we thought we'd let him keep it.

8. I have no idea why nana is so confused, could be that she's 102 years old. Yes, I understand that she never had been confused prior to being in the hospital. I'm sure she was completely in her right mind when she stole that car and was getting ON to that major highway via the OFF ramp just before she hit that car head-on. Yes, we really did tie her up with duct tape, put her in the shower and let the pigs chew on her knuckles last night.

Oh, man....I could do this all night! LOL!!!

WAIT A MINUTE!

In Psych Nursing at the bedside or inpatient, I DO tell my patients< "I am a Registered Nurse NOT a waitress nor maid. That's what the initials R.N. stand for."

This statement represents reality orientation AND limit-setting.

(I also TEACH this to my R.N. students)

Of course, attached to this statement is a clear description of the duties and functions I DO PERFORM in order to provide safe, prudent and nurturing patient care.

And I'll stand in anybody's court to defend my statements---ANYTIME.

Let's not get it twisted---FIRM and STRAIGHTFORWARD is NOT verbal abuse!


SHOWBIZRN

"No, your insurance does NOT cover my services. The fee is $250 an hour and the clock is ticking."

No you are not paying the bill, I am! because you are on Medicaid and are popping babies out faster than we can catch them.

Bwah ha ha ha ha ha ha ROFL!!!!!!!!!!!!!

I actually did this:

We have a frequent flier; an alcoholic, drug-seeking, elderly man. He ALWAYS goes AMA within 12 hrs of admission.

He presented to the ER one early Friday night, ETOH intoxicated, w/ c/o CP (which he has learned gets him a shot or two of morphine). Not this time! He has been totally worked up numerous times for CP - nada. On this occasion, after screening, labs, and an ECG, the night hospitalist admits him to Med/Surg on tele at about 3am, just to get his unruly, demanding azz out of the ER. Here's the icing on the cake: NO medication orders, NPO, bedrest, and immediate d/c orders if he leaves the floor to go smoke.

Anyway, this PIA is on the call bell every 3-4 minutes, demanding pain meds, food, etc. He wasn't even my pt this admission, but everyone on the floor was tiring of answering the bell and telling him "no, the Dr. didn't order you any meds" (or diet, etc.)

At about 4:30am, I had had enough! Marching into his room and closing the door, I approached the head of his bed. Putting both hands on the mattress and leaning down to about a foot from his face, I said: "Mr. XXXX, let me share a little something with you. We've got your number! We know why you are here, and guess what? You ARE NOT getting any narcotics here today, nor are you going to be fed. The doctor didn't order you anything, and we can't give you anything w/o orders. So.... quit being a pain in the azz, stay off the call bell, and if you don't like it you can carry your drunk, dope-seeking azz out of here!"

At 7:15am, during report, this "pt" was last seen headed for the elevator - his tele unit and INT laying on the bed he had occupied. This pt has NOT been back to the hospital since!

As an afternote: On the way to work one night about a month later, I saw this fellow at the convenience store where I stop to get gas. He was buying (what else?) a six-pack of tall-boys. Greeting him by name, I said, "Hi there, Mr. XXXXX. You be sure to be really careful tonight, because the hospital is full and we might have to send you down to XXXXX (nearest charity hospital, 45 miles away - a miserable cesspool under the best of conditions) if you come in tonight! Worked like a charm.

You can't say that to people who AREN'T your patients.

I almost said something like that recently to a woman I know who is highly educated and mostly associates with ex-convicts. I wisely kept my mouth shut because a comment like that would probably get me shot (figuratively speaking, of course).

Damn right!!!