Unruly Patients

[tmitch]

I am a pre-nursing student and I have browsing this website. (It's fantastic!) However, I came upon a thread regarding your most "icky" situations. I was mortified when I read about the old man who relieved his sexual byproduct on the face of a poor, unsuspecting young girl. Then I though to myself, 'what could you do to show an unacceptingly rude patient that you don't bite, or do anything else for that matter, the hand that "feeds" you?' Within ethical realms of course. My first instinct would be to grab the biggest Foley I could find.

If you have any stories reguarding sweet, subtle justice...please share.

[VivaLasViejas, ASN, RN]

I've been putting up with this 20 YO IV drug abuser with endocarditis all weekend..........20 going on 4, to be generous.......she literally will throw tantrums when she doesn't get her way, and we can hear her wailing all the way down the hall. She threatens to leave AMA at least once a day, and while every single staff member would be more than happy to let her go ("and don't let the door hit ya where the good Lord split ya!") we know what will happen if she goes out on the street.......especially with a central line!

Now, I'm a patient woman, but this girl was grating on me so bad by Sunday night that when I made assignments for 7-11P, I turned her over to another nurse who was just beginning her three-day stretch. This was AFTER I'd finally gotten fed up with her babyish fits and crying jags, and I told her she had some decisions to make and so far, they were bad ones........anyway, I ended the conversation by telling her to "GROW UP!!" :angryfire

I knew I probably shouldn't have said it, but *I* sure felt better, and even the nursing supervisor said she would have said a lot worse than that! I pride myself on being able to deal with difficult patients, but this kid pushed me WAAAAAAAY beyond my limits. :stone

[Elenaster]

I had one a few weeks ago, who I swear, by the end of my third night, if I could have gotten an order to put a garbage bag over his head I would have probably done it. I don't think the docs were too far away from giving me one either. Every time he didn't get his way he would start screaming to the top of his lungs about how horrible he was treated at our "god-awful" facility. He also kept complaing about how "where he came from things were such-and-such way." I actually heard myself say out loud within earshot of him "then why the hell didn't you stay there instead of coming across the STATE to torture us?!" He's probably banned for life from every hospital in the eastern part of the state.

Believe it or not, I actually thought I developed some rapport with guy, taking the "more bees with honey" approach, only to have him turn on me during morning rounds and holler about how mistreated he'd been through the night. It was so bad, my other patient was giving me sympathy simply because she could hear every ugly word coming out of big mouth.

[mattsmom81]

Speculating said:

This particular MD tells his pts. that are rude to their nurses that they need to be nicer to their nurses than anyone else. Because, these nurse are capable of withholding the pills they need to keep them alive or in fact not keep them alive. So, they need to be nicer to teir nurses than anyone else they know.

LOL! One very wise pulmonologist I worked with told me he is always nice to the nurses because they control how much uninterrupted sleep he gets at night. :rotfl:

[lisaloulou]

I personally do not think that a "reality check" is a bad thing when a patient's behavior goes over the line. I just hate rewarding bad behavior! Sheesh we arent robots.

[Dialyzin' Dar]

We had a dialysis patient at my unit who was full of conspiracy theories-- all the nurses were out to kill him, they deliberately messed with his machine, they set his goal too high, you name it. I said to him, "Well, they must be STUPID on top of it all, because I've been a patient here for eight years and I'm still alive!" Dead silence from the patient-- which is what I wanted in the first place! :)

[Hellllllo Nurse, BSN, RN]

Dialyzin said:

We had a dialysis patient at my unit who was full of conspiracy theories-- all the nurses were out to kill him they deliberately messed with his machine, they set his goal too high, you name it. I said to him, "Well, they must be STUPID on top of it all, because I've been a patient here for eight years and I'm still alive!" Dead silence from the patient-- which is what I wanted in the first place! ?

There are pts like that at the dialysis unit where I work. They accuse me of adding time onto their tx. They don't realize that the shorter their tx is, the better staff like it.

[Diprivan/Vented]

Unruly pts require conscious sedation. 4 mg Ativan bolus with diprivan, titrate for ramsey 3.

?

[CHATSDALE]

I Work In A Physc Nursing Home And We Have Seen It All And The Legal Reactions Are Being Taken Away One By One We Use To Be Able To Use Restraints When Necessary Now We Cannot And If They Hurt Another Resident We Get Threats Of Lawsuits From Relatives. We Do Not Have Time Out Rooms And Chemical Restraints Are Not To Be Used Except In Absolute Necessary Situations So Far That Has Been At Our Discretion But You Never Know What State Inspectors Are Going To Require Next