How do you handle that "crazy" patient?

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    We got a 54 y/o woman in yesterday. She didn't like the way we did anything and I'll be dammed if she didnt' call Channel 4 news and the police. She tried to have one of the nurses arrested because the IV stick hurt. She was telling Channel 4 that we were ignoring all of her requests. It was her birthday and she wanted a steak dinner and a birthday cake. She told us that she would have gone to another hospital but that they had once killed her (apparently brought her back) and they she was in litagation with that hospital and that she had recently learned that her medical records were convienently missing. A real fruitcake I tell you. Wants to go out to smoke constantly. Admitted with COPD exacerbation. I know I should feel compassion for this fruitcake and actually I do but I avoided her like the plague because I don't want to get involved in any lawsuit. She was saying how she was best friends with the CNO and CEO (of course they don't know who she is) , she's saying she's going to have everyone's job before it's over. If you get assigned a person like this how do you handle them? I've had patient tell me before that they were going to sue me because I wouldn't give them pain meds early or let them go out to smoke and stuff like that and I basically told them that I was following the rules and would not put my licsence in jeopardy and they could do what they felt that they needed to do as far as a lawyer was concerned. This particular patient seems different, really scary.........any thoughts?
  2. 19 Comments so far...

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    Psych consult, STAT!! :chuckle

    Just be sure to document every encounter with this patient, what she says and does, as well as your nursing care. And yes, if not already done, you'll want to ask her attending about a mental health eval.

    Good luck with this patient........she's like a loaded gun with a hair trigger.
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    Quote from mjlrn97
    Psych consult, STAT!! :chuckle

    Just be sure to document every encounter with this patient, what she says and does, as well as your nursing care. And yes, if not already done, you'll want to ask her attending about a mental health eval.

    Good luck with this patient........she's like a loaded gun with a hair trigger.
    Very good advice. Thanks! I do believe a psyche eval has been ordered. I heard her talking on the phone. " you know how it is when people think you're crazy but you know you're not, that's how I feel" Her labs show her dig toxic and she's not on dig. She is on Mepergan, Xanax, Lortab, Oxycotin. That would be enough right there to make me crazy!
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    Quote from RN1976Nurse
    Very good advice. Thanks! I do believe a psyche eval has been ordered. I heard her talking on the phone. " you know how it is when people think you're crazy but you know you're not, that's how I feel" Her labs show her dig toxic and she's not on dig. She is on Mepergan, Xanax, Lortab, Oxycotin. That would be enough right there to make me crazy!
    Sounds like someone has taken one of her "goodies" and switchd it for dig. I guess there's another one just like her rattling around out there.
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    When someoen threatens me with a lawsuit, or to go to my boss, I always say, "that's your right, but we still need to....." Makes the threat a nonissue as far as manipulation goes.
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    Quote from canoehead
    When someoen threatens me with a lawsuit, or to go to my boss, I always say, "that's your right, but we still need to....." Makes the threat a nonissue as far as manipulation goes.
    To tell the truth, working in a prison, it seems every other inmate says he is going to sue for whatever way you look at him, or whatever it is he wants and doesn't have. Been there 4 years. Nobody has sued. As long as the nurse conducts him/herself professionally, and follows the MD orders, what is there to sue about?
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    Had a family member take my name today over the phone because I wouldn't give information on patient, saying she wanted to know specifically who to complain about. (Gimme a break lady, at least spell "HIPAA" correctly when you tell them WHY I wouldnt give info .)

    I do grow weary of being threatened with lawsuits over silliness.
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    Seems this time of year the 'nuts' are running rampant..ughhh :/
    Guess it depends on what mood I'm in @ the time how I handle it..some days I just try to suck it up...others, when I've HAD IT , I suggest they discuss their concerns with the MD giving them paper and pen to be sure they don't forget anything...or offer them an AMA sheet, explaining that if they are that unhappy with the services we provide that there are no bars on the doors and are free to go elsewhere for care (said in a very nice way of course )
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    I once had a patient, a man with a history of drug abuse and psych problems, not taking meds and so forth. He had a mediport for long term antibiotic therapy d/t other issues. He was ordered a antibiotic bid, he was always complaining about his line or something. I was assigned to care for him, went in to check him, he had removed his needle during the night, said it was not easy to sleep with it in, when I told him he could not do that, it was not safe, he told me he had been doing it for days and no one had said a word to him. He reported me to the charge nurse for not knowing my job. I smiled and told her I would not accept responsibility for him and she would have to take care of him. After a day, he was put on po antibiotics and released 2 days later. I guess when he was made a supervisory problem it was time to ship him out the door.
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    3mg IV push of Ativan


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