"Difficult" Patients - page 2

I love getting report when the RN tells me about how unmanageable a particular patient is because then I make sure that they're not going to ruin my day and it feels like an accomplishment when I've... Read More

  1. by   proud nurse
    I agree that it may be just a change of nurse that's needed. I think about people in my own experience that rub me the wrong way for no apparent reason, and it's possible that is what happened with the nurse giving me report.

    Killing them with kindness is a good strategy, but I find that most adults can see through that, so I do it in a way that makes it less obvious. More than anything I keep them updated, because most patients just want their doctor to come round on them.
  2. by   ABitterPill
    I agree, I always give a little more TLC to those that have given the prior shift a hard time, most anything to get me through my shift w/out incident and to make them happy. But there are those that are just miserable people and are determined to make it miserable for everybody else. Then you just do the very best you can to try to appease them.
  3. by   SaoirseRN
    Some people are just difficult no matter what. However, I do try to find out "why" this is and see if I can't find a way to work with them. You can't get along with everyone every time, but often you just need to figure out what approach works best and stick to that.
  4. by   BSNbeauty
    OP you are doing what we should ALL be doing as nurses. I do the same things you mention and don't have an issue. Sometimes, I had the opposite happen, where patient was being difficult for me and no one else ( even though my nursing care hasn't changed). Sometimes patients react to others differently. Sometimes there is transference of emotions from the patient to the nurse because the nurse reminds the patients of someone in their past.
  5. by   CodeteamB
    Quote from ABitterPill
    CodeTeamB: Do you have a "sane" nurse manager?! Cause, if we try the "scary nurse pants" thing on our floor and a patient or family member expresses the least little thing about it, we're reprimanded...leaving me to wonder, just how much abuse is a nurse expected to take---from pts, family members and my nurse manager?! I'm about at my ultimate limit sadly.
    Yup, my manager rocks... But I also think that the public health care system (I'm Canadian) leads to less entitlement from patients, at least based on the stories I read here. We don't go in for the "customer is always right" foolishness. Patients have come to the ER for our service and are expected to behave in a civil manner. To my knowledge a patient has never complained about me telling them to shape up.

    Also I am young and still quite naive in the ER world, while my scary nurse pants may be effective, they are nowhere close to as intimidating as some of the nurses I work with, and I haven't noticed them getting into trouble either.

    I feel for nurses who don't get this support. If I was expected to take abuse I'm pretty sure I would no longer love my job
  6. by   Fiona59
    I'm also in Canada and have had my share of difficult patients. Over the last five years, my unit has had only one complaint come in, and nobody remembered the patient. The charting was pulled and the unfortunate nurse who had had them documented every complaint the patient made. They were in an outpatient unit and managed to complain 18 times in three hours. Everything from the temperature of the waiting area, how slow the doctor was, the chair wasn't comfortable. We also had four letters of appreciation for the same shift and two of those mentioned the unreasonable behaviour of the complainer and how patient the staff were with her and her family!

    My favourit manager called a doctor and had a really difficult patient sent home. He had verball abused one nurse so loudly the unit heard it all from his room. Homecare is rumoured to have visited twice and then told him to go to his GPs office for his daily dressing!
  7. by   BrandonLPN
    In LTC the "kill them with kindness" mentality can sometimes be majorly counter productive. Making special accommodations is the last thing you want to do for residents with behavioral issues. These people live here, firmness and boundaries are the only way to deal with difficult patients in LTC. Regular staff works hard to establish a routine with mutual expectations. For a new/float nurse to come in and cater to demands shatters this hard won set of boundaries.

    When you tell Mrs Jones that no one will help her go to bed until the CNAs finish with the supper trays, or Mr Smith that he has to stop to get his pills before going to activities, you aren't being "mean", you're establishing rules that are absolutely necessary for any nursing home to survive.

    This is why some NH residents act like it's Christmas morning when a new/float nurse comes on duty. It's like when we were kids and we saw there was a sub teacher. We knew we could get up to all sorts of shenanigans the regular teacher would never stand for.
  8. by   StNeotser
    Sometimes it takes a pysch consult or some labs. I remember ducking a woman who was trying to lasso me with her catheter bag. Very low sodium as it turned out.
  9. by   StNeotser
    Quote from ABitterPill
    CodeTeamB: Do you have a "sane" nurse manager?! Cause, if we try the "scary nurse pants" thing on our floor and a patient or family member expresses the least little thing about it, we're reprimanded...leaving me to wonder, just how much abuse is a nurse expected to take---from pts, family members and my nurse manager?! I'm about at my ultimate limit sadly.
    And this is the sad thing. The one time a family complained about me, and they were being thoroughly nasty and disrespectful to me, they couldn't come up with a single rude thing I said or did or anything that came up as not doing my job. They said it was my body language and facial expression.

    When I'm getting yelled at by rude folks, I may well cross my arms and not smile at them. They were mad because the patient had a fever and he was already being treated with IV antibiotics and antipyretics............and I was merely telling them that after a couple of hours those drugs may not be working yet........... Of course the patient survived well enough to be back a couple of years later and a year later after that, ad infinitum.......despite my arm crossing and the fact I wouldn't smile..................and in any other setting other than health care when someone yells the way that family did they get shown the door and the threat of calling the cops.
  10. by   WindyCDE
    I totally agree with all of you- I've always cherished my "difficult" patients because, if they were all easy, I would never learn anything new!

    I've somehow gotten a rep for handing the difficult ones and I don't mind one bit when they get "dumped" on me. After report, the game is on as far as I'm concerned and if I get them to smile or even laugh just once before end of shift, I've won!! Just like most of you have observed, a little extra time, a respectful approach, and allowing them some autonomy given their limited situations works wonders. It's such a shame, really, when I see nurse colleagues taking a patient's frustration personally. It just sets up an contrary relationship and makes the shift much looooonger. Let's face it- being sick sucks, so anything I can do to make it a little less distasteful for patients and their loved ones rarely goes unnoticed. Especially by the "difficult" ones.

  11. by   wannabecnl
    When I was a student, I had a patient who was very demanding, resented and complained about every single thing I did, and ended up requesting to NOT have me the next shift. My instructor talked to me and asked about what might have happened to prompt the patient's request. I told her the events of the evening, and she felt I had done all I could to accommodate the patient and deliver care. THEN she told me that the same patient had lodged complaints about a series of nurses that all looked like me! The patient ended up assigned to one of my classmates and loved him to pieces. Things that make you go hmmm...
  12. by   CVmursenary
    treat them like any patient; assess them and givem their meds and shut the door; call it a night
  13. by   NDXUFan
    When we had people would not behave in the jail, we took their shirt away, pants away, shoes away, and left them only with t-shirt and socks, in confinement. One night, had a very bad fever that would not go away, went to the ER, this couple was yelling at the Nurse. I had a bad headache and did not want to hear it. I told them, if they did not speak at a reasonable level, they were going to jail for disorderly conduct.