Patients who can do ADLs but want nurses to - page 3

I've been coming across more and more patients that are perfectly capable of taking care of their personal needs, but simply don't want to. Example: ringing the call light to ask for the box of... Read More

  1. Visit  BrandonLPN profile page
    8
    Quote from GrnTea
    Saying, in a sincere voice, "I am very concerned that you're not able to do that. I'll be calling the case manager to look into your options for nursing home placement if you're not going to be able to take care of yourself at home." Miraculous cure often results.
    And if you're a LTC nurse dealing with a pt like this who's *already* in a nursing home, just imply that they may have to be transferred to that even worse nursing home down the street they saw on 20/20 last night....
  2. Visit  kmarie724 profile page
    2
    The strangest thing I've encountered in this area was a pt with orders to straight cath for post void bladder scan greater than 400 cc that admitted she tried to hold in her urine while she was on the bed pan (naturally she was "too sick" to get out of bed to use the toilet) so she would have to be cathed. Many pts can magically void once you tell them they will need a cath if they are unable to go! I've never seen anyone who wanted a catheter before.
  3. Visit  RNsRWe profile page
    1
    Quote from BrandonLPN
    And if you're a LTC nurse dealing with a pt like this who's *already* in a nursing home, just imply that they may have to be transferred to that even worse nursing home down the street they saw on 20/20 last night....
    LOL.....the twists and tricks we sometimes have to employ to wheedle good behavior!
    Fiona59 likes this.
  4. Visit  RNsRWe profile page
    7
    Quote from kmarie724
    The strangest thing I've encountered in this area was a pt with orders to straight cath for post void bladder scan greater than 400 cc that admitted she tried to hold in her urine while she was on the bed pan (naturally she was "too sick" to get out of bed to use the toilet) so she would have to be cathed. Many pts can magically void once you tell them they will need a cath if they are unable to go! I've never seen anyone who wanted a catheter before.
    Ok, that's weird. Unless she thought that by having one she'd never have to get her butt out of bed??

    I found, when working the med-surg floor, that the mere presentation of a 16F foley to most men would create a virtual RIVER of pee
  5. Visit  EHNurse19 profile page
    2
    I have been noticing this more and more in our patient population as well. My go to line is "Who does this for you at home?" If they say that they do then I just let them know that as their nurse it is my job to ensure they can saftely and adequately take care of themselves upon discharge otherwise social services may need to set up home care or possibly even a stay at short term rehab upon discharge. That seems to always makes them become as independent as possible very quickly...
    amoLucia and Fiona59 like this.
  6. Visit  Ruby Vee profile page
    0
    Quote from amoLucia
    To edimo - I apologize for the LOL. I'm a great one to bemoan the use of unfamiliar abbreviations; I freq have to ask about some just like you did. (I really questioned something earlier today on another post re a nsg job position.) I AM NOT computer-speak saavy. I only learned LOL recently just be being here on AN - I figured it was a safe one. I've should've known better ...

    Likewise, each nsg specialty seems to have its own language. It took me forever to figure out NSTEMI (smile, all you cardiac nurses). So LOL seemed to fit very nicely into LTC. Hey - I work LTC but I had NO idea what NOC was (11-7 shift) until I saw it here!!!
    What is "nsg"?
  7. Visit  aei631 profile page
    0
    Quote from Ruby Vee

    What is "nsg"?
    Nursing
  8. Visit  HeartNurse3 profile page
    4
    My line to solve this little problem is "Here at {name of hospital where I work], we like to encourage patients to do as MUCH for THEMSELVES as they can." This simple little phrase has worked every time and patients often have nothing to say in return.
  9. Visit  loriangel14 profile page
    3
    Oh yes I have used the " maybe you njeed to go to a nursing home if you can't care for yourself" chat before.Also the " who will wipe your butt at home?" as well.They get the message.
  10. Visit  pfongk profile page
    1
    I know I felt rather embarassed when I needed a bedpan and help wiping after I had my son as the spinal still hadn't worn off and I couldn't actually feel from about 1/2 way down my chest down. I don't know why people want people to do it, I see it a lot at work and I've actually been known to tell my residents that if they can't do it obviously they can't do something else they want to do as it's the same action, like if they can't wipe themselves they obviously can't go to bingo.
    GrnTea likes this.
  11. Visit  cjcalimer profile page
    1
    We actually had a patient who faked being a para just to get a helocopter ride. He was miraculosly cured when we told him his family couldn't wheel him to the lounge in a geri chair, but that instead he needed the special tilt back wheelchair with the seatbelt due to his paralysis. He got right up and walked. I work on a primarily Ortho floor so our favorite line is that things like wiping are part of therapy and that everyone has to at least try. Sometimes the larger spine patients genuinely do have a hard time reaching, in which case a prompt call to OT is made to get some tongs. It's important to start practicing early! I never ask who does it at home anymore because one time I had a patient answer that his wife had been wiping him for the last two years. I was completely astounded.
    RNsRWe likes this.
  12. Visit  Altra profile page
    6
    Yesterday I walked a 50-ish patient from the ED waiting room to a treatment room. She ambulated steadily and had come to the ED from work for an urgent-care type complaint. As I was getting her a gown and orienting her to the room, she said, "I'll need a bedpan soon." Her complaint was not one we would need a urine or stool sample for diagnosis. I replied, "let me show you where the bathroom is before you get undressed, then" ... thinking to save her from having to walk the halls in the dreaded hospital gown if it could be avoided. She looked levelly at me and said, "oh, you're going to be one of those nurses -- you don't want to wait on me or take care of me."

    I'll spare you all the rest of the conversation -- but in her mind, coming to the hospital for what would probably be a little over an hour visit meant that she should *enjoy* the perks of another human being "waiting on" her - hand, foot, and peri-area.

    True story.

  13. Visit  imintrouble profile page
    5
    The pts that really get me are the ones who look hurt when you balk at personal care they can perform themselves. Who can't believe you're not chipper and perky, and ready with the wash cloth whenever they ring.
    They'd never expect a waitress to feed them in a restaurant.
    Wouldn't expect a saleslady at the dress shop to dress them.
    But think a nurse's job is to do anything the pt doesn't feel like doing.
    Last edit by imintrouble on Feb 21, '13

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