Patients who can do ADLs but want nurses to

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cjcalimer

33 Posts

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.

Altra, BSN, RN

6,255 Posts

Specializes in Emergency & Trauma/Adult ICU.

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.

:facepalm:

Specializes in LTC Rehab Med/Surg.

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.

Paul'in'FL

45 Posts

...... I've never seen anyone who wanted a catheter before.

Well, after the doc nicked my bladder during a colon resection, I had the fun of a Foley for 6 weeks while the area healed. Can't say that it was "fun".....but it DID allow me to sleep through the night, something my aging prostate does not permit me to do routinely! :smug:

monkeybug

716 Posts

Specializes in Public Health, L&D, NICU.
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.

:facepalm:

That is just bizarre. I know, I know, I've encountered the same sort of patient, but I guess I'll never understand it. I cannot imagine expecting another human being to wipe my butt if there were any possible way for me to do it. I mean, is walking to the bathroom and wiping oneself really so burdensome?

I am not in acute care and I just find it amazing that people would want the nurse to do these kinds of things that they can do for themselves. Especially peri-care. That is some bizarre behavior if you ask me.

Maybe patients asking for unnecessary help with peri care are perverts? Is that too strong a word?

CrunchRN, ADN, RN

4,530 Posts

Specializes in Clinical Research, Outpt Women's Health.

No. I was trying to behave for a change so I didn't say that word, but that is totally what I think!:roflmao:

RNsRWe, ASN, RN

3 Articles; 10,428 Posts

Maybe patients asking for unnecessary help with peri care are perverts? Is that too strong a word?

No, not too "strong" a word, but not the right one either. Nope, not perverts, but people who for one reason or another feel that this attention is due them. Some think that being a hospital patient means that every little thing must be done FOR them.....some think that if they show the ability to do something themselves, they will be asked to do more (and they actually want to do much less). Some enjoy the attention, and the image of themselves as "too sick" to do whatever.

Most people are familiar with the syndrome of Munchausen by proxy (in which the damaged individual makes someone else sick to bring attention to themselves); how about all those we come across who would fit the bill for Munchausen Syndrome itself? They make themselves sick (or make it appear to be so) to further increase the attention they receive.

And some, let us not forget, are Just.That.Lazy.

uRNmyway, ASN, RN

1,080 Posts

Specializes in Med-Surg.
I work LTC, and I'm most taken aback by the older lady, who is alert, oriented and ambulatory. who is here for some short term rehab/convalescence post hospitalization. The LOL is now peeing the bed EVERY NIGHT while sleeping thru!

My CNAs do incont rounds q 2-3 hours and they tell me LOL is wet each time; she never asks to use a bedpan or walk with assist to BR even though CNA asks. (I mean afterall, the CNA is doing pericare and bedpad changes and/or a whole bed change if nec.) LOL never says she has pain and she very ably assists with turning & positioning as she chit-chats with the CNA.

When I go ask LOL what's up, she tells me it's the only opportunity she has had to get some uninterrupted sleep !!! At home, she has to trek to the BR during the nite and she hates to do so. This lady is due for discharge at the end of the week!!! There is NO reason in HADES for the incontinence.

I shift into my riot act discussion with her. At best, she risks urine burn or diaper rash, but at worst, she risks losing bladder tone for when she goes home. Like if she doesn't use it, she may lose it, and then she'll be peeing her bed and peeing her living room couch!!

The 'living room couch' comment really gets them to thinking as I believe they would find a peed couch embarassing and extra work, esp if she residing with dtr or son..

Boy, I have never seen a cure for incontinence occur so quickly!!! Fully ambulatory and continent at time of discharge.

While in your case the lady seemed to be A&O, I often had patients who were fine, lucid and oriented at admission and would develop as our MDs called it ' hospital related delirium'. Add to that drinkers who dont tell us they are drinkers, sundowning, etc...makes for fun times with the night shift and day shifters who think we are liars when we describe how their angelic LOL from the previous day grew horns during the night lol

Specializes in Orthopedic, LTC, STR, Med-Surg, Tele.
Maybe patients asking for unnecessary help with peri care are perverts? Is that too strong a word?

It's like... reverse voyeurism, or something. Last week I had a patient (elective joint replacement), like, spreading their cheeks and demanding I look at their hemorrhoid. "LOOK AT IT!" And then they poked it. I asked, um do you want some cream or something on that? "No, I just wanted you to see it!"

WHY?!?

I don't know if anyone else has noticed this, but when I was a student at the VA Hospital most of my patients were men and they wanted to do things for them self, whether they needed assistance or not. They wanted to maintain their independence. When I worked at my other hospital job as a nursing assistant, it was mainly female patients who were independently able perform ADLs but insisted that they weren't able to and needed assistance, especially with peri-care. That's gross. You're arms are long enough to reach down there. Whatever method you use at home is still be able to be used in a hospital. Anyway, that's MY EXPERIENCE.

LightMyFire

137 Posts

We've had a lot of requests for full bed baths from patients who could bathe themselves, not to mention the bed-poopers. Is it really preferable to go all over the bed rather than use a bedpan? Especially when they admit they know beforehand when they need to go? Twice lately the tech has been accused of being "mean" for suggesting that a patient use the bedpan. We even had a patient demand that the tech feed her, though she was fully capable. We refused.

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