Patients who can do ADLs but want nurses to - page 4
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
Feb 21, '13Quote from kmarie724Well, 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!...... I've never seen anyone who wanted a catheter before.
Feb 21, '13Quote from AltraThat 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?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.
Feb 21, '13Quote from CrunchRNMaybe patients asking for unnecessary help with peri care are perverts? Is that too strong a word?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.
Feb 21, '13No. I was trying to behave for a change so I didn't say that word, but that is totally what I think!
Feb 21, '13Quote from Kooky KorkyNo, 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.Maybe patients asking for unnecessary help with peri care are perverts? Is that too strong a word?
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.
Feb 21, '13Quote from amoLuciaWhile 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 lolI 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.
Feb 21, '13Quote from Kooky KorkyIt'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!"Maybe patients asking for unnecessary help with peri care are perverts? Is that too strong a word?
Feb 21, '13I 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.
Feb 22, '13We'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.
Feb 22, '13Reminds me of a patient I had who was in contact for scabies....they would call for EVERY LITTLE THING. Independent with their ADL's, too. The problem was, when we answered the call light phone and asked what she needed, all she would say was, "I NEED MY NURSE!" or "I NEED MY AIDE!" So we had to don all of our battle gear each. and. every. time. ugh. One time I went in and she asked me for a piece of toast. Seriously?!
As for patients who are perfectly capable of doing their own peri-care but want us to...that is gross. I would be embarrassed if someone else was doing my peri-care and I could do it on my own. I would MUCH RATHER do it on my own. Patients are weird.
Feb 22, '13When I was a nurse assistant I saw this happening all the time!! So every time I walked the pt to the bathroom I would make sure they had everything they needed to get cleaned up. I usually said to them, in our unit it is our goal to make the pts as independent as possible after surgery and before discharge. We want to make sure pt is stable to walk, able to take a shower or clean herself up, we want to make sure you can be as independent as possible at your own home. I had pts who were not stable to walk on their own and also in so much pain postop. I had to give bed baths, I would tell the pt I will hand you a wash cloth and I want you to clean up every area you can reach. I will help you with your legs and back( specific). When I first started working as a nurse assistant I was doing everything for the pts until a seasoned nurse told me to use the words mentioned above! Saved my life !
Feb 22, '13I try to make sense out of things that make no sense. If I can figure out why people do what they do, then I can direct my interventions appropriately. Some people are just weird. I can't possibly think like them. OK...A different weird than me The others, that are perfectly normal, nice, 60-80 yr olds who just expect in the hospital what they don't need, surely I can figure it out.
I think it's all about control/power. It's what makes the whole world turn. Only I can't figure out why a perfectly normal, able bodied person, would give up their control to someone else. Or why that would only occur in the hospital.
The only thing any of us can completely control is ourselves. When our bodies act up, we go to the hospital and we control nothing. Would that make the pt feel helpless?
Then I think, who's in control when the pt demands peri care they can do themselves? Who's in control then? It certainly isn't me, who's expected to do anything to make the pt happy.
I overthink everything. I need to take the psych hat off cause it just makes my head spin and my brain hurt.
Maybe it's just as simple as some people are just weird.