Patients who can do ADLs but want nurses to

  1. 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 tissues that is a whopping 4 feet away and they have no physical reason to inhibit their ability to reach or get up and get them.

    Or the female pt that wants us to clean her after voiding yet she walked into the bathroom herself and did her makeup/ curled her hair that morning...

    How do you get the message across that we are not the maids/ wait staff/ personal assistant without making pt feel bad or making them angry? It's so frustrating.
  2. Visit  destova profile page

    About destova

    Joined Feb '08; Posts: 71; Likes: 128.

    75 Comments so far...

  3. Visit  Altra profile page
    15
    If I am absolutely sure it isn't pain, fear of falling or some other obstacle that we can potentially alleviate ... I am fairly direct in my approach. (yes, as you know, these patients are out there ... I've had patient walk unassisted into an ED treatment room and ask for a bedpan 5 minutes later)

    "What are you having trouble with?"
    "You are free to move about and set up the room however it's most comfortable for you ... just so that we can still get to you to provide the care that you need."

    Sometimes it's a *blank* look or surprised look from me -- "what has changed in your symptoms in the last 5 minutes?" that encourages appropriate independence.

    You'll have to find the wording that works for you.
    SycamoreGuy, RNMGR, tewdles, and 12 others like this.
  4. Visit  RNsRWe profile page
    32
    When confronted with the patient who feels it is "the nurse's job" to wipe the patient's butt even though the patient is perfectly capable of doing so, I tend toward this response: "it is the nurse's job to make sure that you do everything you are capable of doing....we have no intention of letting you become an invalid while under our care". Period.
    AmandaBusch, tokidoki7, Kooky Korky, and 29 others like this.
  5. Visit  CrunchRN profile page
    19
    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.
  6. Visit  RNsRWe profile page
    31
    As an afterthought, I am reminded of one patient who whined that it was hard for her to "reach back there" because she was overweight. I asked her how she managed at home....and she said she did it, but "didn't like to". Okaaaayyyy.....so YOU don't LIKE to do it, therefore WE should?! I informed her that if she felt it was necessary, I could arrange for OT to work with her so that she could learn how to stretch her arms far enough....sigh. She opted to clean her own bottom, no more requests.

    People are weird.
    flyingchange, tokidoki7, WeepingAngel, and 28 others like this.
  7. Visit  destova profile page
    3
    Quote from RNsRWe
    ...we have no intention of letting you become an invalid while under our care". Period.
    I very much like that response lol... to the point and not rude. Thank you


    Quote from CrunchRN
    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.
    I find it to be very strange... I'd personally be mortified if I had to let someone else do that. I think that's part of my trouble in figuring out what to say to some patients, I'm so confused as to their desire to have these things done. Especially after leaving a room where a lol apologized profusely for legitimately needing help. Why not be self sufficient if you can be?

    The non peri-care requests kind of irritate me at times. I'm running around like crazy trying to get everything done, and you want me to do what? I know there are times and cases where the patients have legit reasons for asking, don't understand that we are more than maids, etc. But the patients that act so entitled and demand so much are getting to me lately. I'm not sure why.... but ugh!
    AmandaBusch, Esme12, and anotherone like this.
  8. Visit  FLICURN profile page
    8
    I remember when I worked on a Med surg/ tele floor we had a mid 40's walkie talkie come in. He would soil the bed and then call for his nurse to be cleaned up. He would moan and complain when we asked him to move and when he was turned to his side he would lift his leg high in the air so he could have his genitals and between his legs cleaned. I was so incredibly disgusted. I think that flew with me once before I learned he was a walkie talkie. I told him after that he would be walking to the restroom since he walked into the hospital just fine. What's wrong with some people in this world!?! He also had some kind of weird relationship going on with his sister also. That's a whole different story!
  9. Visit  aei631 profile page
    6
    When I have a patient who is capable of cleaning themselves but doesn't "want" to..when they ask me I usually just hand them tissue/wipes/whatever and tell them if they aren't clean after THEIR attempt THEN I will assist. But like a previous poster said..if it becomes an issue or if it's something I feel is unrelated to their symptoms (such as pain) I just tell them that they have to "use it or lose it" and As their nurse I won't be the one that helps them grow weaker and more dependent...
  10. Visit  amoLucia profile page
    13
    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.
  11. Visit  edimo profile page
    2
    Quote from FLICURN
    He also had some kind of weird relationship going on with his sister also. That's a whole different story!
    Oh my, I've seen a few of these instances myself with a few patients but that's a different thread topic entirely lol

    I don't understand some people...they walk in completely fine for their admission and the first night, all hell breaks loose and they all of a sudden forget how to do things for themselves. I had a patient complain to another nurse that I didn't pull up his blanket all the way back up after doing morning blood work. Really? Is there something wrong with your hands all of a sudden?! Good grief!

    Btw, can someone enlighten me as to what capital LOL means? I'm clueless!
  12. Visit  Fiona59 profile page
    5
    Little
    Old
    Lady
  13. Visit  edimo profile page
    1
    Quote from Fiona59
    Little
    Old
    Lady
    Haha awe, that's cute!
    Fiona59 likes this.
  14. Visit  Nascar nurse profile page
    12
    I'm with the rest of you....people just amaze me with what they refuse to do for themselves! My two teenagers already know my criteria for when to "let me go" someday...when there is no reasonable hope that I will ever be able to feed myself & wipe my own butt routinely again. I also got into it with a nurse in the hospital once who told me I had bedrest orders and HAD to use the bedpan - first time I ever pulled the nurse card and told her in no uncertain terms "I'm a nurse too and I know I have the right to refuse & I will be taking the 4-5 steps to reach the toilet. I'll give you a bit to get the order changed if it makes you feel better but otherwise I'm just gonna get up and go". (Great nurse - she got the order changed STAT and I promised to be good the rest of my stay).

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