Things you'd LOVE to be able to tell patients, and get away with it. - page 28

:spin:Just curious as to what you would say. Mine goes something like this: Hi, my name is AngelfireRN, I'll be your nurse tonight. I am not a waitress, nor am I your slave. Yelling... Read More

  1. by   leslie :-D
    Quote from SoundofMusic
    To Ms. so-called "chronic pain" patient who demands her dilaudid right on time and undiluted, along with her methadone, her lyrica, her vicodin and her daily percosets for her 400 lb 5' 1" body -- YOU are a disgrace. You are NOT sick -- you are obese and a heroin addict and you refuse to take care of yourself, bathe, or complete any of your tests the doctors has ordered. You are lying here in an expensive hospital bed, of course with no job and no insurance in you are in your mid 50's, (not your 90's) and DEMANDING care and treating all your nurses and doctors like crap, whining and crying and dramatizing -- because you know damn well you can get away with it.

    I'm sorry, but I don't believe your stories. I think you are faking it. If it were up to me, you'd be sent home to detox on your own -- If you die -- well, that's too bad. YOU are the one who decided to do heroin all your life instead of facing up to life's problems. Perhaps you should pay the price for this -- not me, not society, not the U.S. taxpaying, hardworking citizens. Perhaps if someone should hear of your plight, they would decide against doing heroin because perhaps they'd realize no one was going to bail them out of it.

    It's people like you who will put me out of nursing. I can take the mean docs, the crappy co-workers, the hard work -- but I can't take you -- and I refuse to continue to be YOUR servant. If you were actually paying for your healthcare, it might be one thing -- but to lie there and demand that society does this for you because you have ***** up your life so badly, -- I can't even stand it.

    If this is who Universal Health Care is going to take care of -- I'm leaving this country. Heck, it already IS UHC as we continue to take care of these losers, allowing them to work the system and suck it dry. It's not fair and we should be ashamed of ourselves and our government for allowing it.

    Someone shoudl follow these people home and see to it that their stories are true or false, or whatever the case may be. Right now we have to take them for their word, and I have a feelilng their "word" is not worth much.
    i understand this is a vent thread, so just let me say...
    WOW.

    leslie
    Last edit by UM Review RN on May 27, '08 : Reason: Quotes edited post
  2. by   AngelfireRN
    Yep, Leslie, I think it safe to say someone had a REALLY bad day at work.
    Seriously, though, I have really, truly wanted to say that so badly to a select few in my career that really steamed my clams. Especially when I knew that I'd run into them at Wally-World the next week, doing fine, cart full of junk food, walking upright, not grunting and moaning fit to make me hold my ears. It was truly a remarkable metamorphosis. I wish I could figure out how to bottle it. "The Wally-World Cure" I'd make a fortune. LOL
  3. by   SoundofMusic
    Let me clarify. And I did have a bad day with this woman. It was ridiculous -- and the worst was not being able to adequately take care of my other pts because this woman was so demanding every 5 minutes with her "pain relief." She'd turn on the tears at the flick of a switch. It was ridiculous.

    If these folks were at least the slightest bit humble and GRATEFUL for their care, perhaps I could stand it. But here they are demanding, screaming, mad at you, the nurse, for every little last thing that goes wrong, for every 5minutes they have to WAIT for something so routine. They complain non-stop about everything -- I say let them go HOME.

    I don't feel they should be allowed to demand their care. They are lucky to be receiving it -- lucky that anyone puts up with their nonsense, and pays for it to boot.

    Is that tough to hear? Well, I'm sorry -- but it needs to be said. Our society just coddles these people, demands nothing from them. It's bringing us down as a nation and I think it needs to stop.
  4. by   leslie :-D
    trust me soundofmusic, i sooooo understand.
    the only thing i was taken aback about was "if you die, oh well...or something to that effect.
    and truthfully, my line of thinking was along the lines of angel...that you had an incredibly baaaaad day.
    but yeah, i very much empathize w/you.

    leslie
  5. by   shetazrn
    In so many ways I agree with soundofmusic. I cannot take care of patients that are in the ED with an MI or a GI bleed because I am taking care of "the squeaky wheel." It makes us cynical. We didn't get into nursing for the money, we would have gotten out by now. We wanted to care for patients. We try our best not to judge, but it surely is difficult when you pull a visit history and find out that the person in bed A that is screaming his/her head off has been here 50 times in the last 52 weeks for the same "pain" and the man/woman in bed B has a GI bleed and hasn't said a word for the 2 days that they have been here. UGGGGGGGHHHHHHHHHHH
  6. by   jessiern
    How about this:

    Suppose Patient X is in and out of facility often. Suppose this patient demands large doses of demerol. Don't order morphine, or dilaudid, nubain. Nope, demerol. 75mg every 2 hours for a 180 lb man. Who you have to wake up everytime you go in the room. Or, if they are awake is eating burgerking (dx: abd pain). Sometimes you can't find them...they are in the waiting room watching tv with friends.

    Also, suppose patient X calls nurse's phone every 30-45 minutes to ask for pain meds. Dont' forget, nurse also has 5 other patients with REAL med needs.

    Wouldn't it be nice to say "Patient X. DO NOT CALL MY PHONE AGAIN FOR PAIN MEDS. I have 5 other patients with needs, and I can't attend to those due to you pestering me. At 34 years old, you can look at the clock and see it is not time. When it is time, I will bring it. If I dont' come AT THAT MINUTE you can assume I am too busy at the moment, so dont' call me to remind me. Believe, you are not forgetable. You may call if you have any other needs. But DO NOT CALL ME FOR PAIN MEDS"



    Oh yeah...I did tell that to Patient X
  7. by   BlueRidgeHomeRN
    Quote from angelfirern
    especially when i knew that i'd run into them at wally-world the next week, doing fine, cart full of junk food, walking upright, not grunting and moaning fit to make me hold my ears. it was truly a remarkable metamorphosis. i wish i could figure out how to bottle it. "the wally-world cure" i'd make a fortune. lol
    lol!!!chuckle

    i've seen them look at me, blanche, and start in with a fake limp.

    had a diabetic tell me the junk food in the basket was for her grandson, not her [sure, and i've got property in louisiana that's great at low tide!!] she came to me, btw...i don't even say hi to pts unless they speak first.
  8. by   imburnedout
    Not just patients, my own family members as well (in-laws), people never cease to amaze me:

    1. Being a nurse does not qualify me to be the family doctor. If you are sick, call your doctor. I've just worked 12-16 hours on my feet, so no! I don't want to drive across town to look at your swollen ankles when I know dang well that you havent been compliant with your diet or diuretics because you wanted to go play bingo today and skipped your lasix.

    2. Yes, I can understand why your joints hurt, they are carrying around an extra 200lbs. Yes, it does make sense that your knee wants to buckle after a while of standing.

    3. Yes, you are going to keep chronic bronchitis when you continue to smoke 3 packs of the cheapest brand of cigarettes available; and no I can't fix it for you.

    4. To the 19 year old patient with 3 babies at home: I don't care if you are mad that I won't go "swipe" you a bag of diapers to take home to your kids. Is it not enough that I have to come up here and put up with you, so they can take taxes out of my check to pay for the medical expense for you to keep spitting out babies, and to get treatment and pain relief for those "spider bites" that you only seem to get along the viens of your forearms, that you seem to get at least once a month?

    5. No sir, my job duties do not include helping you out with that erection, or satisfying your need for a woman's touch.

    6. No mam, I do not speak spanish. Would you go to a nudist colony and ask them to put their clothes on?

    7. No mam, I can not tell you how much of your mother's B/P meds you should take.

    8. No, I can not give you just a little extra pain meds and yes they will miss it.

    9. No I really don't want to come wipe your butt just because you are too big to reach it.

    10. No mam, we can not keep your momma an extra day or two because you want to go visit your cousin out of state.

    11. Yes mam, your mother is very sick and we are doing everything we can to help her; though it seems she is sick because no one has checked on her in some time and she had to resort to eating cat food because no one saw to it that she had food.(this really happened)

    12. No, we will not insert a foley because you don't want to get up to use the bedside commode RIGHT NEXT TO YOUR BED!! (actually had a pt. ask for this once)

    13. I'm sorry, we are fresh out of the cure for stupid.

    14. What?? Your ticked because you've brought the whole family to visit daddy in the nursing home and he's all dressed up in a hospital gown and someone else's socks?? Then bring him some clothes!!!

    15. No I will not call the doctor out of surgery to come talk to your daughter since she had a hair appointment this morning and missed him.

    16. No, I will not let you (patient) bum a cigarette.

    17. No, we can not just call you in a prescription for oxycontin, as you are not a patient here, or no we can not refill your pain meds early because you accidentally flushed THE WHOLE BOTTLE down the toilet again.

    We actually had to evict a patient out of the nursing home because his wife was getting his check every month but refused to pay his bill. I later learned that ours was the third facilty he had been evicted from for the same reason.

    But my all time favorites are the ones who show up to the ER screaming chest pain, only to find out they've had a sore throat and didn't want to have to wait in line behind all those other people.

    To the young, new, frat-boy doctors: NO, I will not just "fix it" and send you the order to sign. I would however like to find out where you went to med school, so I can sign up. **With this particular doc, we've actually had to send the police to his home to get him when he wont answer pages, calls or faxes when he is on call for ALL the docs in town**


    Just my rant's but then.... I'm burned out.
  9. by   -MNC_RN-
    I'm going out on a real limb here, revealing more than I normally would. I do this becuase I think it illustrates a very real frustration that nurses can have and to show that we are all, in fact, human and can do stupid, stupid things.

    Keep in mind that: I actually said this to a patient, and that I did not get away with it.

    I said this when I was overworked, overtired, and dealing with some personal stress. This does not excuse my actions. Remember, though, that as a nurse, you may experience the combination of factors I did. Make a different choice.

    Patient was admitted to my unit after his third, or fourth suicide attempt--overdose. Vented in the ED but waking very nicely, thank you. After confirming that he was, in fact awake and able to appropriately follow commands, we extubated him.

    He immediately began a foul-mouthed tirade against my hospital, about how horrible the care was, about how he would rather have gone to such-and-such hospital, but they didn't give him a choice, etc. He started flaming me personally, and all of my fellow staff had the pleasure of his wrath as well.

    I had had enough. So at one point I snapped and said...


    [Wait for it.]








    "Well, the next time you try to kill yourself, do a better job!"






    It was like I was outside of my body. I could see the words in a balloon over my head as I desperately reached out to shove them back in my mouth.

    Ooops.

    The charge nurse was in the room with me at the time. His jaw hit the floor.

    Fortunately, his family (sort of) supported me and informed him that he deserved what I said. (I don't agree with that, but at the time I took any support I could get.) My fellow staff did a fantastic job of calming him down and talking him out of a lawsuit. My manager just about burst into tears when I told her about it the next morning. (Imagine the first thing you hear at 0700 is one of your favorite staff greeting you with, "Say, we need to talk about something...")

    I use this almost every time I teach a class to illustrate that even we nurses get burned out by things or do/say things we regret. There is no "super-nurse".

    By all means, enjoy thinking the things in this thread as a form of therapy. But keep an eye on your emotions. If you're thinking these things too emphatically, you need to talk to someone for your own sake.
    Last edit by -MNC_RN- on May 27, '08
  10. by   SoundofMusic
    MNC, thanks so much for your candor and insight. We could all use a lot of that around here, as well as at work.

    I think I'm at this point now, in a baby jr. nurse sort of way, and if I stay any longer, it will grow to be a really festering problem. I need to talk to someone about it.

    I will admit, I have a hard time with these types of patients. I'm very impatient with it. I'm a person who had a very tough childhood, yet survived it and went on to build a beautiful life and family w/ my husband of 20 something years. I had choices and took the high road every time, even though it was tough and I was tempted not to. I wanted to give up at times, but didn't. I am all about hard work, being ethical, being honest, and doing the right thing. I have a lot of impatience with people who do not.

    People who are truly SICK -- now for them I have all the compassion in the world. I'd almost trade places with them at times -- or at least want to be there for them in the most real way I can. I pray for them personally, at the end of my shifts and they are constantly on my mind when I go home.

    I want to be dedicated to people who are sick - not people who are faking it to get drugs and feed their terrible habits.

    I dont know where to get "help" for this feeling? Where can I go? Any books to read? Suggestions? If a hard lecture is what I need -- then by all means, someone step up and do it. I just don't know where else to turn with these feelings. I am a Christian person, but somehow, my faith isn't coming through for me here . . .
  11. by   rph3664
    Quote from imburnedout
    Not just patients, my own family members as well (in-laws), people never cease to amaze me:

    <<snip>>

    We actually had to evict a patient out of the nursing home because his wife was getting his check every month but refused to pay his bill. I later learned that ours was the third facilty he had been evicted from for the same reason.

    <<snip>>

    **With this particular doc, we've actually had to send the police to his home to get him when he wont answer pages, calls or faxes when he is on call for ALL the docs in town**


    Just my rant's but then.... I'm burned out.
    The first patient: Wow. Just wow. How cruel - and how long before word gets out and NOBODY will take him?

    As for the doctor issue, we too have a doctor, who looks after LOTS of patients, who answers pages whenever he feels like it. Calling the police - never thought of that!
  12. by   -MNC_RN-
    Quote from SoundofMusic
    I dont know where to get "help" for this feeling? Where can I go? Any books to read? Suggestions? If a hard lecture is what I need -- then by all means, someone step up and do it. I just don't know where else to turn with these feelings. I am a Christian person, but somehow, my faith isn't coming through for me here . . .
    Well, first of all, it's completely normal to feel this way. We are only human after all, and resentment builds against our wishes. Most of the time it works to simply acknowledge you feel that way, then let go.

    When you can't, you need to go a step further and talk to someone who understands. Forums like this one are actually quite helpful for that. Not only do you get to vent safely, but you will hear that you're not alone.

    If it's becoming a festering problem that's actually affecting the way you interact with others, then you need to leave. Not nursing, necesarily, but where you are working.

    Back when I started, I worked in cardiac care. I loved, and still really enjoy cardiac medicine. However, I hated the patients. I hated dealing with fat, diabetic, smokers who thought that all they had to do was come to me for a cure and then back to their old lifestyle. I hated that people in general didn't care about their health until too late. I hated people blaming their crap life on "genetics" and "oh well, since I'm doomed anyway, I might as well have this side of rare beef..."

    Hated. Hated. Hated.

    So I moved to trauma. Where I dealt with gangbangers, wife beaters, child abusers, murderers, a-holes who would kill families while driving drunk, or idiots who thought it was a good idea to car surf.

    You know what? It doesn't bother me. Not one stinkin' bit. I don't like these people per se. In general they're a pretty dispicable bunch. But as a nurse, it doesn't bother me. They're in pain and I help them. They're scared and I comfort them.

    Now why is it that I can't stand the one population (the one where genetics really can give you a crap hand) and work so well with idiots and bottom-feeders? Beats me. No accounting for taste, I guess. My point is that I'm a thousand times a better nurse dealing with one group than another. If I stayed in cardiac, I'd be an angry, eat-our-young sort of nurse. Instead, I give what I can, and leave satisfied and fulfilled.

    All of this is the long way of saying, your feelings might not mean that you're a bad nurse, or not cut out to be one... maybe you're just helping the wrong people.

    Or maybe you're just in a funk. Heaven knows we all get in one now and then. Eventually you'll get out and be wiser for it.

    Either way: talking helps.
  13. by   twistedpupchaser
    MNC RN you have hit the nail on the head. While I am stil relatively new to nursing I have found that I have certain populations that I am able to work with better than others. In my instance I need to wait for more experience in particular fields to move into the area of nursing that I wish to specialise in.

    In the meantime I have developed some coping mechanisms of my own. I talk, with a group of colleagues over a few drinks, (this is a group that I started my pre-nursing education with... we are still close). I try however to only bring home the "fun" side of nursing home, funny stories or the ones we "saved". If I told my wife the bad side of nursing or vented with her we would both be unhappy, she reminds me of the good side of this career decision when things are harder.

    Another thing that helps is sites like this, I started a thread while still a student because of a situation that I found on ward. I realised that everyone had a similar enough experience that they gave me good advice that helped me through the rough patch. Reading the humour threads also helps...(I have my favourite threads).

    If these things don't help there are organisations who have mental health professionals who specialise in providing counseling and coping mechanisms to health providers who are going through a rough trot with work.

    Good luck with finding something that works for you. Just dont lose faith, "Not all patients are idiots! You can't help the good ones if you let the bad ones get you down" (The bad ones also make the good ones that much better)

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