What makes a "good patient"?

  1. 1 I have seen venting (normal and appropriate) about problem patients, and sometimes it's enough to make me wonder how anyone can go into the profession. Yes, it's part of what made me decide to focus on my technical skills when I was considering going into nursing... I've known a lot of nurses, at all levels. It's a hard job. I'm also prone to understatement.

    I'm relatively young, but in the last year I've had two admissions to the medical/surgery unit due to respiratory issues (pneumonia both times, but the asthma exacerbation portion was what I think made them admit me). I was laid off shortly after being discharged from the first admission, and wasn't able to maintain my COBRA coverage, so last week when I was there for two nights, I didn't have insurance. The hospital is being really, really good to me, and they even filled my antibiotic prescription for free (that was the one I was really worried about in regards to cost, it wasn't cheap).

    But I know I'm not at my best when I'm sick -- I don't think anyone is. The fact that I'm a charity case right now makes me feel even worse if I annoy the nurses. Both times I've been in, I've been put pretty close to the nurses station, so I heard enough both times to know they were extremely busy with patients with a much higher acuity than mine.

    So... I really tried not to hit the call button. I mean, they checked on me enough that, for example, this last time I only had to twice... once when they'd wanted me to save a urine specimen and there wasn't a hat or a cup or something in the bathroom, and I needed to go. The other time was the one I feel really badly about because they were slammed and I could hear it both in the lady's voice who answered the button, and just the noise of the ward in general.... they'd had a hard time sticking me, so when they moved my IV site to my left side, they left the IV port in the right hand that the ER had put in. My fever had broken and I sweated through the tape, and the IV port came out. I had pressure on it by the time they were able to get to me, but I'd managed to bleed all over.

    They did have me on oral pain medicine to help with the pain of coughing, but I knew that was the absolute lowest priority in comparison to keeping me breathing, and keeping other patients who were likely post-surgical comfortable. During morning shift change the second morning, I'd asked for my pain meds, but I knew they'd come when the rest of my meds did. They'd worn off overnight and when the RT came in a little over an hour later, he could tell I was extremely uncomfortable when coughing for him, and hit the call button and asked for the pain meds then. Without me asking. I felt badly because I knew I hadn't been forgotten about, just that it was busy, and it could have seemed like I had complained when I hadn't.

    I also *always* said please and thank you. I mean, that's just manners.

    But are there any other tips that you guys would have for patients who really don't want to be pains in the tookus?
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  3. Visit  moriahcat} profile page

    About moriahcat

    Joined Mar '13; Posts: 16; Likes: 9.

    21 Comments so far...

  4. Visit  TheCommuter} profile page
    9
    Quote from moriahcat
    But are there any other tips that you guys would have for patients who really don't want to be pains in the tookus?
    Hello, and welcome to Allnurses.com! I hope you've recuperated from your illness by now.

    Offering pointers to become a better patient would, in my honest opinion, be pointless. I see nothing wrong with your description of your behavior during your hospital stay. I cannot see how you were a bad patient.

    "Bad patients" are a sign of the times. Values such as mutual respect, honesty, and unselfishness are disappearing as we head into the future. Too many people in society treat each other like crap, will tell lies to get what they want, and are so self-centered to the point that they only care about themselves.

    Our patients come from the society in which we live, so it should be no surprise when "bad patients" disrespect nursing staff, throw full urinals and poopy bedpans at the nurse, curse and swear, lie to stir the pot, and are so selfish that they'll complain to management when the nurse beings the bedtime snack late because she was involved in an emergency rapid response in the next room (yes, some patients know the nurse is coding someone in the next room, but they do not give a rat's behind about their fellow human being).

    My tip for you is to not change anything. You already seem considerate of other people, respectful, and gracious based on your posting style.
    poppycat, beckster_01, jrwest, and 6 others like this.
  5. Visit  eatmysoxRN} profile page
    7
    Honestly your consideration is admirable but you should remember that you are a primary concern. Nurses want you to be comfortable. Be lenient but if it's been 30 minutes and still no pain medications, call again. Nurses forget.

    You sound like you would have been a great patient. Hope you feel better and can stay out of the hospital.

    ~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~
    poppycat, dudette10, tnmarie, and 4 others like this.
  6. Visit  Ruby Vee} profile page
    9
    Unless YOU make a big deal of it, the nursing staff will never know whether you have excellent insurance, pay cash for your health care or are a "charity case." Nor do I really care. It makes no difference in the care I'll provide you.

    What does make a difference, and you'll see nurses (especially ER nurses, since they're at the pointy end of health care) vent about, is the patient who can afford the latest cell phone, cigarettes, manicures and expensive shoes but who makes a horrendously dramatic scene about not being able to afford her prescription for a $3 antibiotic. Or pregnancy test. That sort of thing grabs the attention of even us ICU nurses, when we encounter it. That, and the patient who throws a fit about one thing or another that cannot be helped and ends it with "You're just mean to me because I'm on disability." In fact, throwing fits at all is generally seen as "bad patient" or "bad visitor".

    A "good patient" is one who, despite being ill, makes an effort to be nice. Please and thank you are disappearing from our collective vocabulary, but the patient who remembers them is remembered in a good way. If I have to stick you 13 times, it isn't because I'm mean and want to torture you, so throwing a fit about it is nonproductive and being as nice as you can about it helps everyone through the difficulty. A "good patient" remembers that she's not the only patient I have, (and even if she is, she's not the only patient in the ICU) and is gracious if I forget the ice water after the patient next door is through coding. And a good patient puts on the call light to request the pain medication she needs so that she can participate in the physical therapy that's going to shorten her hospital stay. Really.

    The patients we like are the ones who accept the discomfort and outright pain of their treatment with as much grace as they can muster, who cooperate with our efforts to help them get better and who are polite to us. Beyond that, I don't know who is paying for your care -- and if I am, I'm happy to see my money going toward the care of someone who works hard to get better.

    Now lest you think that I am mean and just don't understand what it means to be sick, let me tell you that even though I'm back at work now, my participation in health care for most of the last year was as a patient. And I DO understand that some cultures are just more dramatic than others. There's something wrong, though, when the patient (ME) was doing her best to be calm and polite and multiple family members were attempting to outdo each other in the fit-throwing department because they were under so much stress because their family member was sick. (OK, I'm sorry. That last was off-topic but irritated me so much I can't seem to restrain myself from commenting.)
    poppycat, mercurysmom, anotherone, and 6 others like this.
  7. Visit  jadelpn} profile page
    2
    When one can't breathe, it is uncomfortable and anxiety inducing. When having to then go through some RT, it is painful. Because you are a nurse, you perhaps are more learned in what the floor is like, and that the nurses are busy with higher acuity. But higher acuity is subjective when you are in a patient room and not in the mix working. Charity case is demeaning to yourself. I really don't have the inclination to check out what insurance one has, or lack thereof, my goal is that you are comfortable and able to work with RT to regain your function. Please see the social worker at the hospital you were in to talk about insurance. If you have no income, then state insurance. See about unemployment benefits. If your asthma makes it impossible to work, then by all means see about disability. Or public assistance until you can get on your feet. You can't let pride get in the way of you being able to function. Best of luck.
    poppycat and uRNmyway like this.
  8. Visit  opossum} profile page
    1
    Everything you've described sounds like a "good" patient to me; I'm glad you've recovered. It must be tough being in the hospital, feeling miserable and worrying about stressing out the nurses...but I think that empathy you have for others is what makes you a good patient and, likely, a good person. Sounds like you were on your call light for completely appropriate reasons. If anything, the nurses may have sound harried around you because they feel bad for their one "normal" A&Ox4 patient with legitimate needs for pain meds and toileting, who is being neglected due to the 5 other patients and family members throwing tantrums over a forgotten diet coke or other perceived injustice.

    As far as insurance goes, it has no impact on the care I'm providing. I can easily find out that info just looking at the facesheet but I just don't care and can't be bothered.
    uRNmyway likes this.
  9. Visit  RNperdiem} profile page
    4
    On these boards the badly behaving patients get more press than the rest.
    The majority of patients are perfectly fine well-behaved people doing their best in a difficult situation.
    We get the occasional "beloved" patient, but like the outrageously bad, they are the minority on the bell curve of life.
    I have been in this business 19 years now, and I cut sick people a lot of slack.
    It sounds like you managed to walk the fine line in standing up for your needs while being considerate of others.
    Chlometov, opossum, LaRN, and 1 other like this.
  10. Visit  advsmuch08} profile page
    2
    It sounds rather simple but sometimes the please and thank you's make all the difference, especially on hectic days. Sounds like you are already a "good patient"
    imintrouble and bebbercorn like this.
  11. Visit  emtb2rn} profile page
    3
    Agree with rnperdiem. When all is said and done, i see more "good" pts than "bad" pts. And as stated by others, i don't care about your insurance. Everybody gets treated the way i want my family treated.
    RNperdiem, imintrouble, and bebbercorn like this.
  12. Visit  bebbercorn} profile page
    1
    In my experience everyone groans when the call light goes off, because 1) we're already busy, 2) we finally got a chance to chart or 3) we are sitting down for the first time in a shift. You sound like a great patient. Anyone who respects me and treats us with the kindness they would expect to receive is a good patient.
    Tina, RN likes this.
  13. Visit  moriahcat} profile page
    1
    Thanks for the well-wishes, I am recovering.

    And yeah, Jade, though I never became a nurse, I knew I wasn't at my best. Breathing is pretty important, and I was sure I sounded whiny and somewhat freaked out at being admitted again, especially the first morning while my sats were still really low and I had a lot of breathing treatments. I know my mental balance, and tons of speed+steroids doesn't help it. (And it may be because I'm only 110 lbs, but solumedrol makes me dizzy -- everything combined and I was very happy for the IV pole when getting out of bed so I had something to steady me.)

    When someone came in the room to check on me and asked if I needed anything, I tried to keep it simple. The only time I really had to wait for anything, beyond the med issue during shift change the second morning, was while they were getting me admitted to the floor (and of course the ER sent me up about 3:30, so that meant they hardly had any time to get me checked in before time for shift change). And all I had to wait for was tissues and an extra pillow.... things that were not exactly priority (I got up and grabbed toilet tissue when I really started hacking, it wasn't like there weren't other options). I got those things around 8 AM when it finally settled down. That may sound bad to some who think pillows are more important than breathing, but in between then I'd already had two breathing treatments, so it wasn't like the essential things weren't getting taken care of!

    Ruby: I really tried not to be a baby about the sticks -- I was dehydrated, and so I knew that was part of why it was so difficult, plus they still had droplet protocols going on since this started as a case of the flu... it was hard for me to breathe through the mask when they had me wearing it, I know it can't help when you're trying to concentrate. In the ER they hit the best vein they could find quickly, but after a few hours that line would only run if the tubing was held perfectly. My nurse had to get another nurse in to help get the second one going, and the fifth try got it... but it *hurt*, more than any stick I'd had in a long time. I was really embarrassed... didn't scream, but I know I made some noise and got teary-eyed. I heard them talking and I know they were using the smallest needle they could for all the fluids and antibiotics that were going to be going through it... I know no deliberate torture was involved.

    And goodness, no, you don't sound "mean", by a long shot. I'm honestly glad I only had my mother come to visit. Her husband called enough that I wanted to have the phone in the room turned off... (long story but he's a drunk and we've been on precarious terms, and he is trying to "make nice"... just doesn't know when to stop, and the booze doesn't help him in making that determination.) If he'd come up there and seen me miserable, he would have thought it was the "right thing" to try to demand this or that or whatever he thought would make me comfortable. Truth is, I was going to be miserable no matter what, and everything that could be being done was!

    A lot of my issue with this is that I am one of those people who just prefers to crawl into a cave when I'm sick. I don't like fuss and bother. And more than that, I hate being a bother.

    One last thing on this, because I know personal medical experiences aren't exactly what this forum is for:

    The non-pharmaceutical intervention that helped the most with my misery? Hot packs. The antibiotics hit fast, and my fever went down quickly. Once I wasn't running a fever, when I was uncomfortable coughing but didn't want any more pain medication, the nurse suggested a hot pack. I put it on my back where I'd had my extra pillow I was using for bracing when I was coughing, over the two lobes of my lung that were unhappy. It helped a lot with the dull aching that was there between coughing spells, and felt good as part of bracing during coughing, even if it really didn't make the lancing pain during the coughing dull much. At home I've been using a heating pad and an extra pillow the same way.

    Once she showed me those, that was at the top of my request list when someone came to check on me and ask me if I needed anything. Miracles in a shake bag!
    opossum likes this.
  14. Visit  JZ_RN} profile page
    0
    A good patient- polite and respectful, honest, amicable and reasonable, asks for what they legitimately need but do not abuse the light or the staff for ridiculous things, compliant, etc. Most are this way. I know when I was in the hospital I never whined about the wait (except maybe waiting for the doctor, but I didn't whine to the nurses, it wasn't their fault). I asked for only things I needed. (I woke up with a nosebleed, need a clean pillow, My mouth is like sand, please fill my water since I can't walk at the moment, need a bedpan, etc.) And I took my meds when they brought them, didn't try to keep them forever, always said please and thank you, cooperated with treatments/therapies. etc. A good patient is just one who doesn't make everything harder by being difficult basically. All patients are a little bit of work but that's why they call it work. A bad patient makes things hard or is just nasty to the nurses.
  15. Visit  imintrouble} profile page
    2
    I've given your question some thought. It's not so much what the pt says, although please and thank yous are rare, and appreciated.
    For me it's not the words, it's behavior.
    The pt gets off the phone when I come to the room.
    Mutes the TV when I'm assessing breath sounds. Looks at me when I'm speaking, instead of at the TV. If they can stand, get out of the bed/sit in a chair when their linens need changed. Help clear their table when meal trays arrive. Use their IS even when I'm not in the room. I can hear them from the doorway when I'm walking down the hall. Walk to the BR instead of asking for a BSC/bepan when there are no physical limitations.
    I guess it boils down to assisting in their own care, as much as they are able.
    Respect, for themselves and for me.
    uRNmyway and opossum like this.


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