What makes a "good patient"? - page 2

by moriahcat 3,764 Views | 21 Comments

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... Read More


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    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.
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    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.
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    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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    A good patient, at least for me, is someone who takes control of his/her medical illness. They are involved with every process and eager to learn about their condition. Those patients are the ones who will probably maintain their health regimen outside the hospital and hopefully, stay away from hospitals.
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    In school we're trained that a "bad patient" is one who prevents you from dealing with their problem. Someone who doesn't complain of pain or new symptoms prevents you from helping them. It may not add to the nurse's daily aggravation, but it makes the job harder.
    It seems like the do-gooder thing to say, but after working in rehab a few months, I've seen people hurt themselves because they didn't want to be a bother. The end result is an incident report and crap from a manager.

    Even if it doesn't get to that extreme, I'd rather have a needy whiner than someone who says nothing to me and complains to their family/friends or our supervisor that we're not doing anything for them.
    opossum likes this.
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    Quote from Nurse_
    A good patient, at least for me, is someone who takes control of his/her medical illness. They are involved with every process and eager to learn about their condition. Those patients are the ones who will probably maintain their health regimen outside the hospital and hopefully, stay away from hospitals.

    The exception to that rule are the Web-MD licensed doctors lol. Its great to want to know more about your health issues, but making yourself a hypochondriac with Web-MD is no better than knowing nothing at all!
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    Hmm, good patient...
    -Polite (as others said, please and thank you, pay attention to you when you are talking to them)
    -Involved (ask questions when the doctor is there, know their medications and health problems)
    -WANT to get better, and do what is required for that to happen.
    -Do what you can for yourself. If you can use the bathroom, do it. If there is nothing physically keeping you in bed, I would rather push you to the bathroom on a commode chair than have you use the bedpan. And for Gods sake, wipe your own butt!! :P
    -Don't make me chase you for treatments and medication. If you have IV meds due at a certain time, try to be at your bedside 15-20 minutes early, just in case I can get there earlier.
    -Be reasonable. That goes both directions. If you want something that is not a priority ie. an extra pillow when there is no respiratory issue, then expect that you might have to wait while I deal with more urgent problems. I will get to it, but not before someone who can't breathe or is actively crumping. Then if you have an actual problem or issue, ASK ME! They don't give us a crystal ball when we pass NCLEX. I can't read your mind. If I could, I probably wouldn't be where I am today. You are my patient, and I want to help you, but I can't do it if I don't know what is wrong.
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    I agree with "imintrouble" about getting off the cell phone. Don't lunge and grab the phone just because it rings while I have a stethoscope to your chest. Please turn down the TV when I (or a doctor) come into the room. Don't cough directly into my face, esp. without covering your mouth.
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    R-E-S-P-E-C-T. That is all.
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    Polite and reasonable.
    That's all we really want.

    If you need something, call.


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