Published Apr 14, 2011
Florence NightinFAIL, BSN, RN
276 Posts
I had a pretty intense night shift 3 nights ago. 6 pts in med-surg floor, 7pm - 7am. So around 8:30 pm I completed meds and assessments for 5 of my patients (I do quick round of everyone after report) when I noticed that one of my confused pts was wanting to leave the floor. He was getting agitated, agressive, loud etc. He was very confused and insisted that he was healthy and well enough to go home (he also thought it was 1954).
Anyway I had to deal with him and security, call doctor, get orders, call family, do charting, etc. That took up quite a bit of time and after I was finished (around 10 pm) I went to my last pt (who I left after taking her vitals) to complete my assessments and charting.
She was not happy.
Her: Your late. You should have done this sooner.
Me: Sorry?
Her: It's almost 10pm. It's time for me to sleep. How come you didn't do this earlier?
Me: [HUH??!!]. I'm sorry ___. I understand but I had to deal with an urgent situation. Besides, 10 pm is not that late.
Her: *rolls eyes* Fine. Get it over with quickly.
I was still worried about my patient who was screaming down the hall and threatening to beat everyone up and didn't have the energy to continue with her so I just finished my stuff and got out.
What? Did she honestly think she was going to get her regular beauty sleep at the hospital? Obviously she is here for a reason, meaning she's not well enough to go home, therefore it should be expected to have interruptions in her usual routine.
Let me not mention the doctor who ordered the bare minimum sedation med (which had no effect on the pt) even when I asked him to give me the usual range.
jammin246RN
94 Posts
Gotta love drama queens.... We have a Dr who orders 1mg of haldol for agitated patients... IM. Usual dosage as you may recall is 5mg.... Ah well just enough to upset the patient. Keep your chin up, you can't please all the patients all the time. I have had patients scream at me for being 20 min late with their pain meds while we were working a code. No worries, when you get off enjoy a movie
macspuds
76 Posts
Nights, days like yours happen more often than folks realize, but it's all part of the job.
Don't take anything personaly for you are special to all that you care for. They just don't know it.
Try to roll with the punches. macspuds
Davey Do
10,608 Posts
When some one asks me if I'm serious, I answer, "As a myocardial infarction".
A general Rule that I like to adhere to is: Most Patients in the Hospital or a LTC Facility are Personality Type C. That is, they're Victims. And Caregivers are the Perpetrators. From their perspective, we have a lot of control and they have very little. And some Patients are just looking for a reason to be upset. As you know, Indigo Summer, reasons are not hard to find.
Keeping this "Every patient is a Victim" Concept in mind allows me to expect and deal with the type of behavior that you ran up against, Indigo Summer. Victims will always look out for themselves. Their job is not to be understanding or empathetic. Their job is to keep an eye out for Preditors, else they be eaten.
Part of our job is to show them that we're on Their Side.
Dave
Orange Tree
728 Posts
I would cheerfully say, "I'm going to be even later to the next patient's room!".
ChristineAdrianaRN, BSN, RN
1 Article; 168 Posts
I hate that crap. The funny thing is that I triage my assessments by who I think would be the least angry with me for getting to them late. Pretty sure that isn't how it should work, but it's the most practical!
I had one patient who got really upset with me that I passed her HS meds (scheduled to be given at/around 9pm)....at 8:30pm. And that's only because she screamed at me. Why? "I normally take them at 7:30pm so I can be in bed by 8:00!" I tried to explain that she's in the hospital and the routine is not going to be the same as it is for her at home. She didn't care. She was 98 years old. I let it slide. Ha.
Mrs. SnowStormRN, RN
557 Posts
Sounds like your patient has the "Arent I your ONLY patient?" syndrome. If you get my drift. Many pts seem to think we dont have to care for anyone else other than them. Im sure this wont be your last time you encounter a pt with this, and to my knowledge there isnt a cure.
nursie_pants
53 Posts
Oh, we get those gems on our floor as well. :) I had a patient tell me a couple nights ago that I enjoyed waking patients up in the middle of the night. I wanted to roll my eyes. Yup, that's why I became a nurse: to sadistically wake you up as soon as you fall asleep.
When we have these kinds of patients - who forgot they were in a hospital, not a health spa - I gently remind them that we are first and foremost concerned with their treatment and keeping them safe.
I then also remind them that they have the right to refuse (and I always use the word "refuse") any treatment while they are here. I think it restores a sense of power that is commonly lost w/patients, especially those who have been in the hospital for some time. Usually they'll have a come-to-Jesus moment and either refuse their 0200 vital signs (which I'll thoroughly document) or agree to follow their treatment plan.
ocean waves
143 Posts
Hello. Thanks for sharing your interesting thoughts about the possible outlook of many patients such as that ".... they are Personality Type C,victims and caregivers are predators....". Though it has long been known that many patients have a perception of loss of control when they are admitted to medical facilities, your words seem shine a brighter light on how patients may see nurses as "predators". Good point! I agree with your comment that "...part of our job is to show patients we are on their side..." . Best wishes.
V-Neck T-Shirt
67 Posts
Isn't it amazing when you get patients who behave completely opposite to that? You know, when you walk into his or her room and apologize for being so late with meds/water/whatever, and they say, "That's okay, honey, I know you have other patients much sicker than me"? Sometimes, when I've been running for hours and a patient says something calm and kind like that, I could just hug them.
nursel56
7,098 Posts
When some one asks me if I'm serious, I answer, "As a myocardial infarction".A general Rule that I like to adhere to is: Most Patients in the Hospital or a LTC Facility are Personality Type C. That is, they're Victims. And Caregivers are the Perpetrators. From their perspective, we have a lot of control and they have very little. And some Patients are just looking for a reason to be upset. As you know, Indigo Summer, reasons are not hard to find.Keeping this "Every patient is a Victim" Concept in mind allows me to expect and deal with the type of behavior that you ran up against, Indigo Summer. Victims will always look out for themselves. Their job is not to be understanding or empathetic. Their job is to keep an eye out for Preditors, else they be eaten.Part of our job is to show them that we're on Their Side.Dave
I need to keep this in mind - for when the planets align in just such a way that you have an uninterrupted run of the most vocal of the species it can take a real toll on your spirit and even cause a person to wonder what the point in doing this job would be other than as a means of making sure Maslow's hierarchy (that applies to us, too--right?) is met in the proper sequence . . .sighhhhhh
Thanks for the reminder Dave
jollydogg_RN, ADN, BSN
333 Posts
I had a pretty intense night shift 3 nights ago. 6 pts in med-surg floor, 7pm - 7am. So around 8:30 pm I completed meds and assessments for 5 of my patients (I do quick round of everyone after report) when I noticed that one of my confused pts was wanting to leave the floor. He was getting agitated, agressive, loud etc. He was very confused and insisted that he was healthy and well enough to go home (he also thought it was 1954). Anyway I had to deal with him and security, call doctor, get orders, call family, do charting, etc. That took up quite a bit of time and after I was finished (around 10 pm) I went to my last pt (who I left after taking her vitals) to complete my assessments and charting. She was not happy.Her: Your late. You should have done this sooner.Me: Sorry? Her: It's almost 10pm. It's time for me to sleep. How come you didn't do this earlier?Me: [HUH??!!]. I'm sorry ___. I understand but I had to deal with an urgent situation. Besides, 10 pm is not that late.Her: *rolls eyes* Fine. Get it over with quickly.I was still worried about my patient who was screaming down the hall and threatening to beat everyone up and didn't have the energy to continue with her so I just finished my stuff and got out.What? Did she honestly think she was going to get her regular beauty sleep at the hospital? Obviously she is here for a reason, meaning she's not well enough to go home, therefore it should be expected to have interruptions in her usual routine.Let me not mention the doctor who ordered the bare minimum sedation med (which had no effect on the pt) even when I asked him to give me the usual range.
I dealt with this almost every....single....day on med/surg. I will not work in another hospital until staffing is more in control and is more in-line with acuity (probably never, but thats ok. i dont care).
You know, I would have had the same reaction as you last year, but somewhere along the way, my skin got thicker (for me, not insulting you), and it's like thompson's water seal just got painted all over my body. Everything just rolls off me now.
Maybe she was expecting you at a certain time? How long had it been since someone had been in her room to check on her? Just understand she probably wants to get the ^&*% out of the hospital and get home. Can't let little things like that bother ya, no use even putting it in your mind for one minute. Kill them with kindness, and everything will be better. Apologize once, and that's it, because you had a job to do and you were overworked. That's all there is too it. Any employeer who doesn't recognize that is one that isn't worth working for.