Are you or someone you love the worst patient ever?

dirtyhippiegirl, BSN, RN · Jun 4, 2012

My mom passed away a few days ago from COPD/heart failure complications. Obviously, she had quite a few hospitalizations over the last few years of her life and - dear god! - I witnessed first hand how much the nurses seemed aggravated by her, but didn't totally understand why until I started working in a hospital myself.

She had very limited mobility so was a full-transfer for toileting and also on the call light for every little thing. Glasses fell on the floor. TV remote out of reach. She would go through copious amounts of liquids - she was always needing more, needing more ice, etc. And she was that sort of patient who would call you in, ask for some ice, then call five minutes later wanting a pain pill. Us kids stayed with her and helped when we could, but she rarely had us around 24/7.

When she could still smoke, it was aconstant stream of “Can I go out and smoke?” No, she didn't wantthe patch or the gum. She wanted to smoke.

She hated being in the hospital onprinciple. She had polio as a child and thus spent quite a bit oftime I hospitals – maybe that was it? But she complainedconstantly. To everyone. Not so much towards the end because she wasso tired. And to her credit, she never cross-complained. Shedefinitely came off as the type of patient who would complain aboutyou to the doc or send in a nasty Press-Gainey or whatever but shenever wanted to get anyone in trouble. But I think the complainingwas even worse because she was usually in the hospital for a COPDexacerbation – essentially something that was self-inflicted.

She was a lawyer by trade – so sheasked a lot of questions. Often questions that no one had an answerto. During her last prolonged hospitalization, she became fixated onwhether the hospital used generic pain medicine and then what brandof generic. I argued with her for hours as to why her nurses wouldn'tknow that information, so she needed to stop asking.

If you did have an answer, or godforbid tried to correct her about something, she would argue with youuntil she was blue in the face.

Ruby Vee, BSN · Jun 4, 2012

my sister is the world's biggest pain in the posterior as a family member, regularly throwing fits about minute matters and assuring everyone that the rules didn't apply to her because she's a nurse executive with a corner office in a well-known west coast hospital system. whatever she wanted, she wanted it right now. one would think, since she had worked at the bedside for two years in the distant past, that she'd have some iota of understanding that the other patient's vt supersedes dad's request for ice, but no. whenever she didn't get what she wanted, or didn't get it with the desired amount of kowtowing or in the desired time frame, she'd call some nurse executive whom she had met at a conference, or who one of her colleagues knew from somewhere and get the offending employee into trouble. the nurse who dealt with the other patient's vt before dad's ice was counseled about "customer service." no one wanted to take care of dad because mom (who had early alzheimer's which perhaps excuses some of her nonsense) and my sister were so difficult.

my sisters-in-law are no better. they all take pride in the size of the fit they can throw, and strive to outdo one another at throwing fits. they don't just have pain, they're in agony. if the call light doesn't get an immediate response, they start moaning and carrying on, the volume escalating until every patient in the wing is complaining. and as soon as they get whatever it is they wanted, they immediately think of something else that is vitally important that they have right away. and so on. one sister in law actually developed a blister on her call light finger. visiting hours? what visiting hours? let's bring eight people in at 7 am and stay all damned day, because "sister needs us to help her." meanwhile, if sister needs her straw bent, all eight visitors are looking up and down the halls for a nurse to bend the straw for her, and they're mad because the nurse didn't anticipate sister's need for the bended straw and bend it for her without being asked.

when one sister-in-law had a hysterectomy for fibroids, only the travelers and the float nurses would take care of her.

when the next sister developed fibroids, i'd get phone calls at all hours of the day and night about how she felt like she had an alien in her belly, and she could feel that thing in there getting ready to devour her. her husband is smart . . . he asked the doctor for a prescription for xanax . . . for himself. and got it. after one appointment, the doctor took him aside and told him he didn't know how he'd put up with the drama.

i have cancer. i haven't thrown a fit. but poor dh -- his wife has cancer!

Been there,done that, ASN, RN · Jun 4, 2012

Mom needed to (and deserved) to be in control of her care.

She was helpless ..and dying.. and she knew it.

"Fixating" on an issue such as the brand of medication, kept her mind off of her impending death.

Rather than arguing with her until she was " blue in the face" (was than an unintentional pun describing COPD patients)?

A sense of humor may have solved the problem.

Yes ,Mom.. that pill is green now.. they ran outta red dye.

"she was usually in the hospital for a COPD exacerbation – essentially something that was self-inflicted. "

Wow... a large percentage of patients ARE dying because of a life style choice.

That does not change how we care for them at the end.

**LibraSunCNM, BSN, MSN, CNM** · Jun 4, 2012

I feel like if I were ever a hospital patient (knock on wood so far so good!) I would be on the other extreme. I would sit in bed in pain or needing help or something and not want to call the nurse to bother him/her, knowing that they were probably busy with needy, demanding patients and families. Even when my boyfriend and I went to visit our friend in the hospital, whenever the PCA or RN came into the room I was like, "Sorry! We'll get out of your way!!!" They were like, "Um, you're fine!" Haha. I'm the same way at restaurants--since I've waited tables in the past, I always tip well, even for bad service, giving the server the benefit of the doubt that they were dealing with other stuff/rude customers elsewhere that I didn't know about. However I do have an aunt who is a nurse who is the patient from hell, and I have taken care of nurses myself who were awful---and some who were amazing.

Horseshoe, BSN, RN · Jun 4, 2012

my sister is the world's biggest pain in the posterior as a family member, regularly throwing fits about minute matters and assuring everyone that the rules didn't apply to her because she's a nurse executive with a corner office in a well-known west coast hospital system. whatever she wanted, she wanted it right now. one would think, since she had worked at the bedside for two years in the distant past, that she'd have some iota of understanding that the other patient's vt supersedes dad's request for ice, but no. whenever she didn't get what she wanted, or didn't get it with the desired amount of kowtowing or in the desired time frame, she'd call some nurse executive whom she had met at a conference, or who one of her colleagues knew from somewhere and get the offending employee into trouble. the nurse who dealt with the other patient's vt before dad's ice was counseled about "customer service." no one wanted to take care of dad because mom (who had early alzheimer's which perhaps excuses some of her nonsense) and my sister were so difficult.

my sisters-in-law are no better. they all take pride in the size of the fit they can throw, and strive to outdo one another at throwing fits. they don't just have pain, they're in agony. if the call light doesn't get an immediate response, they start moaning and carrying on, the volume escalating until every patient in the wing is complaining. and as soon as they get whatever it is they wanted, they immediately think of something else that is vitally important that they have right away. and so on. one sister in law actually developed a blister on her call light finger. visiting hours? what visiting hours? let's bring eight people in at 7 am and stay all damned day, because "sister needs us to help her." meanwhile, if sister needs her straw bent, all eight visitors are looking up and down the halls for a nurse to bend the straw for her, and they're mad because the nurse didn't anticipate sister's need for the bended straw and bend it for her without being asked.

when one sister-in-law had a hysterectomy for fibroids, only the travelers and the float nurses would take care of her.

when the next sister developed fibroids, i'd get phone calls at all hours of the day and night about how she felt like she had an alien in her belly, and she could feel that thing in there getting ready to devour her. her husband is smart . . . he asked the doctor for a prescription for xanax . . . for himself. and got it. after one appointment, the doctor took him aside and told him he didn't know how he'd put up with the drama.

i have cancer. i haven't thrown a fit. but poor dh -- his wife has cancer!

well, if you haven't gone crazy from all that, all i can really say is god bless you-you must have the patience of job. :yeah:

Horseshoe, BSN, RN · Jun 4, 2012

Mom needed to (and deserved) to be in control of her care.
She was helpless ..and dying.. and she knew it.
"Fixating" on an issue such as the brand of medication, kept her mind off of her impending death.

I had a patient with end stage brain cancer. His wife would go postal if his blood sugar was taken even one minute past the MAR time. It was completely absurd and was going to have zero impact on her husband's prognosis and comfort, but I let it go because I knew it was probably the ONE thing she felt she could control about the whole situation, and like your mom's obessision about her medicine, served as a distraction from her horrible reality.

I was the only nurse willing to take care of the poor guy because of his wife's behavior.

ShayRN · Jun 4, 2012

See, this is the thing. Patients do deserve the best care they can get, but we deserve respect. Where is the backbone of our managers? Why oh why would a manager even say anything to a nurse who was addressing VT instead of running for water. Even if you wanted to placate a difficult person and say, "Oh yes, I completely understand why you were angry that you had to wait for water" is it really necessary to say anything to the nurse? Just let it go! Shheeeeshhhh.

I am the opposite kind of bad patient. I don't ever think anything is wrong with me, which leads to situations where I walk around on a broken foot for 5 weeks, lol.

dirtyhippiegirl, BSN, RN · Jun 4, 2012

Well, to be fair, the fixating thing happened about two years ago when she broke her leg. It was 100% a control issue. She toned down her feisty-ness and seemed more at peace when she was, actually, dying. Although I think that she was really just tired, too.

And while I appreciate that you may think you know my mom more than I do, I can guarantee that using humor wouldn't have helped the situation at all.

The pun was quite intentional. I have my mother's ashes sitting in my linen closet right now. If I didn't have a morbid sense of humor right now, I'd be a blubbering mess.

Witnessing my mom's hospitalizations over the years and how they affected her and our family and how her own behaviors and attitudes often reflected the medical care that she received...has definitely played a huge part in shaping how I approach patient care. I believe strongly in patient autonomy, in providing choices, and in letting the patient be an active participant in their own care. I work very well with some of our more "particular"/stubborn/argumentative patients and enjoy doing so.

Ah crap. Now I'm crying again because this is just one more thing to add to the list of things that I never got to say to my mom.

Mom needed to (and deserved) to be in control of her care.
She was helpless ..and dying.. and she knew it.
"Fixating" on an issue such as the brand of medication, kept her mind off of her impending death.
Rather than arguing with her until she was " blue in the face" (was than an unintentional pun describing COPD patients)?
A sense of humor may have solved the problem.
Yes ,Mom.. that pill is green now.. they ran outta red dye.
"she was usually in the hospital for a COPD exacerbation – essentially something that was self-inflicted. "
Wow... a large percentage of patients ARE dying because of a life style choice.
That does not change how we care for them at the end.

Esme12, ASN, BSN, RN · Jun 4, 2012

My mom passed away a few days ago from COPD/heart failure complications. Obviously, she had quite a few hospitalizations over the last few years of her life and - dear god! - I witnessed first hand how much the nurses seemed aggravated by her, but didn't totally understand why until I started working in a hospital myself.
.

:hug: My deepest heartfelt condolences and prayers for you and your family.:hug:

Esme12, ASN, BSN, RN · Jun 4, 2012

Well, to be fair, the fixating thing happened about two years ago when she broke her leg. It was 100% a control issue. She toned down her feisty-ness and seemed more at peace when she was, actually, dying. Although I think that she was really just tired, too.
And while I appreciate that you may think you know my mom more than I do, I can guarantee that using humor wouldn't have helped the situation at all.
The pun was quite intentional. I have my mother's ashes sitting in my linen closet right now. If I didn't have a morbid sense of humor right now, I'd be a blubbering mess.
Witnessing my mom's hospitalizations over the years and how they affected her and our family and how her own behaviors and attitudes often reflected the medical care that she received...has definitely played a huge part in shaping how I approach patient care. I believe strongly in patient autonomy, in providing choices, and in letting the patient be an active participant in their own care. I work very well with some of our more "particular"/stubborn/argumentative patients and enjoy doing so.
Ah crap. Now I'm crying again because this is just one more thing to add to the list of things that I never got to say to my mom.

:hug::kiss:hug::kiss:hug:

When my dad passed away there were days I didn't think I'd survive the sadness......I won't say it will go away, but it does hurt less. I miss him everyday.....you will always miss her, but it does become tolerable eventually.

nurseprnRN, BSN, RN · Jun 4, 2012

me, me, i'm the bad patient. when i had surgery and was on clear liqs, i asked for red jello and green jello only, none of that nasty chicken-never-saw-this-soup bouillon and i don't like that crappy hospital tea.

i had a new kind of surgery many years ago, had a spinal because i hate general anesthesia (it must be a control thang). while i was lying there i saw an eight-beat run of vt on my monitor, and began to regurgitate, and being flat on my back i was really afraid i would aspirate. scary, and i asked if i could have the suction. circulator was in a tizzy working a surgery she'd never seen with a physician who was doing his first case in her or, and she looked at me and snapped, "why don't you just lie there and have your surgery?" swear to god, she did. i gulped, and concentrated hard on being bradycardic.

i am also the bad relative. daughter got a good whopping hit of stadol at 8.5 cm dilation, and whaddaya know, baby was sleepy, nursing poorly. so they took her away and put her in the nicu, umbilical artery cath, the works, scared her poor parents half to death. she woke up and was fine, but they wouldn't release her, so grandma stayed and cranked on them about bottles (no! parents say breast only!), q4h heel sticks (never had an abnormal bg, not once), infection control (yes, the baby is going to suck my finger), and so forth... oh, i bet they were glad to get rid of us all...but they didn't do it any faster.