Can I give frank unsolicited advice?

gwenith, BSN, RN · Jun 19, 2004

Initiate a "wllness contract" with her. Start with asking her if she wants to get better - she almost HAS to reply with a yes to that one - then go about setting goals that will ensure that she reaches that target.

Chaya, ASN, RN · Jun 19, 2004

Maybe you could help her turn the situation around if you told her the things you have said here: that you are worried and concerned about her, that you do believe her attitudes and efforts will make a definite difference in her care, that you believe her to be capable of more than she herself may think she is capable of, that you very much would like to see her begin to make definite progress, and that you are willing to support her in all positive efforts in this direction. Offer as specific goals some of the actions you have mentioned here. And be firm! Good luck! She's lucky to have you as her advocate.

Long Term Care Columnist / Guide · Jun 19, 2004

Sounds to me like she could be dealing with some pretty significant depression......sometimes people behave this way because it's the only control they feel they have. It becomes a vicious circle---the less they do, the less they THINK they can do. And that takes some therapy and/or medication to straighten out.

It might be worthwhile to explore this with your patient, and don't be put off if she refuses to acknowledge at first that it might be a problem. This generation prides itself on its self-sufficiency, and many of them see any kind of mental disorder as a sign of weakness and thus tend to deny the need for assistance.

Please, whatever you do, don't be too hard on her.....she doesn't need to be coddled, but neither should she be told to "stop whining" as if she were a child (even though she's acting that way!). If she IS depressed, this will only make her feel worse and cause her to withdraw even further.

Just my $.02 worth.

Destinystar · Jun 19, 2004

the fact that you stated that this pt. has a crush on you gives you the leverage to put in a sexual harassment complaint and request to be reassigned. does not sound like either you or the pt. are benefitting from the relaitonship. after you do that you can move on to other things and she can be someone elses problem.

CapeCodMermaid, RN · Jun 20, 2004

Certainly you can tell this patient that she needs to be a participant in her own care and be somewhat responsible for her health. You might try to get her doc to come in and tell her the same thing. But for heaven's sake , DON'T tell her you're tired of hearing her whining or YOU will be the one in trouble.

angel337, MSN, RN · Jun 20, 2004

it sounds like this lady is suffering from major depression. does she have family? friends? if not, it probably contributes to her need to feel important. i would talk to the doc about a psych consult or subscribing her antidepressants. and yes it is ok to promote self care with patients. nurses are there to help patients maintain the most optimal health to their best ability and encourage wellness.

leslie :-D · Jun 20, 2004

- my 1st thought is a 60 yo in a ltc facility.....now that is depressing.

- secondly, i smile when i think of all my elderly female pts. outright flirting with anyone remotely looking like the male species. so a sexual harassment suit? please don't even go in that direction, it's an insult.

- thirdly, i agree a psyche eval would be in order.

- and finally, there are those patients that in spite of saying they want to go home, they really do 'enjoy' playing the sick role, for there are benefits to be derived from that too.

- in your nursing career, there are going to be so many pts. that try your patience. don't enable her dependency; respect what is rightfully hers (such as her modesty re: catheterization) and be supportive with her in a firm but loving manner. social worker might be helpful also.

dotter · Jun 20, 2004

There is a patient like this in every home I've worked in. You can't please them, they are demanding of everyone's time and they just want to keep someone in the room with them all the time. I think it's just the kind of person they are. I have a patient just like this now. She calls you to come do one thing then she remembers all these other things that she wants and keeps you trotting back and forth. She does the same thing with the cna's. She's a "me" person. Probably has been that way all her life. This probably sounds harsh to some of you but I think it's the truth.

Dixiedi · Jun 20, 2004

My least favorite pt type is the just over the hill female. All so often demanding, unappreciative, unfriendly, and always complaining!

Give me a man pt anyday! Even if he has 50 Xs the medical problems!

Often times, I agree, it is depression. These women have taken care of everybody in their lives all their lives and now they can't. They have a lot of problem allowing themselves to be weakened and become so depressed over the whole thing it just gets worse! Everything is wrong! They are just never going to get better, etc etc etc.

Give me a man anyday! or leave me to my kids in home care, much beter choice!

nurse555 · Jun 24, 2004

We have had several like your lady. Just a thought was she a spoiled child who became a spoiled adult? Also was she married or have children? It seems like a lot of women who were never married or childless have this type of behavior. It is almost as if the family and friends enable this type of behavior by giving them excessive attention or they will cater to them. Not trying to sound judgemental but this has been the case in my experience with ladies like this.

mscsrjhm · Jun 24, 2004

Initiate a "wllness contract" with her. Start with asking her if she wants to get better - she almost HAS to reply with a yes to that one - then go about setting goals that will ensure that she reaches that target.

Loooove this idea- would work for ltc and acute.