how to deal with difficult pt's

dekatn · Mar 4, 2007

Just do your job to the best of your ability, document what you have done, document if something should have been done, but wasn't d/t pt. request not to do it. eg; tx, meds etc. Keep in mind that usually with pt. it is a control issue. Hopefully their hospital stay will be short and tomorrow there will be a different pt in that bed!!! Some people are gonna complain about something regardless what you do. I bet, truth be known, when your charge nurse took that blanket in to that pt. that it wasn't put on the bed right or had a wrinkle in it or something!!!!!! Don't let 'em get to you.

oMerMero · Mar 4, 2007

It sounds like they were going to be upset no matter what you did. So many people are just mad at the world and want to take it out on someone...not that this is right, though. I am willing to bet that they are going to treat the next nurse the same way. Try not to take it personally, as hard as that may be. You have every right to request not to take care of the guy the next time you work.

CrufflerJJ, BSN, RN, EMT-P · Mar 4, 2007

Hi all, i am curious, I had a very rough week last week. I had a patient that no matter how nice I was they would bad mouth me to the cna's. How do you other nurses deal with this.
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any advice on how to deal with the difficult ones would be greatly appreciated. Thanks:(

SJAMBOK! :eek: Nothing quite like a South African police riot control device to settle things down.

http://www.coldsteel.com/95sseries.html

Agnus · Mar 4, 2007

Hi all, i am curious, I had a very rough week last week. I had a patient that no matter how nice I was they would bad mouth me to the cna's. How do you other nurses deal with this. I understand that not everyone in life is going to like you, but if you are kind and do what they ask what do you do? I had to change a dressing and the patien was evidently not happy with how I taped it, so rather than call me they told the cna and tried to get them to redo it. So I put on my best smile and went in the room and told the pt if he was not happy with the dressing I would be more than happy to redo it, soo, I did. His wife was in the room and explained to me that pain meds make him mean. When i left the room everyone seemed happy. Then later I heard they were frustrated I had not put the leg pumps on and how they could not believe I did'nt notice, But a while earlier the patient had asked me to take them off so he could ambulate, not only that but the cna's generraly put them on and so. Im frustrated at this situation, I don't feel as though I did anything wrong. how do I deal with the ones that are nice upfront then stab you in the back later? Needless to say I requested not to have the pt again. I guess they were not happy with the emergency dept either. Oh and 1 more thing, They requested a heated blanket and my charge nurse took it in, when they foun d out who she was they said, "finally someone who knows what they are doing". I fell as though I was set upfor failure and that they may have a misconcieved notion on what a nurse is, I also found out they had a previous history of suing a hospital.
any advice on how to deal with the difficult ones would be greatly appreciated. Thanks:(

This behavior is called "staff splitting" It is an manipulative attempt to literally divide the staff against itself inorder to use them to the patient's own means. They will say nurse A is so horribe to them while telling another nurse B she is the only one who know what she is doing. They alinate some of the staff while coizying up to other staff. Sometimes they are very good in figuring out which staff they can coizzy up to without that staff member figuring out what they are doing. Usually it is a stronger savvy staff member who will be acused as the villan and it is the staff member who is less experienced at recognizing manipulation that they coizy up to.

Sometimes the pt is not that skillful in recognizing weakness in staff members and they do this randomly and they will coizy up to the wrong person. The best defense is to recognize this and the staff be made aware. The staff should be instucted to respond to this in a firm manor and not play into it.

Unfortunately sometime the "good" staff member is too naieve to accept that they are being manipulated and in those cases that staff member should be removed as that patient's nurse.

In this case the charge nurse was being manipulated and she should therefore be the one to set behavior limits on thils patient.

Keep in mind a law suit is no good unless they can prove real harm.

The threat or implied threat of a suit is another form of manipulation.

You can ask to not be assigned to that patient again. sometimes that is the only way out of a bad situation. It is not something I do often but I do when nessary.

Anagray, BSN · Mar 5, 2007

sometimes no matter what you do you can not do things right. I try to keep in mind that most of my patients are anxious and are afriad to die. They take their emotions out on me and while I continue to care for them, I also set limits of what they can and can not say to me.

It is not easy, especially if you are doing your best. Yesterday I was physically assaulted by a demented patient - she pulled my hair, scratched my head and I also had a nose bleed. It took 4 other people to get her off me.

I took really good care of her and this is what I got.

they are sick and they act out.

Hang in there.

Epona · Mar 5, 2007

Hi. I am a nursing student and learning here.

Under this type of situation, can we be somewhat firm and say "Ok Mr. X this is in your best interest. We are trying to help you. We are here to make you comfortable and want to make your stay a pleasant one. I am your nurse and this is what I and the doctor have recommended for you."

I am just guessing here, but if the doc. came in the gentleman would probably act different. I believe that sometimes the patient takes advantage of the nurse no matter what we do just because they think they can get away with it.

I am just wondering if we can be a little firm with them, as we are the trained caretaker. The patients imput is very important, do not get me wrong, but in a situation like this, I wonder if a little assertiveness would have made any difference.

RunnerRN, BSN, RN · Mar 5, 2007

Go work in the ER. Everyone's mad down there. :)

Seriously though, I'm just a happy, nice person in general, and until people are ignorant to me I have a smile on my face. Just do your job, keep your spirits up, and keep your eyes open for true problems that need to be fixed. Otherwise, there will always be those people that do not understand you have 4-5 other people to take care of, this is a hospital not a hotel, and that want to find something to be upset about.

angel337, MSN, RN · Mar 5, 2007

in my opinion this has become the norm for alot of patients. people are just not satisfied with anything and medical professionals are viewed as servants instead of the professionals that we are. you seem like a nice person that is genuinely concerned about patients and their well being. don't be too hard on yourself, you are doing the best you can and that's what counts.