I've had this problem over the past month or so and it frustrates me. Patients that are stationed near the nursing stations so they can be watched, but instead of pushing their call bells, they scream "NURSE" over and over again. The current one yells about every 3 minutes. If no one goes to check on her (she's near the nurse's station so the nurses can look in on her) or come fast enough to suit her, she starts screaming all the louder.
Maybe I'm being overly sensitive, but quite frankly, the yelling that these patients keep doing gives me a headache.
How do others deal with patients like this? I'd really love to tell them to shut up, but of course, I can't. I have to be nice.
I'm not assigned to this patient, so I don't know if there are any meds ordered for her.
there is very little that can be done about the yellers. you'll just have to get used to it! but i have a lot of sympathy for a cardiologist i worked with years ago. one of his patients was constantly screaming "oh god. help me god. oh god, please help me," and so forth. he had been sitting at our nurse's station making phone calls and listening to the yelling. finally, he got up, went to the call light system and dialed into her room.
"mary, this is god," he said. "i want you to be quiet now so that the other people can sleep."
she was quiet for several hours after that one!
we use the posey bed alarms (for those of you that may not be familiar, the pt gets up, the little clip on there gown disconnects from the one of the bed, and the machine "hollers" to alert the nurse). with the models we have, you can record a message on them to play when the patient gets up. a resp tech recorded "mr. jones, this is god. get back into bed are i shall smite you." (yes, he was a cut up, probably went a little too far on that one). 'mr. jones' proceeded to remain in bed for the rest of his visit with us.
We use the posey bed alarms (for those of you that may not be familiar, the pt gets up, the little clip on there gown disconnects from the one of the bed, and the machine "hollers" to alert the nurse). With the models we have, you can record a message on them to play when the patient gets up. A resp tech recorded "Mr. Jones, this is God. Get back into bed are I shall smite you." (yes, he was a cut up, probably went a little too far on that one). 'Mr. Jones' proceeded to remain in bed for the rest of his visit with us.
There's a nursing research article out there somewhere that I ran across dealing with verbal ("help me"; "oh lordy") versus nonverbal ("aaaah") yellers. Out of curiosity, the researchers later tracked the mortality of these patients and (if I recall correctly) found most of them were dead in a year (most of the nonverbals were dead in half a year). Good article; wish I'd made a copy.
and those that don't know how to utilize a call light....
pressing a button can be challenging to ppl that are confused...
the first few times they do it... run in there like they are the most important person on earth... then educate them on how to push a button....
some/most of them know how and are just trying to get attention fast....
be kind with them.... joke with them.... humor is always good...
most yellers are yelling cause they are freaking out because they are in the hospital...
educate them on the proper use of the call light... reassure them... comfort them...
if that don't work.. i don't suggest a sock and some 2" silk tape.... that is just wrong!!!!
and could get you in a lot of trouble....lol....
seriously though... ppl that yell can be educated.... in a calm manner that they need to use to call light.... otherwise you might go running in there w/ the crash cart...
also... explain that they are upsetting other pts... and that just aint right....
pt. education.... just let em know that they scare others and yourself when they do that.. and to not do it anymore.... even psych pts understand it... for the most part....
I just keep trying to re-educate them to use the call light (thoses that are capable).I tell them there are 2 very compelling reasons and it isn't just for our convenience.
1) We can't tell which room the yelling is coming from without looking into many, but we can see which light is on over their door from way down the hall.
2) If no-one is near the room where someone is yelling, they will not be heard. But the call bell/light can be heard by staff members in any location on the floor. If we are doing care in another room with a patient we may not be able to leave the room to hunt down a "yeller" immediately but hearing the call bell will alert us that someone is in need and the first available staff member will answer it
i really feel bad now... the one that i asked for help about her yelling passed.
[color=sienna]please do not feel bad. it was her time. i once had a resident "yeller" in ltc ask me if i was retiring soon. when i said no, why? he answered, "please do not retire until i die" he passed away a week later.
There are two types of yellers. Confused and Not Confused. With confused patients the best thing is to try and get an order for a 1:1 sitter/observer because they wont yell if someone is always there. The yelling constantly can be very disruptive to other patients and staff so I think the best option for confused/dementia patients is a sitter. I worked as a CNA on a tele floor where sometimes there would be 8+ patients with sitters (35 beds).
If the patient is A+O they should not be yelling. I think you should answer their calls, acknowledge their problem/anxiety then set limits. Let them know it is inappropriate to call out unless it is an emergency (not for a packet of sugar. )
After checking abc's and addressing needs, I calmly explain to them that they are scaring the children and frankly they are scaring me by yelling so much!!!!!!!! I tell them calmly and usually this works. ( I work in an ER) I truly cant stand when the elderly yell and are alert and oriented, they are just being Pains in the duppa's!!!!!!!!!!!!!!!!!!!!!!!:thankya::thankya:
I morphed into a yeller once, when I was inpatient after a surgery. I was 26 years old at the time. I remember that the night nurse ignored my pain all night. Then, in the AM, my surgeon came rounding and ordered me ALOT of demerol and who knows what else. Well, it completely dis-inhibited me. I went from inadequate pain control to way toooooo much narcs in my system. So I was dis-inhibited and mad from being ignored all night. That, and I had just had a surgery that was traumatic emotionally for me.
So the day-shift nurse looked at me like I was a rude idiot. And I was. Kind of. I do remember being totally snowed, being mad about the pain of the night before, and thinking about how I was going to be billed the $5000 deductible for my health insurance for my night of pain and crappy care. I yelled my thoughts off and on. My nurse looked at me from the hall like she'd like to smother me with my pillow. I remember that. I bet to her, I was an A&O rude patient.
I see it differently, though. I had not had adequate pain control, and then I was snowed way too much. The emotional pain of the surgery, which was a big surgery, was never addressed. I wish they would have called a social worker for me. I needed help. I do remember I shut up when the surgeon came back and said he'd talk to me later - and that I really really needed to be quiet so I didn't disturb the other patients. I had been yelling my surgeon's name, too. I remember yelling "Dr. ---- get in here and fix this for me!"
Anyway - there's a view of the other side of a "rude and yelling patient." I'm embarrassed about it, but I wish my nurse would have understood that I was a nice person (probably) who had been pushed too far emotionally, and physically, and then snowed. Had I not had this personal experience, I don't think I'd be so understanding of inappropriate behavior.
while one's reaction is usually appropriate, it's much easier to deal w/it, when recognizing that we all come w/our own baggage.
i suck as a patient.
not a yeller, but do (most) everything ama.
i have found (in the absence of dementia) that once you see the pt as a person, and not as another task, you gain invaluable insight into their private world.
had a nurse said to you, "i'm really sorry about the losses you suffered in surgery" and acknowledged your grief, it would have appeased some of the pain.
:thankya::thankya:
jessiern, BSN, RN
611 Posts
we use the posey bed alarms (for those of you that may not be familiar, the pt gets up, the little clip on there gown disconnects from the one of the bed, and the machine "hollers" to alert the nurse). with the models we have, you can record a message on them to play when the patient gets up. a resp tech recorded "mr. jones, this is god. get back into bed are i shall smite you." (yes, he was a cut up, probably went a little too far on that one). 'mr. jones' proceeded to remain in bed for the rest of his visit with us.