Dealing with VIP patients

Nurses New Nurse

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I'm hoping to get some advice from other nurses who have dealt with overly demanding patients. I've been a nurse for almost a year and was recently given the opportunity to be the evening nurse in a brand new, state of the art rehabilitation unit built onto my old facility. Last night I admitted a former pro athlete who totally fits the bill as a VIP patient. From the moment I entered this man's room he has been rude, difficult, and personally offensive. He questioned my competence as a nurse right in front of me when I brought another nurse in to assist in setting up his wound vac (for a massive stage IV btw). I politely responded that 4 hands are better than 2 when doing the procedure given that he requires total assistance with bed mobility. Didn't work. He told me I need to get my act together when I told him I didn't have a medication he requested because it wasn't ordered by the physician. The list goes on and on. The patient has even said hateful things about me to my aides when I leave the room. I have been nothing but professional in dealing with this man and have gone above and beyond to fulfill whatever he requests, but I'm at the end of my rope. I am young with only a year of nursing experience, but I know abuse when I see it. How can I make this situation better without whining to my boss or eventually going off on this guy? I appreciate any advice.

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Specializes in IMCU.

I'd change the heading to Dealing with Difficult Patients. There are people here with loads of experience with that.

Sorry you are getting a hard time.

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Specializes in OB/GYN/Neonatal/Office/Geriatric.

Are there certain lines truly being crossed by this patient? Then you may need to speak with someone about it. Find out how others are handling the interactions with this patient. Is there a liaison you could talk to? Sometimes we do have to eat a certain amount of crap, but we should not have to be defamed (a civil offense) or take threats of abuse (criminal). Good Luck.

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Specializes in M/S, Tele, Sub (stepdown), Hospice.

Ugh....VIP patients...say no more.

Can you refuse to have him as a patient??

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Specializes in Psych ICU, addictions.
Can you refuse to have him as a patient??

I agree. I would explain how he is treating you to your charge/NM and ask for another patient.

Or you can stand up to him: politely state that what you're sorry that he doesn't like the care you are providing, you will not tolerate being verbally abused by him and that if it doesn't cease you will ask to be reassigned to a new patient. Sometimes difficult patients just need to hear that you won't take their crap and they'll back off. Also the fact that you tell him that you don't want to take care of him may knock VIP's ego down a few pegs.

Or you can put the decision on VIP: next time he goes off on you, you can say "I'm sorry that you are not happy with the care I am providing. If you like, you can request another nurse be assigned to you. I'd be happy to let my charge nurse know of your wishes."

I think just asking for reassignment is the best option--I think that you'd have more success convincing a brick wall to have more empathy than trying to convince him.

Best of luck!

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I'm unable to request a different patient unfortunately. On the bright side, because my unit is strictly MCR with aggressive rehab, he has a maximum of 60 days worth of services. He can't stay forever. I will let my supervisor know what he's been doing, and I think it's a good idea to always have another staff member in the room with us when I provide care. Thanks for the replies. :nurse:

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Specializes in PICU, Sedation/Radiology, PACU.

Try to understand what's going on with him. Why is he acting so mean? I'm willing to bet that, as a former pro athlete, it's extremely frustrating for him to be dependant on others to even move. He may be lashing out because he is really angry with himself.

Even though it's difficult, try the "kill him with kindness" approach. When you start your shift, let him know that you want to take good care of him and ask if there is anything he needs at the moment. Let him know that you have other patients, but if he needs anything you will be available as soon as you can. Make it a point to check in with him and ask if he is comfortable. Try sitting down and asking if there is anything he wants to talk about. If he is rude to you, ask "Would you like to talk about what is bothering you?"

I took care of a very similar patient when I was a CNA in a nursing home. He came in as a skilled patient after having a stroke at age 48. He had left sided paralysis. He became more angry and more demanding as the days went by, until finally there was only a few CNAs that would enter his room. He complained about everything, demanded extra food, said that we were hurting him, and threatened to sue or call the police. It was stressful and exhausting and we should not have been treated this way, but this man was depressed and bitter. He was lashing out at us because we were the only ones he could direct his anger toward.

Your patient's behavior is not nice, nor is it warranted However I really doubt that he has a real problem with you, but rather with his situation.

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