Demanding patient wanting me to page MD about insignificant issue.

Nurses Relations

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Worked a late shift and had a patient who was admitted by a specialty service. It was about 11pm and patient wanted his eye vitamins NOW. (he usually took them with HS meds, but when inpatient a lot of MD's won't order vitamins, especially weird ones like OcuVite). I try to explain this to the patient, but patient wouldn't take NO for an answer. Basically insinuated that the next time I see him I better have followed up on this issue. This would mean that I would have to page a specialty service (surgeon) at 11pm for an eye vitamin as no in house MD was consulted.

What would you do in this situation?

calivianya said:
I had the exact same situation happen - apparently, the patient's regular MD had said something that the patient interpreted as he would go blind if he didn't take his eye vitamins exactly when he was supposed to, every single day. The patient was nearly having a heart attack over losing his vision because his eye vitamins didn't get ordered, and he called his family members in an absolute hysterical panic to have them buy new vitamins and bring them into the hospital. I swear his eyes were rolling around in his head and he was just about foaming at the mouth he was so freaked out, despite my trying to convince him it was just a vitamin and he'd be okay without one dose...

I ended up calling because there was no good way to get out of the situation if I didn't - if I just let him take his vitamins and he told the next nurse I let him do it without an order, I would have been in hot water. Some times, you have to do this stupid stuff to keep your job and stay out of trouble. There's a reason I like sedated, intubated patients the most! They can't get you in trouble over stupid things...

I would page the Dr for the anxiety symptoms.

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Specializes in Pedi.
calivianya said:
I had the exact same situation happen - apparently, the patient's regular MD had said something that the patient interpreted as he would go blind if he didn't take his eye vitamins exactly when he was supposed to, every single day. The patient was nearly having a heart attack over losing his vision because his eye vitamins didn't get ordered, and he called his family members in an absolute hysterical panic to have them buy new vitamins and bring them into the hospital. I swear his eyes were rolling around in his head and he was just about foaming at the mouth he was so freaked out, despite my trying to convince him it was just a vitamin and he'd be okay without one dose...

I ended up calling because there was no good way to get out of the situation if I didn't - if I just let him take his vitamins and he told the next nurse I let him do it without an order, I would have been in hot water. Some times, you have to do this stupid stuff to keep your job and stay out of trouble. There's a reason I like sedated, intubated patients the most! They can't get you in trouble over stupid things...

What if you didn't "let him" do it but he just did it without telling you? Honestly that's what I'd do in the same situation if I were a patient. I carry my chronic meds with me at all times, if the doctors were taking too long to put in my orders or the pharmacy was taking too long to deliver it and I was having breakthrough polyuria/polydipsia (I have DI), I'd just dose myself with my ddAVP like I do twice/day every day. As a nurse, I'd tell the patient that officially I can't give him the vitamin because his doctor hasn't ordered them but I wouldn't be wrestling them out of his hands if he had a family member bring them to him.

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0.adamantite said:
Worked a late shift and had a patient who was admitted by a specialty service. It was about 11pm and patient wanted his eye vitamins NOW. (he usually took them with HS meds, but when inpatient a lot of MD's won't order vitamins, especially weird ones like OcuVite). I try to explain this to the patient, but patient wouldn't take NO for an answer. Basically insinuated that the next time I see him I better have followed up on this issue. This would mean that I would have to page a specialty service (surgeon) at 11pm for an eye vitamin as no in house MD was consulted.

What would you do in this situation?

Eye vitamins (sounds like an expensive marketing ploy imho). There's no way that I'd ever bother anybody with a request like that at that time of day. On the off-chance that the patient is genuinely afraid of going blind due to one missed dose of vitamins, I'd take the time to explain to him/her that vitamins and minerals don't get depleted that fast. Then I'd offer them a hard-boiled egg as anxiety prophylaxis. Voilà ,! Lutein, zeaxanthin and Omega 3. (And leave a note for the physician).

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Specializes in ER, TRAUMA, MED-SURG.
Esme12 said:
No I wouldn't call. I would also assure the patient a "message" had been left and that I was sure the MD would take care of it as soon as possible.

Yes I tell little white lies to patients at 3 am.

This! :). Awesome advice!

Anne, RNC

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I usually phrase it this way - "well I understand you missed a dose of ____ however in order to get an order we'd have to wake the doctor up for that. When he makes rounds in the AM, you can ask him for orders and I will ask if I see him, otherwise I'll pass it on to dayshift". Usually that works because I get the "oh gosh don't wake them up for THAT"

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Specializes in LTC Rehab Med/Surg.

I wouldn't call in the middle of the night for a vitamin. I don't care how much the pt insisted.

However, I've heard the MD tell an enraged patient the next morning "they should have called me".

More and more often you just can't win.

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Specializes in LTC, med/surg, hospice.

I would not call for eye drops. They can use their own drops or go without until the surgeon rounds.

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Specializes in Oncology.

Not eye drops....eye VITAMINS. Eye drops can be more important, even, if a patient has a scratched cornea or glaucoma or something.

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Specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.

I would have just said no... and no again.... and again... Tough sh*t for the patient, it is not an emergency!

HPRN

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I'd be calling the surgeon all right! But I'd be getting an order for a Xanax. (partially silly answer.. partially serious.)

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Specializes in Acute Care - Adult, Med Surg, Neuro.

Yes but what about when it gets around to a manager who is very invested in patient satisfaction?

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I wouldn't want to call, but I'd get all of the patients "demands" together so I wouldn't have to call twice. It is almost the specialty services fault that they don't get house staff to cover. If they were things you knew your hospital didn't have I might say denied. It's hard sometimes to deal with irritating entitled patients who think they are doctors

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