Demanding Patients

Nurses Relations

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Hi, I am wondering if anyone has any advice/tips on how to cope with the stress of demanding patients.

I work in Long Term Care, each shift I am responsible for 20+ patients. I do the night shift, so during the majority of the shift, it is OK (they're asleep), it's just when I have the 0600 med pass that things become difficult. I only have an hour window before and after the meds are due to give them. I start my med pass at 0500 then should end by 0700 when my shift ends. It always seems that the patients complain, need help finding something, or constantly are needy when I am on a time restriction.

This morning when I was giving the scheduled meds, one of the patients wanted a PRN pain med. I told the aid to tell him that I will be there shortly with it (as I was busy with someone else's meds). He then said he won't let the aids help him to the bathroom until he get's his pain med. He then threatened that he will hyperventilate if he doesn't get his pain med. When I go in there, I see he threw his Nasal Cannula on the floor on purpose (and told me he did). So he was sitting on his bed and having difficulty breathing. SERIOUSLY? I don't understand why people are trying to be so manipulative. It's like they expect me to drop what I am doing and cater to their every need. I understand pain meds are important but if I am busy getting meds out for another patient, I will NOT bring someone else's meds out onto the cart. I do not want to make med errors.

Another patient, I take all her meds to her and she says that she wants yogurt to eat hers with. I then have to waste my time looking for yogurt, which the pantry doesn't have. Then she fusses about not having any.

I then have the people who want to tell me their life story and complain on how bad their life is. I really would love to sit and talk with them, but I have 20 other people to give their meds to in two hours. Is there a polite way to tell them I am busy? I don't want to damage my relationship with the patient but it's not fair to the next nurse when I am running an hour behind.

I am just stressed because it seems my patients think the world evolves around them. If they have to wait for something, they get aggitated, complain, do threats, etc. And after I wake them up to give them their meds, they all want to get out of bed and go to the dinning room. I am the only nurse and there are two aids to help me. The aids do good work but the three of us together can't bend to meet everyone's demand. About half the patients are confused and we have to prioritize making sure the ones who are a fall risk are safe first (then the oriented ones complain).

Specializes in rehab.

One way I found to help stop the tantrums that those in their right minds have is that I calmly explain "I don't need to listen to you scream at me. I understand you're upset and if you want to talk to me like a reasonable adult I'll be more then happy to help you. But if you scream at me I will leave and come back later when you can calm down." I found most of the time, especially if it's meds they want they will calm down right away. Others it only takes once of you walking out of their room and returning later on that they will become very calm and explain their problem.

Specializes in retired LTC.

I've 2 lines that I try to use that seem to defuse alert & orient pts who are demanding. "What one thing would help you now?" and I keep repeating this until I can get them to be focused and be specific. Then my second line (which my CNAs love) is "you can be next, but you can't be now. I will help you. Next". This seems to help, but I make sure I do address their response and I let them know what I did.

Specializes in Critical Care; Cardiac; Professional Development.

I am a pretty new nurse but already learning how to draw boundaries. The 320+ lb patient who is uncomfortable and can't move themself who wants to be repositioned every 20 minutes....it is unfortunate that I have to explain that I will not try to move them myself and that getting 2-3 other people to help me so that none of us hurts our back makes them upset, but it is what it is. When this person understood I WILL help them, but that there are parameters that are not negotiable (using the appropriate number of people to avoid injury..that that gathering that many people together at once takes time in the hospital) they at least acceped it even though it made them cranky. One can understand/empathize with why the patient is unhappy and it still not change the facts of what is possible to accomplish.

I do struggle with the ones that come out of their rooms instead of using the call bell, demanding help NOW. We had one of those families this week. Literally every 15 minutes in the hall asking for their nurse because their loved one was in denial about how sick they were. The patient was/is a controlling, demanding, type A who had been thrown for a loop to suddenly be helpless (trauma fractures...wanting to get OOB when that wasn't even remotely an option due to embolus risk. The family's habits for dealing with this person has been to give what they want in order to keep the peace. Not a possibility in this situation and they just could not accept that we were not going to drug their loved one into a stupor and also weren't going to give this individual what they wanted because it was not in their best interest. Gonna need more practice with that type. Took two of us to help the nurse assigned to that room from going crazy with fatigue and exasperation. Again, understood this family had been turned on its ear and the patient, in the prime of their life and career suddenly thrown into a horrible, worst-nightmare (for them) situation..and that NONE of them knew how to deal with it or the hospital environment. But that empathy and understanding still doesn't change the facts of what is possible and what is safe.

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