Dysfunctional patients, families, and visitors

EricJRN, MSN, RN · Jul 31, 2006

Sometimes having a nursing or EMS background can make you worse as a patient. (I have both and I think my doctors would agree that I'm at least twice as much of a pain as most other patients. :) )

I didn't flunk out of nursing school though. I don't think it's necessarily related to setting priorities. Sometimes we're just a little more stubborn and require a bit more convincing than your average Joe.

I really do try to understand patients who want to make their own decisions. Not everyone who signs out AMA or refuses a given procedure is a fool.

LeahJet, ASN, RN · Jul 31, 2006

I would consider it dysfunctional behavior to refuse.

I consider it Darwinism.

PeachPie · Jul 31, 2006

I consider it Darwinism.

HAHAHA!

Trauma Columnist · Jul 31, 2006

When people and/or family members are patients, especially in the ER where it is busy and chaotic, the stress they normally have in their lives is magnified greatly. I always have attributed it to that.

JTwin · Jul 31, 2006

I think often people are in denial about the seriousness of their condition and don't want to believe it's bad enough to require the treatment they're refusing. But not understanding why something's required is also part of it.

gitterbug · Jul 31, 2006

Being a nurse does make me a very bad patient. Can't help it but I want to know everything. Now, my doctors, who are VERY smart, always explain, explain and explain before they tell me what I must do. At times I am able to bargain for a little different form of treatment, other times I just grin and bear it.

I feel sorry for the general public who walk into any type of medical facility without knowledge, under stress, and telling strangers some very personal things. Compassion and kindness are two words I hope to include in my everyday work routines. I pray sometimes too.

chadash · Jul 31, 2006

You came to the right place for answers! My family wrote the book on dysfunction (OK, we didn't, actually, someone else did, but it was about MY family).

It is incredibly stressful, scary and more to have a family member in the ER or hospital.

Then, compound that with no frame of reference to interpret what is going on medically, add a little existing family discord, self doubt, guilt....

I digress, but to answer your concern"

If you are just a little loony in your personal life, you are a whole boatload of loony in the ER.

TazziRN, RN · Jul 31, 2006

I think it's usually denial or fear.

Gompers, BSN, RN · Jul 31, 2006

Sometimes having a nursing or EMS background can make you worse as a patient. (I have both and I think my doctors would agree that I'm at least twice as much of a pain as most other patients. :) )

I hear ya! Just today I was at the doctor and she ordered an ultrasound. Just a regular one, as in an ultrasound tech does the scan, doesn't tell you ANYTHING, then the radiologist reads it, and THEN the next time you see your doc they tell you what was seen. I was kind of upset - I wanted the kind of ultrasound where the doc shows you everything and talks while the scan is going on. Apparently that is a Level II ultrasound because a doc is present and can therefore release info at the same time. My doc tried to tell me it was a GOOD thing that I didn't need that kind of ultrasound - it means that they think everything will be absolutely NORMAL. I still insisted, so now she has to find a diagnosis for me that makes the Level II ultrasound necessary, otherwise insurance won't cover it and the docs won't do it. I told her, "You know how we NICU nurses are - we're so anal!" and she agreed. But she smiled and set up the appointment for me. :)

As far as other patients go, I think it's a combination of lack of knowledge plus this society that we live in. They want the world to be like Burger King - your way, right away. They want medical treatment, but they only want it THEIR way. If they don't understand something, they get mad sometimes and fly off the handle, refusing treatment.

We see this a lot in our NICU. Parents will refuse a vital treatment for their child because they're scared and want some sort of control over the situation. This is where good communications skills come in. If we explain everything to the parents - in layman's terms - about what exactly we're going to do and why their baby needs it, then let them ask questions, they seem to be much more cooperative. People seem to get very defensive when they're scared. I think nursing schools should spend more time on therapeutic communication - it should really be it's own psych class, if you ask me.

rn/writer, RN · Jul 31, 2006

If you are just a little loony in your personal life, you are a whole boatload of loony in the ER.

People who are naturally goofy, mean-spirited, stubborn, argumentative, silly, nasty, thick-headed, overly controlling, manipulative, addled, psychotic or any other flavor of difficult or strange DO NOT IMPROVE under high-stress conditions. We're lucky if they stay at their normal level when confronted with upsetting circumstances. More often, they get louder and worse.

RedSox33RN · Aug 1, 2006

I haven't graduated yet, but I'm a horrible patient. A few times in the past year I've been hospitalized for various things, and end up leaving early. I just call my doc at his office and tell him I'm ready to go, to please call in my d/c orders. He does, and knows better than to try and keep me. I'm a royal PITA, but am always, always nice to my caregivers. It's not THEIR fault I'm a jerk when I don't feel well, and I tell them that, and follow up with a thank you note.

I think the thing about being under alot of stress while a pt in the ER is right on. There is a lot of "hurry up and wait" that I now understand, but other pts don't, which causes a lot of anger, and some nurses and docs just don't have the time or, I'll say it, bedside manner, to explain it. Plus you're worried and concerned for yourself or loved on - it all adds up to a lot of stress.