have you ever had a pt that you cant tolerate!???

Nurses LPN/LVN


Ok...here is the deal. I have a pt who is alert/oriented x 3. The problem is that she CONSTANTLY cries, yells, whines, lies, manipulates and she drives everybody crazy....and when i say crazy i mean her family, staff, and other residents and other residents families. I get complaints from multiple people every single day i work. She will not even attempt to do anything for herself....even though she can do some things like roll in a w/c or feed herself. see...her family kept her at home several yrs ago and waiting on her hand foot and toenail so shes been in and out of other facilities and ours is the only one thats kept her this long . the others wouldnt cater to her like this. anyway....last night was a bad bad night. she started screaming and waking my whole hall up which then got other residents who are demented up and roaming and wandering around and agitated. she was crying b/c she was out of KOOLAID! i GOT HER 2 bottles of juice and she said that i hurt her feelings b/c i put it where she could get to it and would have enough for later. So then....i go in to talk to her and i asked her what the deal was....she just cried and yelled like she does for the entire 8 hours im there. she doesnt act like this when im off. if another nurse has her...she will ask where im at and why im not there and when am i coming back to work...etc etc...shes even had other nurses call me on my day off just to see where i am and when ill be back. but....as flattering as that can be.....she still annoys me with this obsessive crying. she said to me that nobody takes care of her..that everybody takes better care of the other residents than her...which is not true. she keeps my cnas tied up for at least 3 hrs of their shift if not more...they do all the can to please her to keep her from crying and nothing works. shes on all kinds of psych meds which do not help. its impossible to redirect her behaviors. her urine is clear..so no uti....her hubby told us shes done this as long as they have been married.....50 lonnnnngggg years!!!!!!!!!. ...so anyhow...when shes like this...i just cant take it but so long. i asked her if she even cared that there was other sick people around her that needed help too.....and i told her this behavior was not acceptable and that she was in a good place with people to take care of her 24/7 and that everyone was trying to do everything they could do for her within their means. well...my god...you woulda thought i cussed her out. she cried more and said that she was out of kool aid again. i also asked her how it would make her feel if she had a roommate who behaved the way she does....and she said she wouldnt like it and that she wouldnt trade her roomie for nothing.....well....no doubt...her roommate is a freakin veggie who has never walked, talked or nothing! she cant say to her to shut up. I finally got her to settle down and talk about something else......which was that she got her shower day switched.....she was pleased about that. the thing is...she can turn this on and off like a freakin light switch! listening to this bs nonstop days and days in a row drives me insane!!!!! most of the time i can ignore it and im good...but it stresses everybody out...and they come to me and say " cant you do anything with her????".....and like i said...i get this from staff, families and other residents on a daily basis and the fact is...i cant. theres nothing i do that works and ive tried every approach i know of. im never hateful to her and even when ive had enough im always nice to her as hard as it is. i give her what she wants, i call people for her, i push her where she wants to go, i give her meds, i fix her in the bed, i fix her in the w/c, i fix her feet, i take her out to smoke, i give her candy, i give her snacks, i do her hair, i do her makeup, i put her lotion on her, i turn her freakin tv channels even though she can use her own remote!, i talk to her, i redirect her, ...you name it...i do it. it wouldnt be as bad if she was one who couldnt help what she does...but she has complete control of this. she has even said to me that if she cries and yells that she can get what she wants. we are supposed to do behavior modification stuff on her...which doesnt work. psych follows her.....and nothing they do helps either. her family only visits for a few minutes b/c they cant stand it either.....soon as she starts up when they get there....they leave. they always come tell me " well..shes starting up again, i cant listen to this im going home. "......and out the door they run. any suggestions?

Specializes in geriatric,director of recreation as well.

Just plane pure evil.....

IMO, I think that the residents on the LTC facilities need more attention from their nurses than they are getting. I feel that they're being neglected, and it's not on purpose either on the nurses part, it's on the facilities part for not providing enough nurses and aides for good care.

Agreed....but when long-term are was started and the powers that be decided the we need this many nurses and this many adies to take care of this many people......they were thinking ."long term care". and it worked. But so many facilities have went beyong that and moved up to rehab and sub-acute care...that they can not keep up with pt. care. They are accepting pts. that require more care than long term pts. But as "long term care/nursing homes. they are judged by those rules and can't get pass them. Either the nursing homes need to step up and be acute care units and leave long term care behind or they need to step back and become nursing homes again. The transition is killing the nurses and aides.

If you have it organized right it can work. I've worked in rehab sub acute units that had LTC on the other side, and the patient ratios were different than the sub acute unit. But I agree with the previous poster stated regarding aobut how many aides you need to take care of how many patients, and nurses and how many patients etc. But what they're looking at are numbers, NOT ACUITY which is far more superior than the head count. If you go by acuity, then you should have more nurses and more aides. 25 patients per nurse is far too much in a sub acute and long term facility. 8 aides on the day shift for LTC or sub acute rehab is also far too much. Just my opinion.

Specializes in LTC.

Good news. Haha....my particular pesty patient got a new roommate! I got a pt from a different unit who is a realllllll piece of work.....she is a YELLER!...She hollers alot and she cusses people out and calls ya all kinds of nasty names....and they had originally put her in a room with one of mine who is with it but has bad nerves and she complained so much that I rolled her right up to the administrators office and let her complain to him....then he came to me and asked my opinion and I told him to put her in with the pesty one b/c they have like personalities *minus the name calling*....and after about a week....they actually did it and now its been about a month maybe and boy oh boy...has my new one brought my pesky one down about 100 notches! Both of them dont yell out near what they did before. It is fairly amusing now to see this one get paid back for all her long nights and days of keeping the rest of my people awake and agitated with her nonsense. Since this room exchange has taken place my entire unit has calmed down. I dont hear the crying and whining every day like I used to either. I dont have to give out near the prn's that I used to either. Its been quite nice. Here is something funny too...you all should get a kick out of this one. Pt A (the original one) told me one night "Triple up on her medicines..she kept me up all night long with that hollering. I couldnt sleep. She told that cna that she'd quit hollering if she'd put her in the bed. Ive never said nothing like that".....and I got this great big grin and told her "oh...really??? Youve never told somebody "Ill quit crying if you hurry up and take me to smoke!"......and she couldnt say a word back to me about that one.....and then I told her " well....shes not like you. she cant help what she does or says but you can. You used to keep ___ and ___ and ____ up all night long with your yelling. ".....i hate to admit it..but it is sooooooo nice to be able to see her get a good dose of her own medicine on this one...and im not even the one that has to give it to her. hahahhaha

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