How do you feel about the patients that WON't take care of themselves?

[diapason05]

I want to help people who at least want to help themselves. I know people don't always do what they should... but i don't know how I will feel about the patients who have been educated about how whatever they are doing is dangerous, and yet they continue to do it (what it is) and end up back in a hospital over and over.

What do you guys think? I probably need compassion for everyone..I'm not so sure I'll have that.. How do you guys feel about this?

[nyapa, RN]

I am 33 years ond and I have realized that my job as an RN is to treat my patients as if this is the first time they have been through our doors-- even if they know the unit better than I do.

I agree, but it is so frustrating say, someone who is quite capable of sitting plays like they can't even lift a hand to feed themselves, especially when this has been reinforced by family. But how do ppl feel about pts who are at late stage COAD who are smokers (obviously not on oxygen) going outside and having a smoke?

[underpaidrn]

Some patients enjoy being what I call "professional patients." They revel in the amount of attention they get from being sick. I usually just continue to work with them and encourage them to try for themselves. If their family members continue to dote on them, farbeit from me to try and change them. Some people truly enjoy being sick or at times, pretending to be sick.

[SmilingBluEyes]

Chalk me up as a fallable human. There are so many who need my help. I tend to really work hard on those who will at least work with me. Not that I lack compassion for those who won't. But they make their choices, those who are competent to do so. I can only be so tolerant in a busy 12 hour shift with several people who need my care.....and I get tired like any other fallable human being.

[Ruby Vee, BSN]

for patients that won't take care of themselves: it grates on my last nerve.

for patients that can't take care of themselves, i am a little more forgiving.

i get real tired of patients who won't feed themselves when they're perfectly capable of doing so. i've found that the hungry patient will feed himself (as long as the doting wife isn't around) if you discover other things to do at mealtime. but typically that's the patient who doesn't want to try to get better -- he wants you you make him better.

when i was doing pt for my back, there were folks who'd come in and it was obvious even to me that they hadn't done any of their exercises since their last pt appointment. they weren't progressing at all, and they'd blame the pt practice, the doctor for cutting down their pain meds ("how can i do this when it hurts?" in a nasal whine) and everyone but themselves for not doing the work.

it's job security for us, the health care workers!

[elthia]

i get real tired of patients who won't feed themselves when they're perfectly capable of doing so. i've found that the hungry patient will feed himself (as long as the doting wife isn't around) if you discover other things to do at mealtime. but typically that's the patient who doesn't want to try to get better -- he wants you you make him better.

when i was doing pt for my back, there were folks who'd come in and it was obvious even to me that they hadn't done any of their exercises since their last pt appointment. they weren't progressing at all, and they'd blame the pt practice, the doctor for cutting down their pain meds ("how can i do this when it hurts?" in a nasal whine) and everyone but themselves for not doing the work.

it's job security for us, the health care workers!

i work with post open heart patients. 90% are educated about the rehab process before the surgery, and even with constant education , and premedication, and encouragement there are pt's that refuse to cough and deep breath. that won't use the incentive spirometer. that refuse to ambulate, even with the cardiac chair. that throw fits becuase the foley's come out 24 hours after surgery. one surgeon actually writes orders stating "do not place urinal at bedside, pt must ambulate to br to use urinal" for his less motivated male pt's, and "no bedpans" for the females. that throw fits because we insist that they have to be oob for meals, sorry this is not a bed and breakfast, this is cardiac rehab.

i get so tired of stating over and over, "the whole purpose of inpatient cardiac rehab is to get you well enough to go home. to be strong enough to get up out of bed by yourself, off the toilet by yourself, walk around your house without help. to get your lungs recovered from the surgery and prevent postop pnuemonia. to make sure that all tubes are out, and incisions are healing nicely. further stengthening will happen with outpatient rehab".

[ZippyGBR, BSN, RN]

For patients that WON'T take care of themselves: it grates on my last nerve.

For patients that CAN'T take care of themselves, I am a little more forgiving.

this is the key thing

if the patient can't take care of themselves it's good nursing to take care of them

if the patient WON'T take care of themselves it's not good nursing to do it for them - i just wish relatives etc would realise that we are not being 'cruel' and 'lazy' by telling people to get themselves out of their pits and do it themselves or by questioning those who want maid service

[paperboy]

well thats our job aint it?

Whether they repeat their mistakes and get admitted again and again or its due to circumstances beyond their control, i guess frustration will build up if they just don't seem bothered about their own welfare.

[RNperdiem, RN]

It is a bit like the repeat rate for prisoners sometimes. This is an area with plenty of opportunities for research. We could be the richest country in the world with all resources available for everyone under universal health coverage with easy access for everyone and still there would be people who will not take care of their health.

[SuesquatchRN, BSN, RN]

Ystdy we transferred a youngish, obese woman from stretcher to bed. Took three of us. She wouldn't lift her feet for us - she's a&o x 3 - or help, screamed when we tugged, and the SECOND she was off the stretcher whined, "When can I get my lunch?"

I took my lead from the experienced nurses I was with and ignored it. That's all you can do. I'm sure I'll see her again real soon.

[MAISY, RN-ER, BSN, RN]

Many would not want to walk another's path. Everytime I get frustrated with a patient response I try to remember that.

Years ago, my mom needed microsurgery on her ankle for pretty major damaged caused by an accident. She had walked on it damage and all, in pain. Finally she sought help from an orthopedist who had no sympathy for pain or suffering. He actually complained to her that people were whiny, and should "suck it up". His crappy attitude was "renowned", but he was one of the best. As my mother went through therapy, he went skiing. Lo, and behold-he wiped out a knee while in Park City Utah. His partner repaired the damage. Guess what? He was a changed man with regards to pain, patients, and in general. That was 25 years ago and he still remains empathetic to his patients.

Perhaps, only those who have experienced pain, problems, or have been touched by tragedy in our lives can truly have empathy for our patients. We don't know their finances, struggles, or ability to truly understand what we tell them for their own good. Recently, a friend told me that her hospice patients stated they never really understood their English speaking nurses and their instructions. Medications were taken incorrectly, or not taken at all.

As for the obesity epidemic, we've raised the kids for the past 20 years as the fast food generation. Parents did it to their kids-the kids have become adults that for a couple of decades have been eating salt, no veggies, transfats, hi glycemic index foods, etc.....now they are adults who have crappy eating habits with a taste for super size.

For those who choose to ignore their problems, so be it. We need to treat them like any other patient and fix what we can. They know what they are doing-we just need to do our best to help them without prejudice.

Maisy;)

[Jo Dirt]

I'm guilty of being a hypocrite. I don't have diabetes or other chronic health issues (except that I'm too damn fat.) But I look at noncompliant patients who want the doctors to keep them going in spite of their destructive habits. I get frustrated with these people.I also look at noncompliant people who figure what's the point I'll do what I want and whatever happens, happens. Well, I say that is their right and at least they are not blaming anyone for what happens to them.

But when I see a person so fat it takes six people to get them off the floor if they fall I think, how on earth could someone let it get that out of hand? But just because I can see myself and realize when it gets to the point I have to wipe myself with a sponge on the end of a long stick it's time to put the fork down, that doesn't mean other people will feel motivated to change no matter how bad it gets.

We all have struggles, some people can't deal with theirs and I try to remember to be empathetic, regardless, because these people are only doing it to themselves.

[SmilingBluEyes]

Hold on a minute. Just because we admit being human and frustrated, does not mean we don't behave compassionately toward all our patients. Judge not, and all that......

This is a venting thread, from what I see. People are being real here. I think that is ok.