How do you handle this?

Nurses General Nursing

Published

So we all know the type of patient who is constantly on the call light, constantly wants pain meds (and has them available every hour), or one of her other large variety of prn medications, or just wants some random thing, and calls you and the CNA constantly (and calls the nurse when the CNA doesn't get the item fast enough), monopolizing both of your time. What is the best way to tactfully handle these types of patients so they don't interfere with your other patients' care? Anyone have some good tips to share?

Specializes in med-surg/ telemetry.

I work on a med-surg floor and we get alot of sickle cell and other pain patients. At the begining of my shift I put my pain patients together. I write down what they can get, how much and how often. For my clock watching patients I pretend it is a schedule med. I explain to my patient that as long as we work together, we can both be happy. I write due times on the boards as reminders. I ask if they want to be awakend at night if they are due to prevent pain spikes overnight. I believe in keeping the patient happy. Who am I to say if they are truly in pain or just addicted. I also sympathize with them at times!

Specializes in Cath Lab, OR, CPHN/SN, ER.
I'm a CNA, not a nurse, and this probably wouldn't work for people with pain med issues...but as far as people who are constantly on their call light; when I was working on a general medical floor I would tell people "I am going to (check on other patients, pass lunch trays, whatever) and I will be back in x minutes. Is there anything you need before then?" or say "Your pain med is for every 2 hrs, want me to write the time you can have it next on your white board?" for the people who would either forget when they could have it next or think you told them otherwise. Not much help but maybe a little?

One strategy I use is to be proactive and pop my head in when their call light is NOT on. Maybe I'm on my way to do something non-urgent, or maybe I have a free moment, or I'm going to the blanket warmer/pantry/Pyxis anyway, and I might as well consolidate trips. If I know someone is clock-watching, I'll make every effort to get there BEFORE they ring for their med. It only takes a few minutes to give someone a pain pill, and usually I can budget that time out for that. The only problem comes when something comes up and I am not able to get there at eight o clock (or whatever time) on the dot because I'm involved in something that takes a higher priority. I've found though, that people are generally pretty forgiving of that if I've already established a pattern of being reliable and established a friendly rapport with them as well.

Sometimes, there's not much you can do. Some people are just plain needy and all you can do is do your best and let them be upset if they want to.

I work on a med-surg floor and we get alot of sickle cell and other pain patients. At the begining of my shift I put my pain patients together. I write down what they can get, how much and how often. For my clock watching patients I pretend it is a schedule med. I explain to my patient that as long as we work together, we can both be happy. I write due times on the boards as reminders. I ask if they want to be awakend at night if they are due to prevent pain spikes overnight. I believe in keeping the patient happy. Who am I to say if they are truly in pain or just addicted. I also sympathize with them at times!

I agree with all of these!

I think the key is to check in with the patient often. When you say "I need to go see someone in another room, but I will be back between 10 and 1030 to make sure you're doing ok/bring you your pain medicine/do your dressing change". Giving that window allows time in case of emergencies, but also gives the patient a timeline. They may continue to call out, but I feel once you're followed up during that time period as you said you would and the patient develops trust in you, he/she will probably lay off of the call light.

ETA- I don't want to OP to imply I'm saying they're not doing their job. It could be that night shift is swamped and isn't able to follow up well. It could be that you just got a high acuity patient when the ones pain medicaiton was due (send a NA in the pt's room and tell them you haven't forgotten them and will have them their medicine by ___). It could be that the patient is confused and doesn't remember hitting their light two minutes ago (no advice for that one :lol2: ).

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