Patients who refuse to cooperate with medical/nursing treatment....

Nurses General Nursing

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I have just about had it with patients who think the hospital is a joke. I took care of a patient recently who basically refused to cooperate with the medical/nursing treatment and plan....This patient is morbidly obese (and no I am not exaggerating), one of the worst cases of cellulitis that I have ever seen in his lower extrimities....receiving antibiotics Q4....goes outside to smoke at least every 2 hours....then gripes at the nursing staff because his meds are late....(I, for one will NOT chase a pt down in a smoking area to give medication)...stated his PICC was infected and demanded it pulled (no S/S of infection, no redness, no edema)...(we pulled it)....requested to go to another department to see child who was being treated (an adult child with a minor problem according to the patient)....refuses to keep his legs elevated....never content with his food....multiple requests for coffee, blankets, etc....I just wanted to go in and say "Look here, buster...I can't help you until you are willing to help yourself...and I cannot heal your legs in 12 hours.....and if you don't like it we have this little procedure called leaving AMA, and would you like to try it? :( I will be more than happy to fill out the forms.....;)

People like this just make me livid....I wanted slap the s*it out of him, but I figured the mess would be too huge for me to clean up......This pt is probably going to end reporting me and the nurse before me, but I really don't give a crap....I refuse to bow down to non-compliant, arrogant, I can't wipe my own nose patients.....I have drawn my line in the sand....:devil:

Specializes in Geriatrics/Oncology/Psych/College Health.
Originally posted by frannybee

Got a lady in at the moment having I-131 (radioactive iodine) for thyroid Ca...keeps trying to come out of the isolation room with her various bits...

OK - see, that's the sort of situation that ought to have this lady on a temporary hold in a med-psych ward in a LOCKED seclusion room while she completes her therapy. You can't send her home still radiating, and if she's clearly endagering the health of staff, other patients, and visitors by attempting to leave her room, then what other option do you have? (I'm guessing that there isn't such a ward available, or she'd be there.) I can accept people doing stupid stuff that harms their own health, but don't endanger others, too.

Man, I feel for you all. Fortunately, we each get at least one moron patient so no one is too overburdened with having them all ;).

You guessed right, Ratched - her team were discussing it but as she was allegedly competent, they were reluctant to transfer her out anyway. All is well, she went home today and because the room is hot now, we have one less patient to worry about

Specializes in Emergency, Trauma.

Just today, had a pt come in with c/c chest pain. Pain went down from 6 to 3 after first NTG SL, came time for second dose and pt flat out refused any more NTG. Reason? NTG giving her a headache... okay, so explain to her we can easily fix the H/A- doc essentially offers her any pain med she wants for H/A and explains the whole rationale for giving NTG. Nope, still refuses NTG. Okay, hello...let's see risk damage to your heart or deal with a H/A (that we are trying to fix, offered Morphine, Vicodin, Tylox, plain old tylenol...) This pt was willing to go ahead and deal with the chest pain and risks involved rather than following the doc's prescribed treatment. SO WHY ARE YOU COMING TO THE ER SO WE CAN FIX YOUR CHEST PAIN YOU MORON? I don't know people get by in this world with absolutely NO common sense!

Specializes in LDRP; Education.
Originally posted by Stargazer

Okay, that made me laugh out loud, but I actually think the opposite. Life must be relatively easy when you're too damn dumb to even know how dumb you are.

:lol2:

Specializes in Geriatrics/Oncology/Psych/College Health.
Originally posted by frannybee

- her team were discussing it but as she was allegedly competent, they were reluctant to transfer her out anyway.

Glad it all worked out and that she's gone (gotta love a blocked bed for WHATEVER reason lol.) For the future reference of your team, I'd suggest the docs and SW's familiarize themselves with your state's law governing temporary holds. Competency is irrelevant. Ours says that being a danger to others is sufficient reason (or to yourself for that matter.) Competent people still purposely do things that harm themselves and others.

((hugs)) and go home and put your feet up and congratulate yourself on surviving another idiot ;).

Had a guy in the ER the other night for DKA. One of the nurses went into his room, and he had his insulin kit and his Methadone bottle out (also on a meth. tx program.)

She found that he'd drawn up his p.o. Methadone into 2 insulin syringes (both previously used, uncapped, and lying in the bed), and was getting ready to shoot up.

She had gone in there to pull him up in bed...can you imagine if she'd been stuck by this P.O.S.?

Grrrr :(

Be an idiot, but don't draw other people into it and risk their lives...

Specializes in ICU, nutrition.

Reading about all these idiots gave me a good laugh. My husband and I had to take our son to the ER yesterday (Ian had stuck a rock up his nose) and the people in the waiting room were just making us crazy. When we got home, Joe asked me how I could stand to take care of such people and wanted to know if my patients in ICU were as low-class as the losers we saw in the ER. I think he thinks I'm crazy, but he enjoys the extra $$$ I bring in every two weeks.

I hate explain to the same patients night after night why they must comply with the doctors orders. Lucky for me most of my surgical patients are there electively and the doctor will come in and yell at them in the morning. Amazes me that people sign up for surgery and then put there health at risk by thinking they can do whtever they want now that they got their surgery.

Specializes in Hospice, Critical Care.

Oh we must have had related patients, deespoohbear.

One of my patient for three 12-hour shifts in ICU this weekend was a 300+ woman who had been declining treatment for her HUGE PVD legs with craters in them except what her husband could do at home for her. (He now has a staph infection from her and requires surgery.) She consumed 80 percocet in two days to combat the pain in these legs (not a diabetic, no neuropathy) and guess what? She became lethargic and they were able to drag her into the ER where she required intubation. Husband told us to look out when she wakes up (she's on diprivan, thank the Lord) because she kicks, she hits, and she curses nurses and goes home and brags about how mean she is to nursing staff. Pulmonologist asked me if we thought we could start weaning her off the vent this weekend. I said, "sure but if you extubate her I'm signing off the case!" Her leg dressings take at least 45 minutes (I got good at it; first time I did it, it took me 90 minutes).

I say we discharge her upon extubation....

Specializes in Oncology/Haemetology/HIV.

Can we vote on a "Three strikes and you're out" law for patients

yea I had one tonight. Admitted from the floor to ICU. Admitted for exacerbation of copd but goes in the bathroom in the room and smokes.:smokin: Went to xray and came back unresponsive. Could it be the two pain med patches that the pt put on without the nurses being aware she had them.:idea: I'm for three strikes law

Specializes in Med-Surg Nursing.
originally posted by ?burntout

oh yeah.....hear ya loud and clear.......:cool:

oh and don't you just love when your copd patients go outside and smoke and then come back, calling for a breathing tx., because...............they can't breathe!! :rolleyes: :devil: :nono:

this happened all the time at the last place i worked! the pulmonologist would write orders for them so they could go out to smoke. nevermind the fact that they were wheezing to beat the band and couldn't carry on a normal conversation while walking cause their lungs are so bad!!!!! one guy got livid cause it was 3rd shift and we were busy with paperwork and such and couldn't take him out when he wanted to go. pt said that we were all sitting on our orifices doing nothing and that he was going outside right now and if he fell then he'd sue us! whatever!!!! so glad i don't work there anymore cause that was getting ridiculous! i used to smoke but if i would ever have gotten to the point that my breathing were so bad that i had to be hospitalized then i think that'd be the time to quit!!!

one pt would come up to the nurses station and ask for her pain shot cause the pain in her back was unbearable then as soon as she got it, she'd get a cup of coffee from our supply ( that place didn't supply staff with coffee, we bought our own) and walk outside for her smoke. excuse me, but if your back hurts that bad, then you don't need to be going outside to smoke!

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