Good patient?

**canoehead, BSN, RN** · Oct 16, 2009

My good patient asks a lot of questions and gives me feedback as far as what helps them and what doesn't. I don't mind those that decline care, but I do want to know where they're coming from, and I want them to know the other side of the coin- then I won't hassle them.

And they can't flash their willy and scream. I'm easy to please.

systoly · Oct 16, 2009

"XYZ is a good patient" doesn't tell me anything. Even if I knew the source it'd be fairly meaningless. Most of my experience is in geriatrics and the always pleasant, non-complaining, always cooperative or always smiling patients certainly raise all kinds of flags and frequently require more assessment time. So, if you will, I tend to prefer the "Spitfires". (Show me some spunk et give 'em h..l) :D:D:D

Batman24 · Oct 16, 2009

I don't really see patients as good versus bad. I like when patients ask questions. That's a good thing. It shows they are coherent and looking to get better. They want to contribute to their healthcare and that's welcome.

There are some that don't comply with care and that comes at a cost to their own health. It's self destructive behavior and needs to be addressed on another level. I worry that the cycle will repeat until they do further and/or permanent damage and that is something we never want to see.

MassED, BSN, RN · Oct 17, 2009

Ok I have noticed lately more and more nurses saying oh he's a good patient. I understand good is equal to cooperative and doesn't ask for much but I think it sends a bad message. I mean if there's good patients then that makes the others bad and that us just not true. What's your opinion?

I'm guilty of calling report and saying "oh this one's a good patient." By that, I mean, virtually no PMH, no meds, no allergies, hardly any xrays/meds to report - easy stuff. Also good behavior and not being nasty to the nurses/staff means "good," but it's a general term for an "easy" patient, to me, anyway. On the other side of the coin, when I call report and say "Oooohhh I have a GREAT patient for you...." that's not so "good." The tone decides if it's truly a "good" vs "good" patient. Haaaaa!

ChristyRN2009 · Oct 17, 2009

Well to me a "good" patient has meds and interventions that are generally easy to do, and who complies with most or all of nursing instructions etc. Not rude or harassing. I don't even care if they ask for pain meds frequently as long as they don't do it when just waking up from a sleep so deep I need to reassess them. A bad patient can be a bad one for varying reasons, harassing or rude, has a million meds and needs to take them one pill at a time with a whole glass of water in between, needs constant reinforcement and supervision despite being aaox3 and young, refuses care that will only help them and is simple (like ambulation). Those are bad ones. Then there are those patients who are "busy" which is a whole other animal. They just have a million meds and interventions, need constant turning, feeding, etc. but are otherwise pleasant. I think we are all human and saying a patient is good or bad gives the oncoming nurse an idea of how to handle a situation. Some patients are just somewhere in between and don't get such qualifiers but hey, if I have a doosey coming on to my shift I want to know right away, so I can plan my time accordingly. Nothing worse than getting a rosy report and finding a terrible patient only to find out later that the patient has had security called on him, risk management is involved, he spits, etc.

Nurse1966 · Oct 17, 2009

For me a "good patient" is the one that's not getting ready to crash and burn. They'll keep me busy, but not to the point I want to pull my hair out. The "not so good patient" is the one who's crawling out over the side rails, o2 sat in the 70's, and screaming for help, all the while being naked with his willy in the wind. I rarely label a patient anything but "good", maybe busy, hectic or a handful on occasion. Depends on how complex the care, not necessarily now crazy the patient.

jonesecho, RN · Oct 17, 2009

Ok I have noticed lately more and more nurses saying oh he's a good patient. I understand good is equal to cooperative and doesn't ask for much but I think it sends a bad message. I mean if there's good patients then that makes the others bad and that us just not true. What's your opinion?

I agree that it is really not an appropriate thing to say at all and a good term to disuss. If anyone that is a patient or one of their family members heard this it really sounds bad. I have been a nurse for 29 years and I have heard it and more believe me. We all need to think more about some of the things we say before saying them. Just the fact that you have thought about this lets me know you are caring and sensitive to how we as nurses come across. I think the stress of nursing makes some nurses talk like this and let's face it there are other nurses who would never even think about the term or care. good point though.

Virgo_RN, BSN, RN · Oct 17, 2009

Ok I have noticed lately more and more nurses saying oh he's a good patient. I understand good is equal to cooperative and doesn't ask for much but I think it sends a bad message.

I think "good patient" can mean a lot of different things.

Sometimes the "good" patient is someone who is a partner in their own plan of care. Someone who is involved and invested in their own health and wellness. Someone who doesn't just expect us to "fix" them with no effort required of them. I always really enjoyed my interactions with post MI patients in particular, especially the ones who wanted to know what happened, how it happened, how it would affect them, what they could do to decrease their future risks, what their medications were for, how and when to take them, how to know if they were working and what side effects to monitor for.

Now obviously, not everybody is capable of being involved in their own care to that extent. The 80yo LOL with severe dementia, for example. Typically I'd probably refer to a patient like that as "busy", if they required a lot of my time due to their confusion/restlessness/sundowning, if they needed to be turned and toileted Q2, fed, changed, had a gazillion meds, dressing changes, and so on.

For some nurses, a "good" patient might be a very complex, unstable patient. It can be stressful to spend a lot of time with one patient when you have several, but it can also be rewarding to be intensely involved in getting a patient through a crisis time when they are unstable, and some nurses really like that.

Sometimes, a "good" patient is one with a diagnosis that I have little to no experience with, so that I will be learning, expanding, and developing my skills, therapeutic communication, and critical thinking.

Sometimes, a "good" patient *is* the nondemanding patient with very few needs...particularly at the end of my four day stretch when I'm exhausted. I don't think there's a single nurse in existence that hasn't been thankful for an easy patient load at one time or another.

Sometimes, one of my patients in particular stands out as just a really nice person, and so I might think of them as a "good" patient. Not that the others are "bad", just that this one stands out.

I don't think it's so terrible for nurses to use the word "good" to describe a patient, but perhaps it's not so good to do so in earshot of patients and family members who may not understand, and may misinterpret the meaning, since the word "good" typically implies a value judgment. Perhaps we should use words like "busy", "complex", "involved", "easy", etc.

tatara · Oct 17, 2009

Where I work, there are no "good or bad" patients only "benign and toxic" ones.