Hospital or Spa?!!!

PurrRN · Feb 25, 2008

I think many people can relate. I also think that we are in an era where patient expectations of nursing staff is being exploited by hospitals for P-G scores and the like. Another aspect from my point of view is that in addition to the advertisments of hotel like stay from the hospitals, people are in general becoming more selfish and self-centered so that when they come to the hospital expecting to be waited on like a 4 star restaurant, they REALLY DON'T care about the SOB patient down the hall that needs the nurses attention immediately.

It's a lose-lose situation, especially since there is not enough nursing staff in most cases to handle these types of patients.

I think if this is the direction that hospitals are wanting to go (the 4 star experience), then they should hire people who's only job is to go room to room fulfilling these requests. Course, I doubt that will really ever happen but honestly, give me a break.

FireStarterRN, BSN, RN · Feb 25, 2008

She sounds like quite an endearing patient! :rolleyes:

In a case like this, it's a good plan to enlist the cooperation of the whole healthcare team. Social services, etc. Everyone needs to be on the same page when dealing with unreasonably demanding types.

SDS_RN, RN · Feb 25, 2008

I would be documenting every time you are in that room and what is being said and done. She sounds like one of those that no matter what you do for her it's not going to be good enough and she will more likely complain. Cover your behind so if she comes back to say otherwise you can rely on that documentaion.

Altra, BSN, RN · Feb 25, 2008

She can only abuse you if you allow it ...

Hopefully she can be educated on her condition, something along the lines of, "You were admitted for electrolyte imbalances, which have now resolved. All hospital patients are encouraged to do as much for themselves as safety and their condition allow, so as to preserve their independence and dignity. As you are nearing discharge, your condition allows you to be mostly independent at this point, unlike some other seriously ill patients. As your nurse I have continually assessed and reassessed your condition, medicated you as per your plan of care, coordinated your plan of care with other departments and looked after your safety. If there is a specific task where you are having difficulty please let me know so that it can be addressed with your doctor before you are discharged."

And then chart something like, "patient given verbal education on her now resolved admitting dx, independence at self-care tasks encouraged."

Of course she may continue to be demanding, but at least you'll have given her the benefit of the doubt and *educated* her.

santhony44, MSN, RN, NP · Feb 25, 2008

I think if this is the direction that hospitals are wanting to go (the 4 star experience), then they should hire people who's only job is to go room to room fulfilling these requests. Course, I doubt that will really ever happen but honestly, give me a break.

I agree with this. Of course, I also think the patients who want this type of service should pay extra for it (not their insurance companies, but the patients themselves).

"Yes, ma'am, you can sign up for our concierge service, we'll be happy to do that for you. That will be $50 a day, you can pay me in cash or by check."

Isn't that the way it happens at the 4-star hotels? You pay for the level of service and type of accommodation you prefer.

squeakykitty · Feb 25, 2008

Has anyone ever come across a patient like this? Last night I was caring for 7 patients on my med-surg unit that I work on, and I had this lady who was admitted 4 days ago with electrolyte imbalance which has since been resolved and she is now eating a regular diet and is fully hydrated, and it's looking like discharge time pretty soon, who would put on her call light literally every 5-10 minutes, and the secretary at the nurse's station kept flagging the room for a nurse's aide. After awhile I went in there to give my aide a break, and found that each time she wanted someone to put toothpaste on her toothbrush for her or to stay in there and rub her legs for awhile, or to get her more coffee when she is fully capable of doing these things for herself. She is now strong enough for a shower but insists on a bedbath because she quote "doesn't want to get up". I got her up to the commode, and she told me she wanted me to stay with her because she doesn't like to have to call for someone, and she takes a good while on the commode as do my other patients, so I gave her her call button for when she's through. Eventually she came out and said, "I am paying top dollar for this health care, and I don't care that you have other patients, I should be able to get what I need from you when I need it" Meanwhile we had a man across the hall go nonresponsive even to pain stimulus, and had to immediately be transferred to a more critical floor. My job as her nurse is to help her get as independent as physically possible, not to be her servant. This woman is like none I've ever seen before, and really through me for a loop. Can anyone seriously relate to this?

This lady sounds selfish to the core. She probable wouldn't care if someone died as long as she got her way. She seriously needs limits set and an attitude adjustment.

casi, ASN, RN · Feb 25, 2008

As a naughty nursing assistant on more than one occassion I've told these kind of people: "It's my job to help you do these things for yourself. We need to know that when you go home you can do these kind of things independantly."

CHATSDALE · Feb 25, 2008

i think that this woman doesn't want to go home, as long as she is unable to do things for her self her stay at the hospital will be extended

their isn't much that you can do because you don't know what is proventing her from wantinf to go home

as a tip. it is usually the opposite of what she is saying,

ie if she says she can't wait to get home to her children they probably have become too much for her to handle, same with work or husband

Dolce, RN · Feb 25, 2008

These type of people are so hard to care for. I do my best to be patient with them but encourage independence. When she calls you to come into her room to "put toothpaste on her toothbrush" patiently instruct her how to do it herself. Teach her that this is part of her rehab in going home. You as a nurse need to make sure she can perform her own ADLs. Teach her to rub her own legs. Every task that she asks you to do teach her how to do it. She wants a servant but what she needs is instruction (over and over again, if need be) that she needs to perform her own cares.

I have a nursing diagnosis for this!!!!! Self-care deficit.

EmmaG, RN · Feb 25, 2008

Eventually she came out and said, "I am paying top dollar for this health care, and I don't care that you have other patients, I should be able to get what I need from you when I need it"

Oh really? Is she self-pay? And more to the point, will she pay?

Altra, BSN, RN · Feb 25, 2008

i think that this woman doesn't want to go home, as long as she is unable to do things for her self her stay at the hospital will be extended
their isn't much that you can do because you don't know what is proventing her from wantinf to go home
as a tip. it is usually the opposite of what she is saying,
ie if she says she can't wait to get home to her children they probably have become too much for her to handle, same with work or husband

I respectfully disagree.

OP gives no indication that there was any kind of self-care deficit prior to this patient's current hospitalization. She will not remain in an acute care setting just because she wants someone to put toothpaste on her toothbrush for her or desires massage.

I may be mistaken, but I read the OP and see a patient (unknown age or comorbidities) who is capable of self-care but believes that this capability is somehow suspended while she is in the hospital. She needs to be reminded of her dx and abilities, needs to be educated on the role of her nurse during her acute-care stay, and needs to have some limits set on her wants vs. her needs.

And she needs to go home or to a sub-acute setting.