How do you deal with demanding/unreasonable patients?

allnurses Guide · Mar 12, 2015

For the call light ringers, usually a good, old fashioned listening session gets to the bottom of the matter. As above, if I have learned this is a needy person, I am going to address all possible needs prior to leaving the room, so that if they are on the call bell again as I am halfway out the door, I feel very justified in waiting to respond.

Patients needing pain meds get pain meds. I write the drugs they can have and the next time they can have them on their white board. Each time I give a dose, I change the time appropriately to when they can have that drug again. Then I verbally go over with them, pointing at the board, what meds are due when. Every single time. As long as I get in there on time (I try to make it a point to, for MY sake as much as theirs), we do just fine.

Lonely people, I will stand in their room and chart. Mean people, I listen listen listen and then do what I can to resolve/empathize/validate.

Those with unreasonable expectations get educated on the kind of floor we are, what the plan of care is and what to expect for the shift. Then I discuss THEIR goals for the day and work that into the plan of care as well.

imintrouble, BSN, RN · Mar 12, 2015

The last time I had such patient they broke me. I used every bit of compassion and understanding I had. Every trick in my bad patient orificenal was dusted off and used. Nothing worked.

Then we had a heart to heart.

I shared with them the parameters of their care. Meds, activities, and nursing time constraints. After several days as inpatient they already knew the limits of their care, they just didn't know the limits of their nurse. I told the patient what I would and wouldn't do. Plainly. No simpering or therapeutic communication. I've always believed some of these behaviors are just games a bored patient plays for entertainment.

drg1984 · Mar 12, 2015

The same way that customer support hotlines deal with angry callers. You stick to a script and don't show any reaction. Don't be wishy-washy but don't be overly firm either. Just matter-of-factual and don't get caught up in it.

macawake, MSN · Mar 12, 2015

The same way that customer support hotlines deal with angry callers. You stick to a script and don't show any reaction. Don't be wishy-washy but don't be overly firm either. Just matter-of-factual and don't get caught up in it.

I respectfully disagree. No two patients are alike, a script is in my opinion much too inflexible to adequately address each individual situation. I think that it also ignores two integral components of nursing, assessment and critical thinking skills. Why is the patient acting this way? Can something be done?

Anna S, RN · Mar 12, 2015

I have outright told pts that they are keeping critically ill patients from getting the attention they need with frequent calling. I tell them that unless it's an emergency, like severe bleeding or something similar, I will only come once an hour.

Tenebrae, BSN, RN · Mar 13, 2015

The same way that customer support hotlines deal with angry callers. You stick to a script and don't show any reaction. Don't be wishy-washy but don't be overly firm either. Just matter-of-factual and don't get caught up in it.

Mehhhh and watch the patient get really annoyed when they realise you are putting out the same tired line you have used for every other patient

dannibeeRN · Mar 13, 2015

I don't feed into their drama or neediness. I let them know I am there to help them and give them what they NEED but that I also have other patients to care for so they may have to wait a bit before I can get to them unless there is an emergency. We have CNAs and 3 charge nurses so someone is always rounding on the patients and that usually is sufficient in the patient's eyes. I love my patients but I don't play into nonsense. When I have difficult patients, I keep my answers and interactions with them short and sweet and go on about completing my necessary tasks for the night.

empatheticRN · Mar 16, 2015

What do you mean by one shifters? The drug seekers, all I can do is give them the meds they can have as ordered. What else could you do? The bell ringers GET UP out of bed and away from the call bell. If all they are going to do is ring they have to be removed from the vicinity of the bell. I have done it in the middle of the night. You gonna ring instead of sleep? Up you get.No choice is given.Or else they get a lecture, nice but firm.

Ones- shifters are patients who require you to spend the entire shift with them and not

classicdame, MSN, EdD · Mar 16, 2015

I think of them as psych patients and treat them accordingly. This helps me not take anything they say as personal. Also, I set limits and I am careful to keep my word if I make any promises, like "I'll be back in an hour". I try to involve them in the care if possible. DO NOT try humor. They tend to think you are mocking them or the situation.

~PedsRN~, BSN, RN · Mar 16, 2015

For the disrespectful patients/families - I will absolutely say outright - you will not speak to me that way. I understand you are frustrated/in pain/etc but you are not going to treat me like trash on the floor.