How to deal with a MEAN patient

[twalls]

Question, had a postpartum patient that was quite difficult, compassion is what drove me to become a nurse, so when I encountered particularly nasty postpartum mother I was taken aback. Now for those of us to deal with these patients, you know we have all kinds of family dynamics. I don't have a problem with this, not the issue. she announced to me that "I expect you to be in here to check on me every 30 min" - to wit, I replied that I would be "in frequently to check on her" if she needed me she could call - which she did - over and over and over. I began to think this 20 year old enjoyed having me at her every whim - and the fact that she was extremely rude to her very passive "baby's daddy" telling him to "SHUT UP - she didn't like his attitude" (WHAT?? - his attitude???) Her baby was in the nursery at the time due to a minor issue that was being resolved. She was demanding that he be brought back at once! Our neonatologist brought the baby back in - still not happy:banghead: After hours of this, running back and forth watching how nasty and disrespectful she was to extended family who had simply come to see the baby - I was going to be sent home early due to a drop in census and I would be handing her off to another nurse. Patient had requested pain medicine and this other nurse took it in to her ( I was in the middle of discharging another patient). Patient wasn't due for pain med until 3PM - she received it at 3:20P and she was screaming saying I had not been in in hours to "check" on her. Vitals were done on her and baby at 12:30P, DC IV site at 1:30, at same time I picked up new patient while eating lunch. What gets me is that patient was flipping out, charge nurse went in - and I got no back up from Charge nurse , she actually questioned me beyond what I had voluntarily offered in information on this patient? I had done nothing wrong. Could I actually get called in for this? For what?????

[PAERRN20]

There will always be mean, nasty patients. Not much you can do about that. Documentation is your best best. I hope you documented vital sign time, IV site d/c time, etc. Although she demanded you to be in the room every 30 mins, you cannot get in trouble if you were in there hourly with documentation to prove it. I'm sure most patients would love us to be in their room every 30 mins but that is not a reality unless the patient's condition warrants. She may have had some emotional and hormonal issues coming into play PP. Sorry your charge nurse didn't back you up. That stinks. But remember to document, document, document.

[twalls]

I do document, Ad Hoc special chart, ect. I did critical care for a year, so I can deal with painful patients - it just rattled me that this particular charge nurse accepted my response, but gave me the feeling that she wasn't standing up for me based on my past performance and I work my tail off for this unit.:/

[SlightlyMental_RN]

Personally, I usually document a ton, and I also let the bad attitude roll off of me. Additionally, I would have asked her, "You seem to be very angry and upset at both myself and others that are trying to help you. I have some time--would you like to talk?" Now, she may have blown you off, but perhaps she needed someone to unload on....who knows? Maybe she's freaked out about motherhood, and the bad attitude comes from stress. Maybe it's PPD?