How do you deal with "patient-know-it-alls"?

[gizzy76]

I just had to ask b/c I am finding lately that a lot of my patients seem to think they know how to do my job better than I do because they watched a procedure one time or another. What do you all do when this happens?

Just this morning I had a 26y old female whom I had to re-prime her IV line b/c it went partially dry in the tubing. She kept telling me that I didn't need to unhook the tubing from her heplock, I could just run it. Um...OK, whatever. Then she decided to tell me how I should poke the tubing into the new Saline bag. Not even 30 seconds later she's telling me that I put the tubing in the pump wrong because she had less tubing to work with for movement than she had previously. Sorry, but I wanted to throttle her.

[jnette, ASN, EMT-I]

:rotfl: :rotfl: :rotfl:

That's when ya gotta dig deep...no, Gizzy... not for that rubber hose you have hidden under your uniform/scrubs/whatever... but for your sense of humor!!! And make sure it's something you can laugh loudly about to relieve the stress.

(and as an added bonus, make sure the patient doesn't "get" the joke... then just saunter out of the room chuckling to yourself... better yet, a merry little laugh...)

[zambezi, BSN, RN]

When patient's act like that, I do my best to explain what I am doing...I just figure that the patient is feels a loss of control at being in the hospital and that acting this way makes her/him feel more in control of their situation. I also try to give choices (like with kids...only i don't act like I am talking down on them :) ).

And there are those people that just think they know everything, nod, smile, and get your job done, support them as much as you can and leave.

[jnette, ASN, EMT-I]

Originally posted by zambezi

When patient's act like that, I do my best to explain what I am doing...I just figure that the patient is feels a loss of control at being in the hospital and that acting this way makes her/him feel more in control of their situation. I also try to give choices (like with kids...only i don't act like I am talking down on them :) ).

And there are those people that just think they know everything, nod, smile, and get your job done, support them as much as you can and leave.

aw gee, what fun is THAT? How bland ! How professional ! And how CORRECT you are indeed !

[mother/babyRN, RN]

Sometimes the only way a hospitilized pt regains the sense of control they have lost is to seem in control...Then there is the manipulative side of some patients. I streamline my responses and care to what I know about the particular patient. Sometimes they are just lonely and want to talk. Sometimes they have bonded and want to impress you. Sometimes they feel helpless and sometimes they think they are helping. Sometimes they are just doing it to bug you....So, in that case, tell them you appreciate the advice but you have to do it the right way....

wanting to throttle the patient says more about you than the pt..((and believe me, I have been there)....

[jnette, ASN, EMT-I]

Originally posted by zambezi

I also try to give choices ...

I could think of a few right now... "you want this tubing stuck WHERE ?" :rotfl:

Whew! Gotta overlook me guys... it's the fever talkin'. Better go back to bed before I get myself in BIG trouble...:imbar

[mattsmom81]

Originally posted by mother/babyRN

tell them you appreciate the advice but you have to do it the right way......

I LOVE IT!!! And I will definitely use this one on my next 'know it all' TV inspired medical expert.

:roll

[ratchit]

I'm always tempted to ask them when they will be well enough to go home since they know so much..

If it's a stupid, clinically insignificant thing like how the tape is done on the outside of a dressing, I'll ask them how they PREFER it and do it their way. No skin off my back, makes them happy.

If they just don't know what they're talking about (like the IV tubing thing), I'll usually encourage some idle chatter or explain why I'm doing it this way and have the problem fixed before they can finish complaining about how I am doing it. Earn their trust by example, without making them feel badly or making them stubborn. Then I just don't mention it again. I'm not going to try to convince them they are wrong, but I won't do the wrong thing, either.

If a patient is really persistant about things like "The other nurse held it this way" I'll say something like there's usually more than one way to solve a problem- this works best for me."

I've only had to be blunt a couple times. I'll ask what the patient does for a living, then say (for example) "I don't know how to make a cheese souffle- you're the expert. I've done this a couple more times than you- can I try it my way once?" I say that very sweetly with a big smile- it goes over MUCH better than it looks here.

[mother/babyRN, RN]

That s exactly right....

[zambezi, BSN, RN]

Jnette: you crack me up...I'll admit to wanting to give some of the choices you mentioned a couple of times...:rotfl:

Hope you feel better. :kiss

[tmiller027]

I think most public service professions are subject to this. I've worked in law enforcement for 5 years and constantly have people telling me how to do my job. I told people a few times.."I don't go into your trailer factory and tell you how to put RV's together do I?" Usually they just look dumbfounded the rest of the conversation lol

Tim

[Marie_LPN, RN, LPN, RN]

I tell ya, i rue the day that WebMD came out, and i'm not even a nurse yet.

Sure it's got information, but TONS of people come in with their OWN diagnosis and they won't listen to any other opinions. I understand that a lot of people are going to fight for certain tests (how many stories do you hear about where someone had to push and push for something to be done), but some have been readin a list of symptoms online and then say "yep that's wht i got".

One guy in the ER aid that he "looked it up on the computer" and he had acid reflux BY GOD!! Wound up being a massive heart attack.