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

tmiller027 · Nov 20, 2003

Originally posted by LPN2Be2004
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.

This sounds like some of the people in my A&P class. Our professor is an M.D. and yet, when he talks about what certain healthy organs should look like, or do, there's a couple students who ALWAYS know someone with whom this isn't the case and want to argue. Drives the rest of us nuts lol

LilgirlRN, ADN, RN · Nov 20, 2003

I have to give some patients credit, they know their sh*t. Especially patients that have some weird disease that I've never even heard of. I let them educate me, even if I know a little something about it, it let's them feel helpful. Often it is helpful. There are other times however when help is not warranted or appreciated by me. The thing I hate most of all is when a patient says they have a fever when their temp is 98. "I always have a temp of 96.8, 98 is a fever to me." grrrrrrrrrrrr

robynrn2b · Nov 20, 2003

Oooooooooohhhhhh---that drives me INSANE!!! "Well, I normally run about 96., so I should actually have 102 temp. GRRRRRR. Okay, mine normally runs 99.2, so does that mean when I have a fever, I don't have a fever???? Sometimes when I have someone getting smart with me about their care and as they are telling me about how much I don't know, and how much they know, I hit them with a big string of medical/technical language, as if they SURELY should know what I am talking about. I have had a few CNA's, who think they are nurses (nothing against CNA's--we have excellent ones) but some of them who argue with you about how to do your job, I do the same thing to them---bowl 'em over with medical jargon that they coulden't possibly understand--they back down every time.

sbic56, BSN, RN · Nov 20, 2003

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.

Great answer! Sometimes it feels like some patients just want to drive you nuts with their "helpfullness". Thanks for the reminder that they may just be trying to stay active in their own care and relieve their own anxiety. I have wanted to do the same, but usually hold my tongue when a healthcare provider is taking care of me. (But, it's hard!)

ktwlpn, LPN · Nov 20, 2003

Originally posted by LPN2Be2004
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.

...Good thing he decided that acid reflux was an emergency....:chuckle

Marie_LPN, RN, LPN, RN · Nov 20, 2003

Originally posted by robynrn2b
Oooooooooohhhhhh---that drives me INSANE!!! "Well, I normally run about 96., so I should actually have 102 temp. GRRRRRR. Okay, mine normally runs 99.2, so does that mean when I have a fever, I don't have a fever???? Sometimes when I have someone getting smart with me about their care and as they are telling me about how much I don't know, and how much they know, I hit them with a big string of medical/technical language, as if they SURELY should know what I am talking about. I have had a few CNA's, who think they are nurses (nothing against CNA's--we have excellent ones) but some of them who argue with you about how to do your job, I do the same thing to them---bowl 'em over with medical jargon that they coulden't possibly understand--they back down every time.

I know what you mean, I watch everything i say to try not to sound like i'm telling someone how to do their job.

Agnus · Nov 20, 2003

Some of these post remind me of a horrible patient that I has when I was a home health aide.

She asked me if I knew the"right way" to fold sheets. I knew this was a set up. I replied, I know how I fold sheets. How would you like me to fold your sheets?

It was not the answer she expected. Took all her venom away.

She would have loved for me to argue with her on this.

nialloh, RN · Nov 20, 2003

Being a cardiac nurse, I don't come along peritoneal dialysis (pd) patients very often. The first one I came across, the pt wouldn't let me touch him until an experienced nurse showed me first (I knew the theory, but no practice). After that, he let me do the next exchange, but kept telling me what to do. The more exchanges I did, the more tips and tricks I was shown. He was a grumpy pt, but one day explained that if I did it wrong, he was the one who had to live with the peritonitus afterword. He was a good teacher, and tought many nurses well.

The thing I learned from this is when a pt has a chronic illness, they are often very focused, and can know more then we do. I have been supprised many times by the level of knowledge they have.

That is not to say I haven't been equally supprised by their lack of knowledge. But that is another story.

jschut, BSN, RN · Nov 20, 2003

Oh, I usually don't have the issue with my pts in LTC, but mine are the CNA's who insist that this one or that one has this or that!

Not a complaint, really, cause these gals are good CNA's, but they insist they KNOW what's wrong!

I just laugh and say "Ok, ok......" or I call them "doc".

gizzy76 · Nov 20, 2003

Thanks for the fantastic replies! I guess my choice of wording of "throttle" wasn't so hot. I bit my tongue with this gal and tried my best to satisfy her wishes. I hear dayshift had quite the time with her as well. :)

vossy · Nov 20, 2003

I remeber a parent of a 2 month old, who came in with her little one, because of some minor surgery. She had a 12 pages handbook written out for her baby and demanded us to care for the child according to her handbook. It had explanations like; Burp child after feeding, Change diaper when wet etc. I was amazed but also amused. I so much wanted to ask stupid questions like"how do I know if the diaper is wet?" Or "what does the burp sound like?" But we didn't.

My VCR has a manual to:)

Rapheal · Nov 20, 2003

Don't you just love when a patient asks you their BP and you respond 128/70. They then say "That can't be right. I had it taken at the doctors' last week and it was 120/68." lol

And yes you will do teaching on how BP fluctuates and then you will later hear a blood curdling scream and you run into the patients' room and they are hyperventiliating becuase they saw an itsy bitsy air bubble in their IV tubing (true story). lol