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How do you deal...

Rlien Rlien (New) New

I have a pt who's been in LTC for years. He thinks he knows everything. I'm a newer nurse (6 months post graduation) and I'll admit to not being the most knowledgeable about everything, but at least half of what he "knows" is wrong. He refuses to stay in bed, but then he gets mad when I can't come running to spend 30+ minutes to re-dress the wound vac when it's fallen off his peri-anal and scrotal abscesses. He wants everything done ASAP. He's refusing to take ABT because it's a capsule and not a tablet. An hour of my day is eaten up with him. He's just an obstinant jerk. Is there any way you have learned to get it through to these type of patients? How do you deal with them?

I'm pretty sure it isn't me because 18 of my 19 other patients adore me and complain when it's my weekend off. It also doesn't help that my work is begging me to work 13/14 days.

quiltynurse56, LPN, LVN

Specializes in LTC and Pediatrics.

Some times we have to meet them where they are at. Find out from other nurses how they handle this resident and you can talk with your supervisor to assist you in working this out.

I have a resident that would get mad and yell at me if I brought certain meds later than he wanted them. I could not talk with him as he would only yell at me and call me stupid. I spoke with my ADON and she spoke with him. We came to an agreement about when to give him this medicine that he could accept and worked in with my med pass.

Usually something can be worked out with a resident, but it may take another person to help with working it out.

amoLucia

Specializes in LTC.

I'm wondering if it might not be 'a guy thing' to him to harass you for being a guy nurse. He could just be really trying to pull your chain!

You're a newbie and just to tell you, in nsg, you meet 'all kinds'. Sometimes, all you can do is just nod your head and 'yes' them.

Like PP commented, I would inform your DON/ADON/supervisor that this problem exists. And put it into writing for your personnel file (something bland, non-accusatory, what you've been trying, you have concerns, yadda, yadda). At least there will be previous evidence in your file if he gets really nasty & complains to mgt about you. (Yes, that kind of stuff happens.) And keep your copy.

Also, good advice to learn if other nursing staff (esp any other guys) are having the same issues with him. Discriminatory practices and steriotypes (sp?) among older pt populations exist.

I don't want to discourage you Rlien but some people are just ornery. My in-laws were both in the same nursing home at one point. He was always a happy man and in his decline he was still the same happy man. The staff loved him. She on the other hand was always a demanding self centered and judgmental woman and in her decline nothing changed. Let's just say she was not their favorite resident. In the final years of hospital to rehab back to apartment to hospital to rehab back to apartment endless cycle, my wife was automatically apologizing to the staff before they'd even tell her what her mother said that time. The staff learned to just bite their tongue, do what they had to do, and get out of her room. None of it was a failing on their part. She was just not a happy woman.

I learned real quick not to cater to every little thing and encourage self-care:cat:. I would make sure an order for wet-to dry was in place if unable to maintain the wound vac and make him wait till end of shift to put it back on if it happened more than once, but I'm not the bright-eyed nurse I was going in to LTC! :devil: Oh-and it should not "fall off", talk to your wound vac rep for suggestions if you're having problems. Mine would personally come down and trouble shoot with me. If it continues to "fall off"-he's purposely taking it down to be a jerk.:yes:

Check his progress notes and find out from other staff members if this is his regular behavior. I'm not sure of his age, condition, or Meds, all these things may play a role in his behavior. Do yourself a favor and do notify the ADON, DON, Unit Manager. Place his behaviors on your 24 hour notebook/documentation. Please include if you've educated him on whatever it is he is refusing and relative behavior. Also, check his care plan you may want to initiate or update one pertaining to these behaviors. Consult psych if necessary.

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