How do you feel about the patients that WON't take care of themselves?

luvschoolnursing, LPN · Oct 2, 2007

Funny thing is, I have no sympathy for drug and alcohol patients (I problem I have never personally had) but full sympathy for people with obesity related health problems (a problem I struggle with daily)

I guess what I am trying to say is as hard as it is, we as nurses need to realize that their struggles and ours are different and we need to meet them where they are and work with them from there.

Not always easy sometimes...

TheCommuter, BSN, RN · Oct 2, 2007

I think I have a unique perspective, since I work on a subacute rehab unit. My elderly patients who are motivated to recover, attend PT/OT sessions regularly, and take accountability for their own health typically recuperate fully and are discharged home. The elderly patients who lack motivation, want service from head to toe, refuse PT/OT sessions, and blame the staff for not recovering will usually be placed in a nursing home.

Attitude is everything. I have observed on a firsthand basis that a good attitude and personal accountability for one's own health will get them home sooner, rather than placement in a nursing home.

You cannot fully help a patient who is unwilling or unmotivated to help himself.

locolorenzo22, BSN, RN · Oct 2, 2007

Patients after major surgery who exclaim "I'm in soooo much pain...even 1 week after..." don't understand that surgery will cause some pain...they want to be pain-free, and bite my head off when they understand that in order to get better they have to move...I am sympathetic to a point, but I am tough. I explain that once they're up on a BSC, there's no going back to a bedpan....although some decide to poop the bed as an alternative....

Everyone is different, but if you won't take responsibility for your health, why should I?

caliotter3 · Oct 2, 2007

I find it harder and harder to take care of myself, so it is just a little easier to tone down on bugging my patients. I realize that mental outlook has a lot to do with motivation and the ability to stick with a new program of behavior. When I was younger and it was easier, I could make those necessary changes. Now, why should I give a darn? I don't feel any better from day to day. That's not an excuse, just a fact.

SmilingBluEyes · Oct 2, 2007

How do I feel?

In one word: FRUSTRATED.

Elvish, BSN, DNP, RN, NP · Oct 2, 2007

For patients that WON'T take care of themselves: it grates on my last nerve.

For patients that CAN'T take care of themselves, I am a little more forgiving.

classicdame, MSN, EdD · Oct 2, 2007

the older I get the more tolerant I become of this and other issues. I am beginning to see that my ideas are not suitable for everyone. This has taken WAY too long to figure out.

leslie :-D · Oct 2, 2007

my pts are literally, on their deathbeds.

many are there because of their life choices.

they know why they're dying.

no frustration on my or their part.

it's just too sad for words.

leslie

oldiebutgoodie, RN · Oct 2, 2007

There are some patients that I just want to say, "Get a grip!" Yesterday had a patient who would scream and cry when I just tried to removed paper tape from a dressing. She had to have the PCT come in and hold her hand while I did some dressing changes. She didn't want to know anything about her wounds, how to take care of them, how big they were, etc. She wants everybody else to do it for her.

However, if I told her to get a grip, I would probably be out of a job. It's seems to be the people who don't really have any seriously wrong with them that are the biggest babies. (gross generalization, I know).

Oldiebutgoodie

CHATSDALE · Oct 2, 2007

what you are saying is not falling on deaf ears..you ae planting seeds and some seeds take a long time to take root

i must have quit smoking a 100 times before something clicked and i was able to finally put them aside, it has been over 25 years but sometimes i really want one but most of the time i have left the desire behind

i guess that it is the same with people who have drinking or substance abuse problems..

i have not had the same luck with trimming off weight but i haven't given up hope yet, you can quit smoking but you have to have some food every day or you will die

but it is not a disrespect to you and your teaching, they are just struggling with some rough issues and they are scared..just remember the time a truck almost hit you in the crosswalk..this is something they live with every day

Elvish, BSN, DNP, RN, NP · Oct 2, 2007

To add more to my previous post:

I used to work in a community health center and did a LOT of diabetes education with seemingly 'noncompliant' patients, and it taught me a few things.

1) 'Noncompliant' sometimes means 'unable to comply' rather than 'refuses to comply.'

2) What works for one patient will not necessarily work for another, either in terms of education or plan of care. I know everybody here knows that, I'm just saying.

3) Once I had a pharmacist/diabetes educator/type 1 diabetic herself tell me that people who don't do what they're 'supposed' to but continue to keep their appts are really trying to do well but a) need time to get it together; and/or b) really want someone to call them on what they're doing or not doing. They desperately want to do better but don't know how unless you spell it out for them, sometimes.

Those lessons have served me well.

Don't get me wrong. I get frustrated with my 28wk antepartums in PTL and ruptured membranes that get OOB, go downstairs & smoke 7x/day. But I'm a mama to my son only. I explain what we ask of them and why, document, and then go on. Most of them are adults and I have to treat them that way.