How do you nicely handle a patient who is 'needy'?

Southernurse · Feb 17, 2008

it helps somewhat to know where this is coming from. has the patient recently had a major life change? have they recently lost a family member or friend? it helps having been a patient yourself as well. feeling that complete loss of control over every aspect of everyday life is disconcerting. they eat when we tell them to, (or if they can eat at all), they sleep when we let them, they have little privacy, their bottoms are hanging out, and i have seen few staff that remember to close the curtain or door when a patient is vulnerable. staff carry on private conversations over patient beds as if no one else were there. these things are not done to be hateful, they just happen. when the healthcare facility is a second home to the staff, we act like it. there is a comfort and familiarity with those surroundings that very few of the population have. our patients are out of their comfort zone, and unfortunately, that loss of control will manifest itself as trying to control anything they can, i.e. the call light. it is difficult for most people to be responsible for needy people, but if we take one second or two to remember that our patients are real people with other lives outside of the facility that are now for all intents and purposes "captive", we can do our best to make them as secure as possible. they can tell when we are irritated with them, and that may keep them from calling us when they have a "real" need. that can cascade into many unnecessary injuries such as falls, skin breakdown, etc. in my own humble opinion and experience, when active listening is practiced, the patients feel more comfortable. when patients know you are irritated or impatient or otherwise exude a non-caring attitude towards them, it can result in passive-aggressive behavior and using the call light as their weapon of choice. if that were your best friend or a favorite loved one in that bed, allowances would be made. that patient is someone's best friend or loved one. swallow the temporary irritation and treat that patient as if their friend or loved one were watching you.

blueheaven · Feb 17, 2008

Wants to talk all night, wants polident adhesive at 4 am, wants her son's phone number at 6:30 am, wants you to fix her hair at 3:30 am, moves around all day at home but the minute she is in the hospital cant boost herself in bed, ect? I got paged every 1/2 an hour in this room, and couldn't leave 'nicely' because she just kept talking...
I want to be nice, but I had to do other things, too...
What do you do?

Sometimes you just have to set 'em straight (in a nice way first). Tell her she isn't the only patient on the floor and that you have x many other patients to look after as well. I have also asked patients who does all this stuff for them when they are home? If she can move on her own...make her do it.

Southernurse · Feb 17, 2008

oh, Blue, you know she IS the only person on the floor....she doesn't care who else is there or what else you have to do...at my nursing school we would have been shot on sight if we told a patient we had other things to do...as for doing things herself, she may have been before she came in...it would be helpful if we knew if this was her first night in confinement too...usually the "neediness" eases after a few days.

Dolce, RN · Feb 17, 2008

I will sometimes mention another patient who has a problem that is a "priority." Using that term is not always nice but it does get the point across.

pattycakeRN · Feb 17, 2008

It would be nice to have time to assess the 'emotional needs' of 7 complex individuals who possibly have cardiac drips, labs to interpret, physical needs, medications to give, and at least 20 other things going on. There is just no way I can sit down with mrs. smith and have a textbook nursing 'feelings' discussion.

Id love to

but not with 7 patients

Ms Kylee · Feb 17, 2008

I have had one for the past several days. She didn't like the other PCT but for some odd reason, she adores me.

Tonight, she's NPO for tests tomorrow and she's worried. She also has slight dementia and thinks she's going to have surgery when there is no surgery scheduled.

After I take care of her basic needs for what I was called in for, I always take her hand and hold it for a bit so she knows I care. Then I gently extract myself and say "I need to go to the bathroom now, but I'll be back to check on you in a little bit". Works like a charm every time.

NurseCherlove · Feb 17, 2008

It would be nice to have time to assess the 'emotional needs' of 7 complex individuals who possibly have cardiac drips, labs to interpret, physical needs, medications to give, and at least 20 other things going on. There is just no way I can sit down with mrs. smith and have a textbook nursing 'feelings' discussion.
Id love to
but not with 7 patients

This is a large part of why I am so burned out and really starting to hate nursing. While I love the problem-solving aspects, I did not get into this profession to treat people like another one of the tasks at my job - do it quickly and then move onto the next kind of attitude.

I HATE not having the time to get to know my patients better, offer my cousel, and provide more than a cursory education on their dx/tx/meds.

hollyberry678 · Feb 17, 2008

This is a large part of why I am so burned out and really starting to hate nursing. While I love the problem-solving aspects, I did not get into this profession to treat people like another one of the tasks at my job - do it quickly and then move onto the next kind of attitude.
I HATE not having the time to get to know my patients better, offer my cousel, and provide more than a cursory education on their dx/tx/meds.

WOW, great comment. Thanks.

Katie82, RN · Feb 17, 2008

This lady sounds incredibly lonely. Does she live alone? Does she sleep all day? She sounds like someone who lives alone and has a family who is not as attentive as she would like. They cling to any amount of attention or kindness they get in the hospital, because they know that when they go home, it's back to the same old status quo. This could be her problem. Ask Social Work to intervene, maybe she could use some attendant care during the day.

NewWayofLife · Feb 17, 2008

I have truly found that MOST patients like this are anxious over something else (an upcoming procedure, concern over a new diagnosis, etc) and trying to control what little they can. That said, there are a few who are just used to being waited on and expect that of us. In either case, sometimes you do need to set limits. I just try to address the feeling while doing so... "Mrs. Smith, I know you're concerned about looking your best before your pacemaker insertion this morning, and I'll do my best to help you, but I have to make sure everyone gets their medications first. Would it be ok if I came back at 5AM?" And when all else fails, like another poster said, screaming in the med room works too.