I have never met anyone like her...

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Specializes in Corrections, Cardiac, Hospice.

We had a woman admitted to our floor tonight that wasn't confused, wasn't a psych patient, she was just plain MEAN. The CT department called and said, we are sending her, be prepared, in 20 years we have never met anyone like her. Well, it didn't get any better for us. The nurse tried to do her assessment and was told "YOUR PUSHING TOO HARD WITH THAT STETHASCOPE, STOP YOUR HURTING ME!" She refused to answer any of her P&A questions because "her doctor knew everything and we didn't need to know her business." So I call the doctor and tell him, first thing in the morning, you need to talk to your patient, She is being abusive to my staff and I will not tolerate it. In the meantime, any advice you can give on how to handle her would be greatly appreciated. Ofcourse, she is on the call light every 3 minutes, the room is too hot, the dinner is too cold, can she have a second dinner tray, her stomache hurts, she is having chest pain, her hip hurts, her neck hurts, her back hurts. This went on ALL night. THEN, the nurse calls the doctor about her hip, because it seems to really hurt more than the others:uhoh21: she REFUSES to go to the X-Ray he ordered. We are in the middle of an RRT and she is screaming at the transport guy...I left the RRT room and told her that she needed to get on the cart because she told us of the hip pain and this is what her doctor wanted. Yes, ofcourse it is her right to refuse, but she was just doing it for attention....So, I go back to the RRT room where we are pushing 12mg of Adenosine:imbar and I hear this woman carrying on. I go back to the room tell the nurses to leave her alone and stop fighting with her, if she doesn't want to go to the X-Ray, she doesn't have to but to sit and fight with her about the reasons is useless. I then informed the patient that the swearing at my staff and the punches she was throwing and abusive behavior would stop NOW, I had a real emergency down the hall and needed the nurses to focus on her. I was DONE playing her games and she was not to call out anymore for nonsense issues, expecially when she would not let us do anything about i. I then called security and they came up to talk to her. After the RRT, I looked out in the hallway and she had found a wheelchair, she decided the X-Ray might not be such a bad thing and was waiting by the elevator for transport to come back up to get her. Poor doctor, I then called him back and gave him a piece of my mind, lol. He said, what do you want me to do, something for nerves? I said, yeah what do you have for me?:chuckle Luckily, I have a good relationship with him, I said, I am just giving you a hard time because I am frazzled and at my wits end with her. He told me he would try to get her home tomarrow:rotfl:

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You know, Pharmacy usually has lots of Ativan. (wink wink nudge nudge) LOL

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Specializes in Corrections, Cardiac, Hospice.
You know, Pharmacy usually has lots of Ativan. (wink wink nudge nudge) LOL

For me or her?:saint:

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For me or her?:saint:

You're the nurse, assess thyself! ;)

You handled it well. You set limits, cut the crap, and called her on her stuff. Had you not done that you'd still be in that room trying to reason with a person that you can't reason with.

When I encounter a person like that and I know they are attention seeking when I offer them their med, juice, whatever... and if they decline I don't debate it. I say okay and walk out of the room. No attention. Play the role of no-nonsense right up front and it kills a lot of behaviors.

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Specializes in Corrections, Cardiac, Hospice.

Oh, thank you for the reinforcement. I was thinking maybe I could have done things differently. I told the nurses on nights that if she started yelling they were just to walk out of the room. I also assigned three nurses to her care, two RN's and and LPN, that way one person didn't get burned out with her or hung up in the room all night not getting anything else done. I told them they could tag team each other, lol.

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On our unit we have behavior contracts for patients who are abusive like this. We have a form which specifies which behaviors will not be tolerated and the consequences of continuing such behaviors. The nurse and doctor go in together and explain to the patient the specifics of the contract and let them know that if their behavior continues, they will be administratively discharged. This has been a very effective way to control these types of people, and it is backed 100% by our legal department. This has been a great way to give our nursing staff power over out work environment.

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On our unit we have behavior contracts for patients who are abusive like this. We have a form which specifies which behaviors will not be tolerated and the consequences of continuing such behaviors. The nurse and doctor go in together and explain to the patient the specifics of the contract and let them know that if their behavior continues, they will be administratively discharged. This has been a very effective way to control these types of people, and it is backed 100% by our legal department. This has been a great way to give our nursing staff power over out work environment.

That's a great idea. If the pts. know that they stand absolutely no chance of getting anywhere with their acting up, then they might leave it be, or go bother somebody else at a different hospital that doesn't have this kind of contract in place:clown:

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Specializes in Med-Surg.

Sounds like you did a great job.

What makes me angry is that these are the patients that call and write to administration and then we get an email from the VP of Nursing about customer service. :)

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Shay...your post brought back memories to me. We had a patient (older lady) very similar (demanding, needy, attention seeking etc...), and she had the entire unit in an uproar by the end of shift. She called 911 on her phone and told them she was having a heart attack!!! Of course they knew where she calling from, since #'s will show up in their call system. Anyway, I was charting & happened to be at the nursing station & answered the phone...they said we received a call from one of your patients that she was having a heart attack & her nurse wasn't doing anything about it!! I said, let me go see the patient, will get right back with you. This woman wasn't my patient, but I knew the difficulty her nurse/techs were having with her. I quickly assessed her & asked her if she was any pain/difficulty breathing etc..., she said NO..why would you come in here & say that?! I said, well did you just call 911 on your phone & report that you were having a heart attack? She said, they were lying she never did that. I went & found her nurse, told her the call I received & relayed the info to her regarding her pt. Well, this same patient called 911 again, before I even got a chance to call them back. Of course it was the same guy on the phone. I told him my findings and he said, okay. Anyway, none the less...finally got a hold of one of her kids....and they said that we could remove the phone from her room!!

When I walked by her room at the end of shift, I swear that woman was smirking when I walked by. Not kidding.

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Maybe she should be a psych patient, because she certainly acts like one!!! We often have at least one patient with characteristics similar to hers on our psych unit.

On our unit we have behavior contracts for patients who are abusive like this. We have a form which specifies which behaviors will not be tolerated and the consequences of continuing such behaviors. The nurse and doctor go in together and explain to the patient the specifics of the contract and let them know that if their behavior continues, they will be administratively discharged. This has been a very effective way to control these types of people, and it is backed 100% by our legal department. This has been a great way to give our nursing staff power over out work environment.

I would like to propose something like this in our workplace. We have contracts like this... kind of... but most of the time it's just verbal redirection, much of which is ignored. A lot of them can't be discharged b/c they have detainers, etc.

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Specializes in ICU, step down, dialysis.

Sounds like the classic borderline personality disorder. They are just SO difficult to deal with.

We had a woman admitted to our floor tonight that wasn't confused, wasn't a psych patient, she was just plain MEAN. The CT department called and said, we are sending her, be prepared, in 20 years we have never met anyone like her. Well, it didn't get any better for us. The nurse tried to do her assessment and was told "YOUR PUSHING TOO HARD WITH THAT STETHASCOPE, STOP YOUR HURTING ME!" She refused to answer any of her P&A questions because "her doctor knew everything and we didn't need to know her business." So I call the doctor and tell him, first thing in the morning, you need to talk to your patient, She is being abusive to my staff and I will not tolerate it. In the meantime, any advice you can give on how to handle her would be greatly appreciated. Ofcourse, she is on the call light every 3 minutes, the room is too hot, the dinner is too cold, can she have a second dinner tray, her stomache hurts, she is having chest pain, her hip hurts, her neck hurts, her back hurts. This went on ALL night. THEN, the nurse calls the doctor about her hip, because it seems to really hurt more than the others:uhoh21: she REFUSES to go to the X-Ray he ordered. We are in the middle of an RRT and she is screaming at the transport guy...I left the RRT room and told her that she needed to get on the cart because she told us of the hip pain and this is what her doctor wanted. Yes, ofcourse it is her right to refuse, but she was just doing it for attention....So, I go back to the RRT room where we are pushing 12mg of Adenosine:imbar and I hear this woman carrying on. I go back to the room tell the nurses to leave her alone and stop fighting with her, if she doesn't want to go to the X-Ray, she doesn't have to but to sit and fight with her about the reasons is useless. I then informed the patient that the swearing at my staff and the punches she was throwing and abusive behavior would stop NOW, I had a real emergency down the hall and needed the nurses to focus on her. I was DONE playing her games and she was not to call out anymore for nonsense issues, expecially when she would not let us do anything about i. I then called security and they came up to talk to her. After the RRT, I looked out in the hallway and she had found a wheelchair, she decided the X-Ray might not be such a bad thing and was waiting by the elevator for transport to come back up to get her. Poor doctor, I then called him back and gave him a piece of my mind, lol. He said, what do you want me to do, something for nerves? I said, yeah what do you have for me?:chuckle Luckily, I have a good relationship with him, I said, I am just giving you a hard time because I am frazzled and at my wits end with her. He told me he would try to get her home tomarrow:rotfl:
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people like that need to be set straight right from the start. we as nurses tend to ***** foot around to much and play all nice.

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