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:
The supervisor came up in about 10 minutes (lightening speed for this type of situation, luckily) She talked to the patient, explained that the hospital was full and there were no other beds except in the SICU. She said she wanted to be transferred to that unit then. The administrator looked her straight in the face and said "If you want to go to the SICU, get out of the hospital, get into your car and drive it into a tree. The SICU is reserved for medically unstable surgical/trauma patients who may or may not live, but under no circumstances am I going to waste a bed in that unit on a troublemaker who has nothing better to do than harass two hardworking nurses on a busy night. You can stay in that bed and cooperate or you can leave against medical advice and face the consequences, but you will not harass the staff any more during your stay here, or we will be calling the police and filing charges".
OMG!!! I'd cut off my right arm for a supervisor who'd stand up to a patient like that! God forbid we don't bow to their every whim and demand. Customer service ya know
In my opinion, your patient is psychologically sick. A normal person does know what is right and what is wrong. I believe referring her to a psychiatrist or a psychologist (if you want me to be subtle) will solve your problem.
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:
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.
WOW! I want one of these. Can I see a copy, please?
The supervisor came up in about 10 minutes (lightening speed for this type of situation, luckily) She talked to the patient, explained that the hospital was full and there were no other beds except in the SICU. She said she wanted to be transferred to that unit then. The administrator looked her straight in the face and said "If you want to go to the SICU, get out of the hospital, get into your car and drive it into a tree. The SICU is reserved for medically unstable surgical/trauma patients who may or may not live, but under no circumstances am I going to waste a bed in that unit on a troublemaker who has nothing better to do than harass two hardworking nurses on a busy night. You can stay in that bed and cooperate or you can leave against medical advice and face the consequences, but you will not harass the staff any more during your stay here, or we will be calling the police and filing charges".
OMG!!! I'd cut off my right arm for a supervisor who'd stand up to a patient like that! God forbid we don't bow to their every whim and demand. Customer service ya know
I have to say that I was pretty shocked by the response from the nursing Sup; I found out later that the 10 minute delay was because she had paged the patient's doc to find out what was up with this patient. The patient had called the nursing sup for a different RN --- same complaints, etc, while I wasn't working. The fact that the patient was smoking in her room just ticked off the nursing sup/charge nurse/staff nurses and other patients. Did I mention this was a pulmonary unit? Vents and HHTC and 02 for everyone? It would have burned very nicely!
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.
Can you give a few more details about this form? I know corporate forms usually can't be duplicated w/o going through the Legal Dept., but some of the key points could help us fabricate our own. This is a wonderful idea and presenting some material to give us a start would be tremendously helpful. Thanks so much-
What's the nurse to do? Dial 911, point to the patient and exclaim, "She's being MEAN!" Maybe the nurse could stomp his/her feeties at the same time to *really* drive the point home to the police officers.
Com'on folks, the police departments have serious issues to deal with. It's time we start calling the authorties with BETTER common sense than people use to come to the ER.
I dont see why you could not call security on a verbal and physically threating patient. And why are you so down on floor nurses getting back up? After all they are sometimes the " whipping boy" for everyone. Pt.s should understand that nurses are there to care for them not take all of their frustrations.
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. :)
I was thinking the same thing, tweety. We had patient just like this a few weeks ago. Unrealistic requests, on the call light constantly and was verbally abusive. Our supervisor took her a "service recovery" gift because she wasn't satisfied with her care! :angryfire
I was thinking the same thing, tweety. We had patient just like this a few weeks ago. Unrealistic requests, on the call light constantly and was verbally abusive. Our supervisor took her a "service recovery" gift because she wasn't satisfied with her care! :angryfire
..you must work for Wellstar!!! They have the service recovery too. Why reward patients and family members for bad manners? :(
:(
grace90, LPN, LVN
763 Posts
A nasogastric tube may have been just the thing for that stomach pain. :chuckle