16 Ice creams

Nurses General Nursing

Published

I haven't been on here in a while, but today I just have to share the experience I have had as a nurse this week. I work on a med-surg floor at a small hospital with 29 patients on the floor. We usually have 5-6 nurses, but often have had 4 and even 3 occasionally.

We are the floor you dump all the miscellaneous crap on, which often includes your chf'ers, copd'ers, gib's, dialysis patients, surgery patients, Alzheimer's, and just about anything you can think of. Not to mention all the people who were brought from the local mental hospitals or rehab centers who are just absolutely nuts.

I was told when I was hired by the staff and my boss that it was a very challenging floor and that I would learn a lot, but be very stressed. Well she wasn't lying. It's practically like an ICU sometimes with how critical my patients are and I don't just have 2. I have 6 and that's being in charge on night shift. Anyways, let me tell you about the patient who has sucked the life right out of me within 12 hours of taking care of her. I had a better night the time my first patient died sudden and unexpectedly after s 55 minute code.

This is a 41 yo female who is a frequent flyer and usually comes in with abd pain, diarrhea, and N/V. She has been denied at 5 different hospitals for accusing male nurses of sexually assaulting her and reported at least 4 doctors for not giving her the pain medicine she demands and the diagnostic tests she believes she needs. She comes I with different names all the time. She states she has had cdiff for 5 years and treatment doesn't work. And she thinks she has SMA, but we're just not properly diagnosing her and not doing the right tests.

So my night started with a call that lasted 7 minutes. She first explained how unprofessional we were when answering the call light and stated that several people have hung up on her. Then she went on to say her scheduled pain meds were due 30 minutes ago, followed by requests for 5 ice creams and 3 apple juices, and many other questions about tests, pain meds, diet, how pretty much everyone has mistreated her. I was very polite, said I would definitely let her nurse know and the issues would be addressed. I was in charge that night. Her nurse was slammed like the rest of us, but managed to get her pain meds to her not late. She received a total of 16 ice creams within 7 hours and wanted more. She was told that we were out and that we could not take the other floors supplies when we use all of ours. Well, that was it. She wanted to speak with the charge nurse.

At the time I had a patient who was q1h bg, total care, agitated, no sitter, tube feeds, ativan q4 or she would climb out of bed and that would just be a whole other issue. Also, taking care of a women who demand dialaudid 2mg q4 on the dot and extremely sick with critical labs, admitted by nephrology. My third was a man who we got to know about a year ago when he came in and refused all care, but had nowhere to have dialysis because every place had kicked him out for being verbally abusive to staff and refusing assessments/care. Nephrology wouldn't discharge him because he was so sick. The man yells at everyone and demands everything he wants, meanwhile not taking any meds you have for him or cooperating with what the Drs want him to do. I guess he wasn't actually hard to take care of, until he started calling and yelling because he hasn't got his chocolate Icecream and coffee and then crapping all over the floor and refusing to let anyone clean it. We call him Mr. Personality. Patient #4 is not bad, but wants me to come at different times for her prn meds, like one at 9, then the other at 10, and so on. My other two were new admits. I got one at the beginning of my shift and another by 0300 even though the next one was supposed to go to someone else and it was my 6th patient. The other nurse is older and just refuses to take anymore. She was busy and if I had given the patient to her she would have complained so much that the rest of us might have gone crazy....or crazier. Anyways, my one admit came up on bipap with critical abgs, total care, >400 lbs and the one at 0300 was a GIB.

So that was my group. I had enough to do without this women demanding things and making everyone crazy. She wanted to speak to the charge nurse because they wouldn't give her anymore Icecream. She had had 16! When I went into her room I introduced myself and asked how I could help her. She started off by saying there's a real issue with the way we are answering her calls and hanging up on her without listening to her 25 complaints and that they weren't telling her nurse what she needed. Then that she needed Icecream because she could only have full liquids and she was being denied it. The next problem was not getting paid meds on time, not getting what she ordered for dinner (3 puddings, 3 soups, 4 ice creams), not getting a ct with contrast, which would diagnose her SMA. So far the ct w/o contrast hadn't shown a thing. She never really did shut up and just moved from one thing to the next. I had to interrupt to tell her that I would see to it that her nurse was being notified of all her needs and that I had witnessed her calls being answered and then the message given to the nurse. She argued with me and said that was not true and I explained that they may be listening to her need/complaint, saying they'll let her nurse know, and hanging up because they think she's done. Also told her that I had answered a call from her earlier that night and i was very polite but shocked at how rude she was. I listened and i told her nurse, but there is a list of callers waiting behind her that could be having trouble breathing or chest pain. I explained that we had to answer everyone's calls and could not spend 5 minutes on the call light. All of her needs can be addressed once the nurse knows to go down there and she did. Then I moved on to the issue about Icecream and this is where I got hot. I've never been nauseated by how mad I am, but I swear I almost threw up all over this lady. I told her we have 72 ice creams stocked at beginning of each week and that she had 16 already, so she could not have anymore and even apologized for heavens sakes. First of all she denied she had that many. I had seen them take at least that many down to her room. So I told her of every one had that many there would only be enough for 4 patients and we can't use all of our supplies and then go take another floors, unless it is a need and that is by no means a need. The women had breakfast, lunch, and dinner and snacks! She needed no more. I then asked her why she would want to eat that much if she was in pain and having diarrhea and nausea, plus a diabetic. She just redirected to another thing, such as getting s soft diet order. I explained that Drs do not allow people to eat when they are that nauseated and in pain and that if she was able to tolerate food that would mean she wasn't in pain or sick from it. It's common sense. She then said I was calling her a liar. Well yes I was. I told her I would be glad to page her dr and request a ct with contrast and a soft diet. She argued and said I wasn't listening to her and that that's not what the problem was and neither was the Icecream. I'm thinking well what the hell is the problem lady? I think IBS caused by a good ole case of crazy. Any ways, when she complained about meds being late I apologized and explained that if any meds are late it is because there is a patient that is in more critical condition who we must treat before treating her pain. If someone's having cp the nurse can't give her pain meds before taking care of the cp. she said I was making her problems out to be fake. She said she was told by a "nurse helper or whatever they're called" that her nurse wasn't busy and sitting down when her meds were due. I immediately asked which nurse she had and what tech. She backed out saying she didn't want anyone to get in trouble. I told her nobody would be in trouble, but that I had to go to each source to figure out at what point she misunderstood what the tech said because none of our techs would ever say a thing like that. First of all the nurses hardly ever sit and the techs are smarter than that and know her well. She then went on to say I know you guys get breaks, it's a law that you have to have a 30 minute break and youfe not allowed to work 24 hours. Oh I was getting so mad. I told her that I hadn't taken a lunch and had been up for 36 hours. Clearly we are all proof that what she was saying was ideal, but impossible sometimes. She asked if I was calling her a liar about that and what the tech said and I just said yes ma'am I am because you have now lied to me about at least 4 things that I have proof are not true. At that point I walked out and paged the dr who said no to the ct. I let her know and she said she was gonna report the dr and the hospital for not treating her and trying to find out what's wrong with her. I just apologized and advised her to do so if she felt hat was necessary and walked out. I told my boss when she got there the next morning and she was not surprised. Even she can't stand lady.

My concern with this is that this women is dangerous! She is going to get someone fired and nobody who I work with deserves that! I thought about that the whole way home. What if I actually got fired because of this women when I was working so so hard to make sure all of my patients were taken care of, dealing with everyone's issues as charge, putting out fires all night long, and not ever stopping to eat or pee. I had to stay until 10 to chart. And I continued to work during that time on/off, helping my patients who would come to the desk and catching up with patients I used to have, crying with ones who just break my heart with how amazingly positive and grateful they are even considering they're terrible situation. It just kills me to think I could lose my job over a women like that when I am a good nurse...I may not be perfect or held it together as much as I should have, but I survived hell. And I didn't deserve the way she was wasting time I needed for other patients who were critically ill. Neither did any other nurse or tech. I literally want to report this women to the police. Pretty sure she's got 4 or 5 different identities. Ugh. I guess I just need to get over it. It sure does help to get it off my chest though. I'm wondering if any of you have ever experienced something similar to this and did you get just as frustrated? What would you have done? Although there really is no advice that could help a person deal with this particular patient. Even the dr and nursing supervisor couldn't win with her. The dr was actually requesting someone go with her to see the patient so that she couldn't manipulate the rest of the staff and say things that weren't true or accuse one of them for mistreating her. Just a ridiculous situation. Anyways, thanks for letting me get this out there lol I realize not s lot of people will probably read this, but at least it's off my chest. You guys know how it is. Nobody cares about your nurse problems. They just don't understand. I wish everyone good patients and hope you never ever have to deal with a dreadful person such as this evil women I had the pleasure of taking care of. Thanks for listening.

Specializes in Medsurg/ICU, Mental Health, Home Health.

Everyone has said some great things.

All I wanted to reiterate...YOU WILL NOT LOSE YOUR JOB OVER THIS WOMAN!

I had no idea we were allowed to limit number of calls haha that's brilliant.

And I think I forgot to mention the patient was found to be recording many of the nurses in and out of the room, so it's a good possibility she recorded me calling her rude and her requests ridiculous. I was polite, but blunt.

If her superfluous calls are hindering your patient care to others as well as putting strain on resources, yes you can limit calls.

If they don't comply I will start the administrative/disruptive patient protocol which can discharge them at a certain point.

Like I said, you run the show not her. She can ***** all she wants, it will fall on deaf ears or you can get a psych consult haha. I bet she will like that.

Specializes in ORTHO, PCU, ED.

Good gracious long post and she sounds like she fell off the turnip truck. All I can say is been there...done that. I have to say she probably would've tipped off any of us to the point we started mouthing off. Boy sometimes I have to remind myself with cra-cra's like that, "I only have to do this 12 hrs...I can get through it...."

Your post is so familiar. We have a few frequent fliers like that on my med/surg unit and they are oh so frustrating. I am amazed at how well you handled the situation while also having your own load of patients to care for. As someone else said, you will not lose your job. And if by some freak chance you did, I'd say "good riddance".

Specializes in Med/Surg.

You can't explain and reason with these kind of people. Tell her no more ice cream and walk out. She didn't need to know how much ice cream there is in the hospital. You have a job to do with all your patients and trying to explain over and over to someone like this gets you nowhere. Sounds like she is well know and you are not getting fired over something like this .

Specializes in Public Health, TB.
You can't explain and reason with these kind of people. Tell her no more ice cream and walk out. She didn't need to know how much ice cream there is in the hospital. You have a job to do with all your patients and trying to explain over and over to someone like this gets you nowhere. Sounds like she is well know and you are not getting fired over something like this .[/quote

This patient may have a personality disorder, and if so, they do not or can not care about others. So I agree, reasoning will not work. She may ask why, but she doesn't care. Firm limits, and perhaps a script, help.

I wouldn't take away all of her control, but she ain't gonna run the show.

And you won't get fired.

I also think a behavioral contract. Meeting with social work on where to go from here.

Full NPO if she is nauseated and has abdominal pain. Can't have a CT with contrast on a stomach full of ice cream.

And perhaps her SBA is lactose intolerance and celiac all rolled into one, so the dietician needs to see her. And home health followup.

Obviously she is a danger to herself and others, so perhaps she can get treatment for her Munchausens. (gosh, I am sure I spelt that incorrectly!!)

Or you can give her a list of all private duty nurses who can come and be 1:1 with her on her dime.....

Does this person have any family?

Specializes in ICU.

If this was the VA she would get an 1200 cal clear liquid diet and her benzos and opiates would be tapered or d/c'd.

The freeloaders decide to shape up or leave. Depends on the weather.

Specializes in SICU, trauma, neuro.
I had no idea we were allowed to limit number of calls haha that's brilliant.

And I think I forgot to mention the patient was found to be recording many of the nurses in and out of the room, so it's a good possibility she recorded me calling her rude and her requests ridiculous. I was polite, but blunt.

Oh yeah... Once we had a stepdown/floor boarder (can't remember which) in my ICU, and she was on her call light literally q 1-2 min. Totally a&o. She was warned that we round hourly, but cannot ignore our critical patients to answer all of these call lights. The next time she rings in under an hour for anything but a true medical emergency, we would remove the call light. Two minutes later she rang and said, "I forgot to ask for an apple juice." Call light was removed.

Well I am prepared to deal with this kind of situation now. I'll be talking to my boss about this behavioral contract to see if that's a thing we could try.

@jadelpn

no the patient had no family and I do believe she had munchausens.

Ok. I spoke with my boss and literally every option I mentioned is not allowed. When it comes to limiting calls she says that we can just not answer all the calls, but eventually it will lead to the patient filing complaints. We are not allowed to take the patients call light because that does not ensure their safety. And as for a behavioral contract, those do not apparently exist where I work. I just don't know anymore. Apparently it has come to a point where nurses really have no rights.

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