So I had this older lady who was hospitalized for pneumonia. All evening she was very pleasant and even offered chocolate each time I went in to see her. It was mentioned to me at the beginning of the shift that the night before she had gotten out of hand and I thought this lady is so sweet I wonder what they are talking about. Well at 6am I found out. She was screaming down the hall that if someone doesn't get her water right now there is going to be a dead patient. I go in the room and her eyes are red and puffy and she starts screaming at me saying I am a horrible nurse and I neglect her and this is a horrible hospital. When I asked her why she was so upset and what she needed she started screaming how she hasn't had a bowel movement in 2 days and I don't care because I'm not calling the doctor. (The night before I did give her something)
I wanted to tell her the reason she isn't going as frequently is bc she won't get her butt out of bed! She refuses to get up to a commode or a chair. But I wasn't going to fight. She yelled for us to get her fixed up in bed so we pulled her up in bed and I laid the blanket on her and she said "this is how you're gonna leave me, you aren't even gonna make it nice." Omg! I wanted to just tell that lady to cut the crap bc she was just out of control but I know we are supposed to be cordial with the patients.
Has anyone ever told a patient to just cut the crap and stop being nasty?
OMG! Where in this post did the OP ask what her diagnoses might be? The question was essentially how do you handle a difficult patient.
Regardless of sundowners, UTI, anxiety, or what have you, we've all had a patient that drives us up the walls. How do you check your attitude? How do you prevent yourself from shooting off something inappropriate to the patient? And if you say those thoughts don't ever come to mind, you're in complete denial. Reading is fundamental, friends. Understand the question first before offering irritating answers.
A possibility that comes to my mind is borderline personality disorder.
And sometimes i think it is appropriate to tell a patient to 'cut the crap.' I can't speak to this one without more information, but sometimes some are simply too out of control and others occasionally appear to want be the child to the parent nurse who sets boundaries.
If you find that the tone that a poster uses rude, then what is your own post supposed to demonstrate? Is this an attempt on your part to encourage a more civilized or cordial discourse?
OMG! Where in this post did the OP ask what her diagnoses might be? The question was essentially how do you handle a difficult patient.
Reading is fundamental, friends. Understand the question first before offering irritating answers.
@ Jaykalkyn, BSN, RN Was the OP really asking how we handle difficult patients? As I understand it OP felt like telling her patient to cut the crap and stop being nasty and wondered if anyone here had ever done that. Beyond that, I didn't really see OP asking for advice on successful ways of dealing with difficult patients. Did you read something different?
OP described her patient as a very pleasant and sweet older female who was hospitalized for an infection (pneumonia). When a patient like her suddenly changes her mood to agitated and rude, a nurse should start thinking about if the cause for this altered behavior can be due to disease (-process) or the effect of meds. Given this patient's age and reason for hospitalization, she is not the right patient to be told "to cut the crap".
There are as discussed in this thread many possible medical reasons for the patient's change in behavior. OP doesn't seem to have taken these into account and is perhaps not even aware of them. That would be bad, as they are things that a nurse is expected to know.
OMG! Where in this post did the OP ask what her diagnoses might be? The question was essentially how do you handle a difficult patient.
Regardless of sundowners, UTI, anxiety, or what have you, we've all had a patient that drives us up the walls. How do you check your attitude? How do you prevent yourself from shooting off something inappropriate to the patient? And if you say those thoughts don't ever come to mind, you're in complete denial. Reading is fundamental, friends. Understand the question first before offering irritating answers.
Fair enough. The OP's actual question was: "Has anyone ever told a patient to just cut the crap and stop being nasty?"
My answer: No, I have not ever done that, and would expect to be disciplined if I did.
Specializes in OR, Nursing Professional Development.
can someone explain to me how this post is not a hipaa violation????
Was enough information provided to identify the patient? There are no names, dates, locations provided. This scenario can play out in every single hospital across the country and perhaps even the world.
Do you believe you have proof to state that the post is a HIPAA violation? If so, please explain. If you're going to start such a discussion, it is upon you to explain why it is.
Delirium, dementia, mental health issues, entitled, impatient....., take your pick. Assess the patient, offer care, document, move on and don't take it personally. Some patients have genuine medical issues that require attention, others just lash out at whoever is in front of them, hate to say it but it is part of the job these days. Keep them safe, cya, and keep moving. Sounds superficial, but, too much to do and too little time.
Nope, never said that to a patient, not even once. But I have done my best to check for the underlying problem and treat that. If the diagnosis truly is nastiness the patient will find that they get the service which guarantees them the quickest exit from my domain.
Okay I have a few thoughts to add to this thread. First of all, we're nurses and we don't diagnose medical conditions; Doctors do. Secondly, sundowning at 0600 seems a bit odd.. have a think about why this is lol. Thirdly, it's completely normal to feel like telling a person to cut the crap sometimes; but it's not what the OP did. Not sure why people are getting on their high horse over it. Nurses are supposed to reflect on their feelings (yes, nurses do have feelings) and let it guide their reactions to future situations at work. I'd be calling delirium if the woman was seeing dancing monkeys and her AMT dropped from 4/4 to 2/4 or less. Irritable, brittle mood is a symptom of many different mental health conditions and personality traits. Especially first thing in the morning; Some people are horrendous when they wake up and that's just normal for them. The majority of general nurses know very little about psychiatry. It's why challenging behaviours can be so hard for you to deal with in the first place. No point trying to act like you're Florence Nightingale every time you handle a patient who is being a tit. It is frustrating but how we deal with situations vs how we think don't have to be synonymous.
maryel
32 Posts
RIGHT?????? and some were so rude!!!