Is it normal to feel this way?

[The0Walrus, BSN, RN]

So I work in a nursing home and psych. I like many of my patients. When patients get really needy I just get annoyed. By needy I mean like one patient in the nursing home comes up to me maybe 30x in on my shift for things like she wants her meds which she already got, she'll use the call bell to play with it several times, she walks over to me or her nurse and stare blankly at you sometimes cough on you. She picks at these scabs on her forehead. I cleaned them up with Bacitracin and she would again pick at it. I cleaned it a second time with Bacitracin and she again picked at it. Another time there was a pitcher of iced tea she drank all of it which was for all the patients and she coughed into the pitcher of ice tea. It's really overwhelming. I have to redirect her her back to her room 30x, give out meds, do wound care, take vitals for 30 patients... It's a lot. I've never screamed at her because she is a patient but it's a lot I have to admit.

Is it normal to get annoyed at patients like that? Where they need your attention so much? I never yell at them but I get annoyed. Thanks in advance.

[caliotter3]

Yes it is normal to get annoyed. The degree of annoyance might indicate a need for some time off to recharge. If a short vacation doesn’t help much, maybe start looking around for a change of pace.

[NightNerd, MSN, RN]

It's normal. Is the patient cognizant of her behavior or are there memory problems, etc.? That would affect how annoyed I would be. It can make you crazy, but sometimes people just can't help it. They're doing their best, and so are you.

[Davey Do]

I know this patient. Or maybe her cosmic psychotic sister.

We rode the storm out with Sister Psychotic until she was eventually, after three months, transferred to the state hospital. There was little we could therapeutically do for her.

The Behavior Mod technique sporadically worked with Sister Psychotic- you know, reward good behavior, give her direction for inappropriate behavior, or make her "persona non grata".

I would give her a subliminal message by holding my open hand toward her, at my side, and say something like, "Until you can behave appropriately, you are persona non grata- you don't exist". Attention seeking attempts resulting in me ignoring her.

Like I said Walrus, it was a hit-and-miss situation, I.e. sometimes the techniques worked, and sometimes they didn't.

Sister Psychotic responded to some staff members than others. She didn't like me, so she'd go out of her way to staff shop. Rooty Payne, psych tech, worked well with her, being the strong silent type who gave Sister Psychotic clear boundaries.

Getting frustrated with this type of patient is normal unless you have the title of St. Walrus. And, I've found out that (not yelling, mind you) speaking emphatically sometimes gives a wake up call. It is especially noted by those, like yourself, Walrus, who've not raised their voice at her.

Good luck, Walrus. I admire your stamina and problem-solving endeavor!

[RN96, MSN, RN]

Yes, it's normal to have a patient like this get on your nerves. I like the ideas mentioned by DaveyDo. Also when you are off work - you are OFF WORK. Recharge at home and take a mental vacation.

[RNperdiem, RN]

Needy and manipulative behaviors are irritating. It is normal to feel this way.

[Closed Account 12345]

It's totally normal, and I think most nurses (including me) would feel a bit annoyed, but there are two sides to this.

Imagine being stuck in a nursing home with minimal human and social interaction, no more public activities, rare exposure to nature, which would a facility courtyard at best, being in failing health, possibly having a family that doesn't visit as much as they should, and staff wanting you to stay in a tiny boxed room all day, which may or may not have another person you didn't pick living in it. Can you imagine how crazy THAT would make you feel, even on the best of days?

She's lonely, and she's bored, and she doesn't know or care that 30 people need vitals taken. She knows that you're her chance at human interaction. I highly doubt that she picks scabs or coughs in tea just to annoy you. Do your best to be compassionate and empathetic towards her; you get to go home at the end of a shift, but, sadly, that is her home.

If she is decently cognizant, can you help distract her with special little assignments or fake jobs where she feels involved and like she has purpose? If she's not, well- that makes her behaviors much less frustrating to begin with because she can't help them.

[The0Walrus, BSN, RN]

Thanks, everyone. It can be tough at times when dealing with difficult patients. My job has also been making me charge nurse recently and I'm not used to dealing with patients who I know are sick but needy. Davey thanks a lot! You're probably my favorite person on this.

[VivaLasViejas, ASN, RN]

I used to work with a NH resident who was totally A&O, who screamed "HELP!" literally every five minutes, give or take a few seconds. She refused to get out of bed even though she was capable of being up in a wheelchair, and was probably the laziest person I've ever known---you know, the one who wants you to give her a drink of water when she can perfectly well reach the glass, and arrange the blankets in a certain way so she can mess them up and have them straightened out again. We were all at our wits' end with her, and it got to the point where we had grim fantasies about giving her some pillow therapy.

Then it occurred to me to ask for a psych consult. Now, getting almost any doctor to visit their patients in a nursing home takes an act of Congress, even if it IS a state law that they must come in at least every 60 days. But somehow we were lucky enough to find a psychiatrist who was willing to come to the facility to assess her, and before long we had a name for her problem: she was suffering from depression and borderline personality disorder. Which made sense, because she was so needy and fearful of abandonment, and yet she was also manipulative and an expert at staff-splitting.

Once she got on some antidepressants, she became less anxious and yelled only a few times a shift. There was nothing we could do about her BPD, of course, but the consulting psychiatrist had referred her to a therapist who came to the facility each week for counseling, which was quite effective. I think it made her feel less lonely and gave her an opportunity to vent her frustrations. Anyway, she mellowed out and became less of a PITA---a win/win for sure.

[Been there,done that, ASN, RN]

This resident is not needy. She has an undiagnosed psych condition.

Get the provider to diagnose and prescribe the correct psych meds.

[FashionablyL8, CNA, LPN]

Normal. A few of my residents get on my last nerve with their behaviors. It's usually the ones who are high functioning, devious and manipulative. I think that as long as annoyance never crosses into actual anger and I don't feel annoyed more often than I enjoy my job, it's all good. I'm blessed to really like my job. It helps to have co-workers that you can vent to/laugh about the more bizarre incidents. I'm sure there are some people who feel that nurses should be saints who adore everyone they take care of. Maybe some of those nurses even exist, but I don't know any and I'm not a nurse yet but I'm confident I'll never be one of them ?).