can't listen to his stories how to I get out fast?

Aberdeen · May 21, 2010

Maybe you could set an alarm on a cell phone and use the ol’ “Oh, (insert name here) is calling me, I have to go. I am soooo sorry, as soon as I am done, I will come back and you can finish your story.” :)

nickos · May 21, 2010

Quick question..you said he was a "resident", so does that mean you work in LTC? I have ideas for patients in hospitals but permanent residents? not so much...

scoochy · May 21, 2010

Have a staff member come to the room and inform you that Doctor so and so (make up a name) needs to speak with you NOW. It has been my experience (the majority of the time) when patients/residents hear the word "DOCTOR,"everything comes to a dead halt. I often use a similar trick when a resident doesn't want to take his/her meds. "The doctor has ordered it for you." Works for me most of the time.....

I feel your pain....been there..............

Brekka, ADN, RN · May 21, 2010

I have worked in a LTC facility for three years as a CNA, and I've been in that position as well. I too have had residents similar to the one you're describing, and the way I usually handle them is through calm explanation. I am a calm and patient person to begin with, so that helped a ton, but it may be something you can try as well.

Try saying something like, "I'm Sorry Mr. Smith, but I do have other patients who need my help right now, and there is only so much of me to go around. If you'd like, I can come back and check on you later and you can catch me up on the rest of that story?" Remember to be assertive as well if needed. When you say you have to leave, follow through while still being as calm and patient as possible.

Usually a calm explanation like that would get me a calm response. I'd then ask them if there was something I could get them to keep them occupied in the meantime, such as stationary for letters or a book. Usually they'd take one or the other, and that would keep them busy while I finished what I needed to do or just take a quick breather. Make sure you come back and check on him at a reasonable time, however, don't just blow him off.

Now it may not be effective right away, and he may not be too happy at first, but as long as you only do so when it's absolutely necessary it should get easier. Usually showing the patients/residents respect and understanding will get you a similar response from them, regardless of who they are.

If that still fails, get a colleague to knock on the door for you after a set period of time and pull you out of the room for something. This backs up your claim that you're needed elsewhere and keeps you from going crazy.

I'm a people person, so it may just be me, but you have to remember the type of life these people lead. Family and friends are usually few and far in between, and the social interactions they have with others is usually limited. Everyone has stories, thoughts and ideas that they want to share, and the elderly or other residents in long term care are just looking for someone to listen to them. Also, people like the resident you're describing seems to be alienating those around him, and is in need of someone to talk to more than ever.

shiccy · May 21, 2010

But that won't fly w/him. He will say he pays x thousands of dollars and he deserves blah blah. I'm thinking of having my aide knock on the door if I'm longer than 5 minutes, but I can't always rely they will be there.

Two things. PLEASE tell me you're not finding another job b/c of this guy... There are MILLIONS of them ALL over. You will never EVER avoid them.

As far as those that we're having trouble with, we have cordless phones in our hospital. We just give the Unit Clerk the number and say, "If I'm not out of room 'X' PLEASE call me and say it's an emergency." The only problem with this is that if it happens every time you are in his room, he'll figure that one out eventually.

As per your quote above, the truth hurts and he has to suck it up. When he cuts you off and says, "I pay $x/month to be here ............." wait until he's finished saying his peace, and quickly and FIRMLY say, "I understand. I have more than one patient, and they all need their medications at the same time as you did. I unfortunately can't stay right now, but I'll be back in about (given time frame). If you're awake at that time and things start slowing down, we can talk then." This should be said while you're slowly making your way to the door. If he tries to keep talking, you unfortunately have to walk out and say, "Sorry I have to go".

That being said, many or all patients that are like that are this way for a number of reasons. These can include the fact that they have no or very minimal visitors (80% of the time), they're scared about what's going on and talking is their only way to get away from it (15% of the time), and there are others, but they're less common.

Finally, unfortunately, sometimes listening to those stories make HUGE differences to people. If he's willing you to tell stories about his personal life, then he probably likes you... He values your ear, so 5 minutes (honestly) seems like eons, but isn't really all that bad.

I don't know if you're an ECF or not, but if you have a med cart, then maybe taking the cart in and getting the next person's meds ready while he's talking? I don't know what else you can really do other than the above.

FINALLY, DON'T let other people's opinions influence you about these types of patients. I would even go as far to say that when given report, if you're given a subjective portion of information about the patients 'attitude' that you don't find appropriate or helpful, request that this information be withheld. I've had info like this from my day RN's about "this patient is a huge PITA, etc", and, honestly, that is NOT useful. The person giving report might think so, but you shouldn't as a new RN taking care of that patient. Things like, "Having med seeking tendencies is sometimes useful, but almost NEVER is the "PITA". (I will let, "He/She's a talker" slide ... if they're not intensely critical, I leave them until last ... this way I don't have to worry about not needing time. I see my patients as quick as I can, peek in on the one I haven't assessed, pass their meds, and then take the person that talks a bunch their meds, do the assessment, etc. It gives you time to HAVE a very small bit of talking time, and doesn't make yourself appear to not care / being rude.

Good luck!

CoffeeRTC, BSN, RN · May 21, 2010

I've had my share of these residents. People may say psych consult. Okay...some of them have had psych care and do have OCD, some don't or this isn't the option.

Having someone call you will work for a while, but he might not get the idea and just get mad and made to feel unappriciated etc.

If this happens to all staff..you need to get the IDT on board and get a care plan in place and set some limits. Stick by them but also let him know that if there is an emergency etc..something may have to chage.

Make all staff stick it. CNA might have 15 minutes to help with ADLs in the AM. You might go in at 5pm for meds and alot 15 mintues no more.

See if something like this would work.

netglow, ASN, RN · May 21, 2010

OP, I would simply stick to your schedule. Do not let a patient determine this. You don't have to be confrontative. State, clearly what you are there to do, and that its all. You don't have to answer or respond to any baiting questions. Sometimes, not answering is answering.

The meds. If it's repeated delay, refusal and you've educated the patient. I have abruptly said, "so, let me be sure that I am understanding you... you are telling me you are refusing this medication that your doctor prescribed? I need to be sure because I have to document this in your records and let him know right away that you don't want to follow the treatment plan he's put together for you..." This usually causes pause.

j621d · May 21, 2010

Based on the limited amount of information on this patient, I have a feeling he is lonely and wants company, even if it makes others dislike him. Negative attention is better than no attention. I wonder how it would be if more nurses stopped in to just say hello. I'm sure you are thinking I'm off my rocker, and I would be thinking the same if I were in your position, however, avoidance is certainly not helping the situation. Try an attitude adjustment on your part: "is this how you want me to place the pill?" "Is this how you like it?"

The hardest may be to say "I'll be back in X minutes" and then do it. Maybe he craves attention. Something to think about.

SuesquatchRN, BSN, RN · May 21, 2010

Save his meds for last. And pity the geezer. He spent his life in a very ordered world and now he has no control of anything to he's going to give orders to his troops -- you and the rest of the staff.

CrazierThanYou · May 21, 2010

I swear they're going to make my days til I can get out of there, absolutely miserable.
I'm desperate for help. I just got assigned to one of our toughest residents. He's disliked by all b/c he can act so rude and plain nasty if things aren't exactly right. He's ex-army/priest. When you go to his room you must knock, wait for him to answer to come in, make sure you shut the door quietly and then proceed. He will then ask why you are there. Then you must wait for the all clear to begin giving his meds. The water must be the exact temperature he likes, the meds must be one at a time on the spoon, capsules must be facing him vertically on the center of the spoon. He then weaves his head to the left and will complain that you can't put it in his mouth straight.
Okay, that's the background. If he likes you and/or is in a decent mood. He will go into stories. Usually they are puffed up versions of what he knows and has been exposed to. Where the Catholic faith is heading...things like that. I don't have the time. Tonight was short, I remained standing even though he preferred me to sit, he kept me 5 extra minutes than need be. I have other time consuming residents. Doesn't sound like much but some days he has kept nurses for 40 minutes with a story. I want to nip it before it goes that far. It's easier to shut someone down early than it is to let them keep going.
Besides the time factor, I seriously dislike him. No onellikes him. He treats the aides like garbage. I don't like the self important way that he handles himself. It seriously grates on my last nerve. I thought of just saying that I have other meds to pass I've got to go. But that won't fly w/him. He will say he pays x thousands of dollars and he deserves blah blah. I'm thinking of having my aide knock on the door if I'm longer than 5 minutes, but I can't always rely they will be there.
The only other thing I can think of, is to say I have something in the microwave that's got to get to another resident, or ice cream that needs to be given to a resident but I don't know. Any other suggestions to get out of there fast?
I cannot get a new job fast enough.

O M G. That's all I can say!

Bug Out, BSN · May 21, 2010

"No habla English"