manipulative clients

NeuroICURN · Mar 5, 2004

It's amazing how patient's often suddenly have the power to reach for their sweets and chocolate, but suddenly loose this power if they see you. I had a patient yesterday who suddenly couldn't wipe his own bottom. I left him for a moment and he suddenly acquired the power.

I hear ya Good Queen! When it comes to patients like that who say they can't wipe their own butt, I ALWAYS ask them..."Well, who does this for you at home?" LOL

mattsmom81 · Mar 5, 2004

So many nurses have trouble drawing that line...in meeting 'wants' vs 'needs'. Sometimes I must put it in exactly that context to demanding and manipulative patients and familes. 'My time is prioritized for critical needs of my patients in this unit, not the many trivial things you seem to WANT.' Then I will suggest a family member stay with them to provide extra attention (what they seem to crave) ...but I insist the family member not be a burden on me in meeting the critical needs of my unit, which is intensive care, after all. One would think the public would understand this concept. So many don't. .

Good_Queen_Bess · Mar 5, 2004

I often get, "No one came to feed my wife/son/whatever".

I feel like saying, "Well YOU were sat there. Couldn't you do it?"

Or when you are behind the curtain for a while with a patient and after you come out, another patients relative asks, "Have you done that sick note for my wife yet?"

"No sir, I have just come out from behind that curtain with another patient. I was at the SAME time writing a sick note because I DO have two pairs of hands and I thought writing a sick note was far more important than saving someone else's life." Sarcasm IS the best form of wit.

In the middle of the night, when it's obvious you're busy; "Can you pick my glasses case up please, I know you're busy, but I'm comfy and I might suddenly need it in the middle of the night!"

ktwlpn, LPN · Mar 7, 2004

for the most part, i believe that manipulative patients require pleasant but firm limit-setting. true manipulators know the art of playing the staff; quite frequently even split the staff and will go to great lengths to get what they want. again, i am saying for the most part. a manipulative patient, by definition, is a personality disorder and interventions need to address the potential damage they are so adeptly capable of. and it's an acquired art to learn how to effectively deal with this special population.

great post-You also described the evening shift charge nurse that follows me daily..to a "T"......I am learning fast-she thrives on reaction...please pass the xanax.........quote-bellehill>I always get sucked in, usually I get it after about 6 hours of non-stop running.>>>> :rotfl: That's when I often "get it" too......

Agnus · Mar 8, 2004

You won't be able to tell every time (IMHO) If your gut tells you something though listen. If you start to "feel" used or resentful this is also your gut talking to you listen.

Like some posters said you will not have a lot of time and will begin to set priorities with patients. This will help. There is a fine line between compassion and being manipulated. Whining is manipulation. Unwillingness to meet you halfway is manipulation.

I have seen even the sickest or most suffering people understand that they are not your only patient and that they might have to be a little flexible.

Manipulators are not understanding. In fact they will sometimes show blatent jelosey of attention given to room mates and do things to steal some of that attention.

Here's a good one that happened to me last week. Room mate had DVT. It was esentially benign and chronic. Great patient understood.

They did one last doppler on her before discharge.

After the doppler the roomate (the manipulator) smiled and said to me. "We'll they finally found my blood clot. and My calf is just killing me with the pain." At which point she grabbed her calf and started moaning loudly.

Now this woman did not have a clot, was not symptomatic, and was not suspected to have one. She was not being evaluated for a clot. Yet, "they finally found (her) clot."

"Oh" is the only response that I gave her. I left the room before I shook my head over that one.

SCRN1 · May 2, 2004

This is a subject I could go on and on about.

I work nights & I think a lot of our manipulative patients are that way because their family/friends have gone home and just want company because they're bored and can't sleep. I've had some who call & want you to turn out their light even though there's a button on their bed to turn it off with...they can't press it, but they can press the call light. Just the other night, I had one patient get up & come find me while I was drawing up meds for another patient. She wanted me to help her to the bathroom. She could walk down the hall, but not to the bathroom in her room???

The thing that really gets me is when someone has a family member or friend spending the night & that person does all the calling for things, but can't do minor things for that patient like fluffing a pillow. Why are they even staying?

The biggest thing that has cracked me up is when a patient recently wanted the tech to fan her while she was having a BM.

gwenith, BSN, RN · May 2, 2004

I had one the other day. In ICU least - sick of the lot of the patients BUT the most demanding - started going on about how "her heart was going" (she had breifly gone into Atrial fibrillation during the night). I ended up telling her to be grateful as she had managed to get through the night without a tube down her throat and on a ventilator and in that ward that was a definite win.

Blunt - maybe not politically correct BUT it was what the patient NEEDED to hear. She needed that plain spoken perspective because she started to perk up and show more life and interest.