Me... Me... Me: A Sense of Entitlement

Nurses Rock Toon

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We've all seen this type of patient. They start out in the ER insisting that they be seen first because no one else could be in as much need of medical attention as them. This behavior carries over to the floor once they've been admitted. They want it, and they want it NOW. What are some experiences you've had with such privileged characters?

Specializes in Medicare Reimbursement; MDS/RAI.

Working in LTC, you often see a sense of entitlement more so in the family members than in the actual residents. Anyone who's ever worked LTC knows your two largest medication passes occur b/t seven and ten in the morning, and seven and ten at night. Our nurse to resident ratios are larger, and it often takes all three hours to just do a medication pass appropriately; never mind if you have resident going south, or a new admission/re-admission, short-staffed on CNA so primary needs have to be attended to. This, in all my 25+ years of working in this field, is when every family member who's in the facility wants your attention NOW, or is calling to see how mother is. No matter how many times you explain these hours really need to be avoided for minor/trivial details that can wait, they want you to STOP right then and take care of everything from the "Mother's pink gown is missing" to My grandmother's roommate has stolen her cookies I brought her yesterday". While these are valid concerns, they are not A)life-threatening or B)time-dependent. If the pink gown is gone, me stopping to look for it down in laundry when she has other gowns to wear is not a priority.

There is also a pervasiveness of entitlement where accomodations are concerned in general. Family members are becoming more and more demanding of a nursing home being like their actual home. We are mandated to become more home-like; the powers that be in our government think residents should have more control over their setting and a SNF should be less institutionalized. While it's a wonderful concept in theory (after all, this is usually the last place many of them will call home), it is a pie-in-the-sky mentality to think management of for-profit facilities (as most are) will ever comply to hire more staff for attending to things like providing the resident the choice to bathe whenever they want (there is a schedule for a reason-if your CNA has eight residents to get out of bed, dressed, and fed by ten a.m., all of them cannot bathe at seven just because that is when they are used to getting one. All of them cannot have her running to the kitchen for their breakfast every half hour because one wishes to eat at eight, another at nine, another wants to have a "light brunch" at eleven). There are family members that request utterly ridiculous things like "make sure my mother doesn't eat margarine on her toast but every OTHER day" (actual true story-because that's how she did it at home to maintain her figure and never mind that mom is demented, refuses to eat at times and actually is at a healthy weight) and "Dad gets upset when we visit so if someone could just sit with him a couple of hours after we leave...." and will NOT hesitate to report your behind to admin if you dare suggest it may be worth your while to limit mom's gowns' colors to pink if that's her favorite and it will distress her not to have it or that if we have volunteers here that day someone will be happy to sit Dad but our staff cannot focus two hours on one resident and ignore their other seven. I was actually reported once because a family member complained to me that her mothers 75 dollar silk gown was ruined in our laundry and she wanted to be re-imbursed; I simply suggested she not buy anything that cannot in a regular wash/dry cycle or either take mom's laundry home to be done. I was rude, impudent, and unprofessional. The admin (who caters to anyone with a private pay account) had the nerve to write ME up based solely on her word regardless that I had witnesses that voluntarily testified to management my behavior was neither.

This is what we are dealing with in the twenty first century folks. The greatest generation is dying off, and the baby boomers are replacing them and the generation X family members are not happy with just having someone to provide competent medical care. They want (IMO) someone who will provide that medical care, coddle them, wait on them hand and foot, tell them they are right to demand immediate and subservient attention (and tell them they deserve it); admin would like for you to do all that, with no additional resources, and no additional remuneration for doing the jobs of the nurse, the doctor, the social worker, and the patient representative, and most especially, no support.

Specializes in Med nurse in med-surg., float, HH, and PDN.

Gosh-almighty, Jules, if you didn't hit it all right on the head with one blow!

The nursing home I started in when I was 20 was waaaaaay different in so many more positive ways than the last one I worked at, about 5 years or so ago. I found it to be exactly as you have described and was totally incensed and horrified; the attitude I got from admin. was "That's the way it is. Period." It was the worst experience I have ever had in my entire career, and if that had actually been my FIRST job in nursing, I believe I'd rather go wash dishes or bag groceries for a living! Not only is it "bad", it is so unethical of the facilities to put nurses in jeopardy, and immoral to treat living, breathing human beings with minimally mandated care.

Specializes in Medicare Reimbursement; MDS/RAI.

Stars, it is unreal how different it is now; I started out in LTC, went to rural health for a number of years, had a daughter that wanted law school so I came back because they do manage to pay well for the most part (or at least better than office/clinic work).

It is an insane and asinine idea to mandate a "home-like" environment in these places and put forth such a demand on already stretched-thin staff. Our residents are waaaaay more acute than when you and I started out, would you agree? We are getting residents with PICC lines, Bi-Pap, C-Pap, wound-vacs, porta-caths, TPN, almost everything but vents. We haven't breached that one yet where I work, but by God, if Medicare manages to figure out a way to mandate it and will pay for it, my facility will do that too. And relegate minimal staff with minimal experience to take maximum care of them. I have never regretted my decision to become a nurse more so than now.

What is even sadder, is that I'm in school to get an ADN, because my employer has decided I now need to be an RN to do the same job I've been doing for 11 years. (MDS). Ugh.

I know everyone should want to advance their degree, but honestly, I have AANAC certification, I have Medicare Boot Camp certification, I keep up with the regs and guidelines, and do everything within my power, within the boundaries of ethics, morals, and the law, to contribute to my employer's wealth (she says with tongue planted firmly in her cheek). I'm not knocking one's desire in advancing their education; but it seems more and more that nursing has become about the degree and not about the experience. I just wish nurses didn't feel pressured to at the insistence of their employers (and the BON and federal regulators in some instances) because it looks good on paper. I really hate we have all become so obsessed with "magnet" status that many have become dissatisfied in their chosen career.

Okay, enough of the vent. Thanks for responding to my post! See you around. :up:

Specializes in Med nurse in med-surg., float, HH, and PDN.

I also remember after graduating, saying, "Well, since people continue to get sick, since I am now a nurse, at least I'll always have a job." Ahahahahahahahaha!

I just pray I irreversibly croak before I am subjected to being a Medicaid-maintained old body in an Old Folk's Care Factory.

When I was a new grad, I had been out of orientation for 2 weeks. An unstable angina patient was moved to our non monitored floor. Well..he ended up coding. Across the hall, I had a 20 something year old patient who had broken both ankles by jumping out of a window of a home he was burglarizing while running from the police. He calls out for pain medication while we were in the middle of coding the gentleman with unstable angina. I didn't know he had asked for pain medicine for a couple hours because of the code. I went to his room when all was done with the code, and he was very angry. I told him I had a patient who was very very sick and had to be transported off the unit . He said he didn't care because his pain was terrible. Needless to say, he fired me as his nurse for the next night. The only person who has fired me in my whole 4.5 years of nursing . And I honestly was thankful.

It is very sad that no one has compassion for other people any more. I believe the press Ganey surveys and the management up this sense of entitlement that Patients have though. "Customers always right," "Pain is what the patient says it is." People are allowed to run all over us, no matter what the reason. And if we stand up for ourselves, oh no, we get a bad survey.

You see the entitlement issues all over the place though. The people who cut you in Walmart line, the kids who get all the toys they want, even though they have been misbehaving, and the patient who gets Mt dew with their trays even thought they just got off an insulin drip. No accountability any where any more.

There's my two cents.

Amy71076 said:

I love it when a patient will call and ask for a drink so you ask them is there anything else they need and they say no. Once you get into the room they now want a snack. So again you ask them if they need anything else and they say no.

So when you come back with the snack they now have realized they are cold and need a blanket. So you go get it for them and After you have asked them again if there is anything else they need and they say no you are walking out and they say "well actually, I could use...." at that point a little pillow therapy would be nice....

Oh my goodness, yes, I hate this! Every shift! They think we have nothing else to do. And when you bring them one snack they finish that one, and immediately want ice cream. Especially if they are diabetic. Smh.

SionainnRN said:
Yeah, how dare we jokingly complain/vent about our jobs to like minded folks!! We should all immediately surrender our nursing licenses!!!!

We will see how his/her attitude is upon entering the real world of nursing....profile says pre nursing student.

I had a patient who fired me and demanded a new nurse because I went on a lunch break. first and only break of the day. the charge nurse was covering me but that wasn't good enough for her. she states "that white nurse is here to serve me, how dare she think she can take a break?!" before I left I rounded on her. aox4, just a monster of a human. I do not get paid enough for this.

Jensmom7 said:
That's why good documentation is key-if it points to him not having MND (and thank you SO much, WebMD and Symptom Check *sarcasm*), his insurance might deny the claim, and he'll get the bill. Which he might or might not pay, but that's another discussion.

I also document if a patient is violent or mean, yelling into the hall, cursing, etc. Because those are the patients who will sue us for the least little thing.

Specializes in Medicare Reimbursement; MDS/RAI.

Yep. My husband (cancer patient at a major university hospital) just got his Press Ganey survey in the mail today. Asked me what it was for. Two hours into the rant, he regretted asking. :woot:

zenitude said:
I had a patient who fired me and demanded a new nurse because I went on a lunch break. first and only break of the day. the charge nurse was covering me but that wasn't good enough for her. she states "that white nurse is here to serve me, how dare she think she can take a break?!" before I left I rounded on her. aox4, just a monster of a human. I do not get paid enough for this.

Wow, that is awful. I cringed when I read this. I am so sorry you had to be subjected to this person. It is so sad that people like that exist in this world.

Ltc facility, pt who's family insisted that she get her meds EXACTLY at prescribed time, in a syringe not a cup (perfectly capable of drinking from med cup) you couldn't throw away cups or syringes in the room because family would pop in and check to see if any drops of medicine was left. Family once complained at Christmas that the pt did not get the same thing in her gift bag that another resident got. Family would insist that the shower room be available at a certain time every cpl days so the personal caretaker could come and shower the pt (and they better not have to wait 5 min for someone else to get done) the list goes on and on. Sidenote... why are patients with ongoing lawsuits against a facility allowed to stay in the facility? Better yet why would they want to? If they have been treated wrong there, why stay?

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