What is your least favorite kind of med-surg patient? - page 6

Mine definately would be the patient with pancreatitis. Although they have elevated levels of Amylase and Lipase and do belong in the hospital they always seem to be the most difficult patient for me... Read More

  1. by   NurseKatie08
    My least favorite patients are the demanding know-it-all types that want to tell you exactly when they're supposed to get their meds, and exactly how their dressing is supposed to be changed--I'm talking a simple cellulitis dressing change--wash, dry, apply ointment, wrap it up...."That's not enough water....you're scrubbing too hard, now you're not scrubbing hard enough, that's not enough ointment, it's too loose, now it's too tight."
    Nevermind that she was A&Ox3, independent with the treatment for the skin breakdown on her upper extremities, and probably could easily have washed the leg herself, but refused to try because "I don't need to know how to do this."
    Also refused a CXR for a fever---"well, what is the CXR going to show?" I won't know until I have the results!!!
  2. by   Longie
    Quote from harley_fan
    I don't like taking care of the noncompliant patients. They come in the hospital and stay for an extended period of time not really committing to any treatment plan, or refusing cares. It stinks that they waste the staff's time, the taxpayer's money, and they occupy a room that could be used for someone who probably would be more appreciative of everything we do!
    :yeahthat:Especially renal/dialysis patients who are noncompliant with their routine outpatient dialysis/meds/diet--they come in, get dialysis in the hospital, scream at the staff because they aren't being given all the no-no foods they've been consuming on the outside, blood pressure/blood sugar takes nosedive B/C MD Rxs increased/new meds thinking admission meds weren't working when in fact they simply weren't taken--stay a month or so, get things halfway under control enough to be discharged and guess who rolls back in several weeks to months later:angryfire
  3. by   ARKYLE
    Post-op hip replacements!
  4. by   newrn05
    I absolutly hate drug seekers. I recently had a patient who refused to go home after having an ovary removed via a lap surgery. OMG that don't hurt that much. She was received dilaudid, phenergan and benadryl. Everyone knows that when a patient has these ordered every 4 hours and demands they get them together that it is to get high. The Doctor she is admitted under admits patients to our hospital but does not round on them. The Dcotro that rounds on them sees her and immediatly dc's all of her meds and puts her on lorcet 10's with 1 mg morphine for breakthrough. I speant 3 hours that night calming her down and stopping her from yelling screaming and swearing all night. Mind you I had 6 other very ill patients that could have used some one on one attention like that from their nurse but didn't cause I was too busy playing babysitter.
  5. by   queenjean
    My least favorite pts are pts with moderate to severe borderline personality issues, and ANYTHING ortho.

    I'll take your drug seekers and your detoxing drunks anyday--for some reason I have no problem with these pts and even enjoy taking care of them. But the borderlines and anything ortho--ugh! With them I'm waaay out of my comfort zone.
  6. by   Tweety
    Quote from newrn05
    I absolutly hate drug seekers. I recently had a patient who refused to go home after having an ovary removed via a lap surgery. OMG that don't hurt that much.

    One must be careful. I remember a day nurse labeling a guy a whiney drug seeker after a lap chole because he complained of uncontrolled pain and she failed to assess the patient properly "everyone knows a lap chole doesn't hurt that much". Turned out he had a nicked bile duct....opps.
  7. by   tsalagicara
    Quote from GypsyroseWolf
    Lately we have had an influx of drug seeking patients on the unit, most of them are frequent fliers, and seek pain medications. I even had one pt who told me straight to my face "I might as well feel great while I am here, and man these drugs are great". I felt as though I should some how inform the MD of the statement so I did, and we slowly weaned the pt off, the pt became enraged and really did become a HUGE problem, the total stay was 23 days by the time of discharge, three specialists, 1 psych MD and the pt was self pay, so you know who took the bill for that. Those are the pt's I have a hard time treating, because I have other Pt's who really are in pain, and the MD is afraid to prescribe anything worth taking, when they deal with the drug seekers everyday abusing the system, and the medications.Thankfully I only have 1 out of 6 like that at any given time. I have learned to research symptoms, diagnostics, and how they relate to pain. I use the faces scale more than the numbers with those types of patients to try and have an accurate rating for the MD, and I unfortunately sometimes have to discourage Md's from increasing doses based on the research, and prior pt history in the facility. That is the part I do not like, I was taught to never doubt a patient when they say they are in pain, but when I have a pt smiling and laughing while they state their pain is a 10, I just have to follow my instincts.
    I want to say that I totally understand and feel your frustration, both from a health care provider's point of view and a patient's point of view. The true "drug seekers" make things very hard for patients that really are in a lot of pain. It's from the patient's point of view that I, respectfully, also want to tell you that not everyone screams, grimaces, cries or writhes around when he/she is in pain. Smiles and laughter do not necessarily equal less pain. Sometimes, humor provides a great distraction from the pain... and sometimes, it isn't culturally acceptable for the patient to outwardly show what he/she is feeling.
  8. by   sistasoul
    Quote from lady_jezebel
    1st: The pts that treat me like a waitress or personal servant.

    2nd: The very obese patients that need constant help using the bedside commode. It's hard to move them, and takes a lot of time (which I never have).
    I agree. Some patients want you to move their pillows a certain way and aree constantly on the bell for small things such as this. When asked how they move their own pillows at home they will say, "but everything is differnt here" in a loud voice.

    Also, the obese patients who say, "My legs can't hold me up". Well do you think I can I want to say. I always get help and refuse to injure my back because of the largely obese patient.
  9. by   ERNRS13
    No one mentioned the good ole c-diff yet. That is one of my favorites!! The constant stinky, mucus diarrhea that runs out as soon as you wipe them. Oh yeah, we all know and love them!
  10. by   GooeyRN
    The type where NOTHING makes them happy. You can deliver them Dilaudid along with their surf and turf, and they would still not be happy, and ringing in 2 minutes b/c you brought them a pepsi, not a coke. And they can not eat the toast, b/c there is not enough/too much jelly on it, it is margarine, not butter, etc. The ones on the call bell constantly, and then act annoyed when you interrupt their phone call to give them scheduled meds. They want their consult with the podiatrist to cut their toenails NOW. Oh, and it has to be scheduled for Friday morning, b/c they have plans all the other days.
  11. by   admorn03
    Hands down for me are the detox patients. Keeping them drugged up so they can sleep off their hang over, makes me scared. You have to spend a lot of time in my opinion worried about over sedation. And I always feels as if my assessments of these people is not on point, but all has been well so far.
    Also confused patient's that will not stay in bed concern for their safety, since restraints, chemical or physical are frowned upon. But again all has been well.