Money Hungry Patients

Published

Specializes in Med-Surg/Long-Term Care.

Hello, all, here I am again. I have yet another war story from a day in the life in the Battle of Nursing. This time, I actually have empathy for the physician :eek: ( I know, I can't believe I said that either)

For the last couple of days, I have had this awful patient. This man came to the ED in my hospital about 3 weeks ago due to a problem. He ended up being admitted and scheduled to have minor surgery. In the meanwhile, the doctors discovered multiple other things wrong with this man. And that's to be expected when you have never had insurance and never seen a doctor before. There is bound to be something that will be discovered the first time one is evaluated by a physician. Anyway, about 5 surgeries later, this man is on a war path.

First of all, and I put this nicely, this man has some major mental issues. This man is in his late 50s and his mother still spoon feeds him. He is very whiny and overly dramatic. And his family member overreact to every "ooh" and "aah" this man belts out. And he is blaming the doctors for all of his problems. The main reason for this is because he had to have a colectomy done due to major problems with his colon. Well, against doctors orders, the man gets up, unassisted, on the side of the bed and his staples busted. Gut busted open and he eviscerated all over the place.

Well, he ended up in ICU and is now back on the floor. And now he blames the physicians, every single one involved in his care, for all of his problems. And I have heard this man threaten to sue the doctors for 12 hours straight. And to make matters worse, his family member, who happens to be a nurse in this facility, is instigating it all. She is actually encouraging this man to sue, knowing darn well that his problems all stem from his stubborness and him insisting on doing what he wants to do.

Well, after listening to how bad the doctors were and how he was out to get them to make him "remember" what they had done to him, I actually am disgusted with this man. He acts as if the doctors did this to him and because they found all this stuff wrong with him, they did it to him. He refuses to acknowledge that until now, he has never seen a doctor and he had problems that have just been discovered. He even had the nerve to ask me my opinion. Of course, I refused to comment and left it at that.

My question to you all is this: Should I inform my supervisors of this man's intentions to sue the doctors and the involvement of the relative-employee's encouragement to do so? Should I inform the doctors of this man's intentions? I know I've charted all the things the family has said and done (I catch them messing with the IV lines), and the patient told me himself that when he got up unassisted against doctor's orders, his incision ruptured afterwards. What is my role in all of this since he has told me so much about it all?

And lastly, I will say, I am totally disgusted at this man and his family. I can't believe that after all these doctors did to try to help this man get better, they would blame them. It infuriates me because although doctors are jerks at times, and they don't respect us at times, they still mostly are in the healthcare profession due to some degree of altruism, no matter how small a degree it may be. And it is a shame that this day in time, some patients (especially backwoods, dumb, inbred people like this patient and his family) are out to make a quick buck off of the good intentions of healthcare professionals. This is a private hospital at which I work and they doctors could have just referred this man to the VA since he is a veteran without insurance (and I don't condone that either, but you know they do that sometimes) Yet, this doctor, who is an excellent surgeon, took on this case without a second thought about ever being reimbursed or anything. This patient even said that he was glad he was in the hospital because he could get free medicine which he couldn't get at home. He and his family are out to make a quick buck and they should be ashamed.

Whew!!!! That was my soapbox, now I'm done. But what do you all think I should do? Thanks in advance.:nurse:

Up Vote Up Vote ×

Can a patient with "mental issues" truly follow DR. orders?

Up Vote Up Vote ×

Improving the management of patients with mental ill health in emergency care settings

http://www.dh.gov.uk/assetRoot/04/08/91/97/04089197.pdf

Up Vote Up Vote ×

My question to you all is this: Should I inform my supervisors of this man's intentions to sue the doctors and the involvement of the relative-employee's encouragement to do so? Should I inform the doctors of this man's intentions? I know I've charted all the things the family has said and done (I catch them messing with the IV lines), and the patient told me himself that when he got up unassisted against doctor's orders, his incision ruptured afterwards. What is my role in all of this since he has told me so much about it all?

Where I used to work, if we were privy to such info, we filled out an occurence form that basically gave the jist of the conversation. Risk management would then review the chart and see if any kind of intervention was required. Perhaps you should discuss this with your nurse manager...

Up Vote Up Vote ×
Specializes in Correctional Nursing, Geriatrics.
Can a patient with "mental issues" truly follow DR. orders?

I think that the scenario OliveVines describes here is more a matter of mental ignorance issues rather than "mental issues", therefore this man is certainly CAPABLE of following dr's orders. He simply CHOOSES not to because he is so blinded by his ignorance and greed for a free ride that he is oblivious to the fact that the healthcare providers are trying to help him and giving him these orders for his well-being. People like this are usually beyond help!!!!:banghead:

That said, OliveVines, I think you definitely need to report this behavior to someone. As the other posters have said, your nurse manager, a hospital risk management team, someone who can take matters to assure this creep is kept in check. And most importantly, YOU keep documenting his statements, his non-compliance, as you said you have done all along. This is critical to stopping frivolous law-suits like this in their tracks. As soon as his lawyer hands the chart to a legal nurse consultant for review, he or she will inform that lawyer that there is NO case for malpractice because the patient brought all his problems on himself. If the family member that is a nurse had any brains she herslf would know that.

By the way, OliveVines...you said his mother was actually spoon-feeding him?? Literally? How weird is that !!??:eek:

Up Vote Up Vote ×
Can a patient with "mental issues" truly follow DR. orders?

Yes, absolutely. It totally depends on the patient in question. Just because someone has emotional problems does not mean they do not know how to stay in bed until someone is there to assist.

Up Vote Up Vote ×

Olive...

Chart and document your little heart out. Write down every bloody thing he says. Miss nothing.

Up Vote Up Vote ×
Specializes in Critical Care, Pediatrics, Geriatrics.

I agree that charting everything appropriately is the best solution to this problem. There are very sue happy people out there. There are ignorant patients and there are meddling family members. But I am almost certain that this guy has been screwed by the government over and over, him being a vet and all. So he is probably just a bitter old man....more than likely it is an empty threat and a way to cope. But charting proficiently will cover you, the docs, and the facility.

As for the family member who works for the facility, I say leave it be. People get emotional and overprotective when they see a family member fall ill. They are angry and hurt and don't really know what to do with those emotions, so they lash out at something else...in this case the docs and the facility. If you report her, she may be reprimanded, fired, or just quit...I dont think that is going to serve any good purpose. As long as you chart appropriately YOUR job and your facility will be covered.

Up Vote Up Vote ×
Can a patient with "mental issues" truly follow DR. orders?

Well. It does depend on what type of mental issues, right?

Up Vote Up Vote ×
Specializes in Critical Care, Pediatrics, Geriatrics.
And it is a shame that this day in time, some patients (especially backwoods, dumb, inbred people like this patient and his family) are out to make a quick buck off of the good intentions of healthcare professionals.

this comment makes me question if there are true mental issues or just this nurses oppinion

Up Vote Up Vote ×
Specializes in LTC.

I'm with Bipley...document, document, document. As far as telling management of his intentions to sue, my gut instinct would be to stay out of that part of it. Hospital walls have ears, and especially since he has a relative RN working at the facility and you have no idea who she may be friendly with, you would not want that info to reach the wrong ears; it could just serve to give them ammo...yes, I admit I'm paranoid by nature, but I think the best defense in this case is not give them a reason to sue, so chart your heart out and give the best bedside care you can.

Up Vote Up Vote ×

Stick with the documentation of everything he and his family says and does. Don't mention his lawsuit threats though. Anything that goes wrong could be used to say it was done in retaliation of his threats.

If I had a dime for every time a patient like him threatened to sue, I'd be rich indeed. They're usually just blowing smoke. If it makes you feel better, you can inform risk management, but there hasn't been anything that's happened that he can pin on anyone.

I'm willing to bet the docs already know about his threats.

~Kat

Up Vote Up Vote ×
+ Join the Discussion