I don't feel like going into detail about the patient and family member right now, but I know I need some helpful advice on how in the world to handle these two insanely manipulative people.
This pt is very sick and whilst he/she and the family member are seriously impeding his/her chances of getting better, which shoud easily be happening, instead, they are speeding down the road of self-inflicted complication after complication. I was excited at the chance to educate.
They will not let me say two words, literally, before ranting and raving about nonsensical theories and constant attempts at manipulating me- the nonconfrontational can't we all just get along- brand new nurse. There are definitely some very abnormal mental health issues going on between the two, but I want to keep this as short as possible.
Yes, the word "sue" has come up several times so documenting is obviously important.
I really need advice on how to care for this pt w/o letting this pair of lunatics drive me to tears every night and seriously impede my ability to care for my other patients. I was at work for three extra hours catching up and my pt load was normal, except for this unbelievably abnormal duo.
They usually start to fall asleep about the time I am giving report to the day nurse. And, on my floor, the pt's are usually sick enough that there is not much change from day to night shift and sleep patterns are not patterns at all.
I really want to learn from this situation. I guess I should probably pull that dusty mental health book off the shelf for a quick review.
I commend you for wanting to learn but this is still a situation your CN needs to be made aware of ASAP if you haven't done so already. If a patient is threatening to sue you need to make your manager aware immediately.
My 2cents worth: No one who is assigned to this pt should be dealing with it in isolation. I have learned that the key to dealing with intense manipulation is consistency and careplanning, with a behavioral contract if needed.
This sort of thing requires a team meeting with the pt and family, including risk management, social work and the pts physician. If the ptb don't cooperate, drop a memo to your institution's risk manager. Sometimes they can light a fire where nurses get blown off.
Leaving each nurse to set limits on his/her own is a set-up for the nurses and plays right into the manipulation. Good luck!!!
Specializes in Gyn Onc, OB, L&D, HH/Hospice/Palliative.
Do you feel it's more of the pt or the family member or the combo platter.? If the pt is an adult and competent then they are the only ones that can refuse meds/treatments. Set limits. Refocus back to the pt. If the family says, she/he shouldn't get this or that, redirect back to the pt. Reinforce it is the pt's right to accept or refuse care. If its all dynamics-- get the social worker involved. You can always suggest a psych consult to end the question of competence. If the pt doesn't want this input from the family how about offering him/her visitor restriction. Random thoughts...
Have you spoken with your charge nurse or nurse manager. This sounds like a difficult situation that would benefit from the advice of a seasoned nurse. I wish you the best in this situation and hope that somehow you can get the advice you are looking for. Hugs.
NurseNature
128 Posts
They usually start to fall asleep about the time I am giving report to the day nurse. And, on my floor, the pt's are usually sick enough that there is not much change from day to night shift and sleep patterns are not patterns at all.
I really want to learn from this situation. I guess I should probably pull that dusty mental health book off the shelf for a quick review.