Published Dec 16, 2012
mmc51264, BSN, MSN, RN
3,308 Posts
I have been working in Rehab unit at LTC facility since June (grad ADN in may). I really love it (other than the 1 hour drive). Until last night. I am a very attentive, on the ball nurse. I am very good at being efficient, proactive; learning what people like (leave me alone, I'll call you, or I want pain meds q 4, wake me up, etc.) I have a pt now that I cannot please!!! For the last 3 nights, I have gone to the room to start 1600 med pass and they have found something wrong. 2nd night it took me too long to get a sleeping pill: I was at room by 1615, but had to go to Pyxis to get the med b/c pharmacy hadn't come yet with narcs-explained the situation exactly and thought there was understanding "I'll be back in a few min, I have to go up front and get med". This person complained that they couldn't believe it was 1625 and hadn't gotten meds yet??????
Last night, at 1830, while I was taking 15 min to scarf down some food and text my husband, I am told that they want a diff pain med that night and sleeping pill later. Okee dokee, got it. Start med pass at the right time. I walk into room and get SCREAMED at for 10 minutes about how I didn't bring pain med @ 1830. I was too busy goofing off, fiddling with my phone. Mind you, CNA had been in room twice and nothing was said about pain. To top it off, I cannot apologize for misunderstanding, etc b/c hearing aide has been taken out and I am just waved off to get out of the room.
Of course it is the weekend and there is no admin or reg supervisor there to help me. I have emailed my DON explaining the situation, but I am so worried that I am going to get in trouble because of how weighty the satisfaction-survey-reimbursement issue is.
I am so demoralized right now. Again, I have never been yelled at like that. I know I am in bad situation (13-17 pts on avg, usually with one CNA) I was hoping to get that magic one year of experience so I could move on. I have been there six months.
Thanks for listening.
eatmysoxRN, ASN, RN
728 Posts
You can't please everyone. Don't beat yourself up. You sound like you're doing a great job.
tokmom, BSN, RN
4,568 Posts
Chart..chart...chart. That way if the customer service Nazi's audit the chart they will see your story.
Otherwise, I would either do one of two things. This could be a pt that feels like they have lost some control and controlling you is their response to that lack of power.
Do they have a white board in the room so you can write down next meds and the general time frame they will be delivered? Don't say 1600, but between 1600-1630. That buys you some leeway.
If nothing can please this person, then can you try to be very direct or will that get you in trouble?
Example: the next time they yell, you can tell them you will be back once they are ready to be respectful.
amygarside
1,026 Posts
There will be days like these. It is part of the job. My advice is to let it go and move on. Don't be too hard on yourself.
CapeCodMermaid, RN
6,092 Posts
I'm sorry you're being treated badly by a resident. You need to make it clear to them that you are not there to be treated badly. I've never let an alert oriented resident speak to me in a disrespectful tone and I don't let them speak to my staff that way either.And who gets a sleeping pill so early in the shift? It sounds like that woman has control issues. Do you job, don't let her being nasty rush you so you make a mistake and when all else fails, just keep smiling at them.
DoeRN
941 Posts
First of all don't let anyone yell at you. Address that behavior immediately. Second why in the heck is someone getting a sleeping pill so early? I always tell patient a time frame. I will be in between 0800-0900. And if I have 0900 meds I may even say 0800-1000 especially if I have a heavy patient load. Some people you can not please. Document and if you have the medication within the allotted time frame then what is the issue. Never say I will be back at 1830. Anything can happen. Give a time frame next time.
amoLucia
7,736 Posts
I've also learned from experience just to back out of the room whe pts start flipping out .
And like other posters have said, don't block yourself in by a narrow time frame --- give yourself some wiggle room. Also back out of the room when pts start flipping out. Our tendency is to become defensive which only further antagonizes the pts (and gets you into trouble). Just excuse yourself and let them know you will be back WHEN they calm down. Just make sure you DO go back.
You did good - there'll just be some of those days....
HouTx, BSN, MSN, EdD
9,051 Posts
Last night, at 1830, while I was taking 15 min to scarf down some food and text my husband, I am told that they want a diff pain med that night and sleeping pill later. Okee dokee, got it. Start med pass at the right time. I walk into room and get SCREAMED at for 10 minutes about how I didn't bring pain med @ 1830. I was too busy goofing off, fiddling with my phone. Mind you, CNA had been in room twice and nothing was said about pain.
OK - am I the only one who picked up this "red flag"? Why did the patient say the OP was 'fiddling with my phone' if s/he couldn't possibly have seen this since the OP was obviously not in the patient's room at the time??? The CNA probably relayed this information on one of those trips to the patient's room, right? Looks like another round of "make the nurse look bad" game to me. Maybe it's time for a heart-to-heart talk with that CNA - about teamwork and appropriate communication with patients.
delilas
289 Posts
That sounds kind of like a patient I have :) I had an outpatient infusion who arrived three hours early and was upset that we didn't have his meds ready to infuse. He asked to speak to the charge nurse, though, who was infuriated because he refused to allow her talk, just railed at her about how unprofessional we are and told her to get out.
But we both understand...some people just...well, for lack of a better term, suck. You could give them a rainbow on a rainy day and they'd tell you the colors are too bright.
Stay calm whenever you encounter them, and offer them their medications. If they're angry "WHY WASN'T MY MED HERE EARLIER?" They're not really asking what happened to delay you. They don't care. Anything you say will be in their head as an 'excuse'. Say it was out of your hands, but you're here with the meds now, would they like to take them? If they're really beligerant, I'm with amoLucia - tell them you'll return when they're calm.
And chart the heck out of it. Keep your DON up to date on happenings with the patient. And best wishes!
Clementia
113 Posts
Some people are just mean. They're mad about not being able to control their lives anymore and they take it out on you. Try not to take it personally. I know it's hard not to, but honestly you can't please these folks because they refuse to be pleased. No matter what you do for them, it will never be good enough. Don't let some bitter, mean elderly person make you feel like a terrible nurse. It sounds to me like you're a very conscientious caregiver.
TheCommuter, BSN, RN
102 Articles; 27,612 Posts
I walk into room and get SCREAMED at for 10 minutes about how I didn't bring pain med @ 1830.
I probably would have listened for a minute or two at the most before apologizing for the delay, letting them know I hear them, and saying, "I'll return to the room when you are ready to lower your voice."
Silverlight2010
61 Posts
A coworker and I both had patients like that about a week or so back. Rapid-fire questions and "requests" but wouldn't let you finish a sentance. Somehow expected us to be mindreaders in the process as well. A lot of "I want" and "go get me" but would cut you off before three words were out. I just remained polite, charted on their actions, statements, and my responses/ plan of care. You can't please everyone, just keep your cool and remain professional. You did fine.