nurses who are bad patients

NurseSpeedy, ADN, LPN, RN · Sep 12, 2016

I have probably been the best patient/family member (mother of patient) 99% of the time. Why? Because I know where the nurse or provider is coming from and can usually work things out if there is an issue. However, if I am met with condescending, argumentative, dismissive, and/or someone who I find completely incompetent and unable to resolve the issue I call it like it is and won't tolerate that type of treatment. It has to be pretty bad for me to come off as a PIA but when I do it's well deserved. Treat me as you would like to be treated and it will be a great day.

Horseshoe, BSN, RN · Sep 12, 2016

I've noticed over the years that when we have a patient who also happens to be a nurse in their "real life", they are usually either the best patients (i.e. calm, rational, patient, and understanding) or the most nightmarish patient (demanding, accusatory, rude, impatient, and whiny).

I don't think that's necessarily true. It's just that the ones on either end of the spectrum tend to be more memorable.

macawake, MSN · Sep 12, 2016

So this is somewhat of a vent, but also a genuinely curious inquiry.
I've noticed over the years that when we have a patient who also happens to be a nurse in their "real life", they are usually either the best patients (i.e. calm, rational, patient, and understanding) or the most nightmarish patient (demanding, accusatory, rude, impatient, and whiny).
What do you think drives the latter?

Well some people are simply rude and demanding/self-centered and being sick, in pain and scared tend to aggravate those personality traits, but don't underestimate the gigantic stressor of being in possession of the knowledge about exactly how many different things and in how many different ways something can go wrong in a hospital. Sometimes ignorance really is bliss.

Editorial Team / Admin · Sep 12, 2016

I'm waaaay overdue for my mammo.

Guess I'm making up for you? Not even to the recommended age yet and I've had several. And by recommended age, I mean the early recommended age due to family history.

I am a bad patient in that I will wait until something is really really bad before I get seen. Hence, why I met my cardiologist in the ER rather than in the office. And I've also been known to disconnect myself from the monitor to go to the bathroom when I really really can't wait anymore- but only when fully independent.

NursesRmofun, ASN, RN · Sep 12, 2016

I think the ones who are crummy patients are probably those who are judgmental, self-righteous coworkers.
Being ill is often a test of ones character. Some people believe it an excuse to become demanding, bottomless pits of need. They think their social obligations are suspended because of their suffering.

So dang true!! I have also seen it both ways....a nurse is usually your best patient or one of your most demanding. As a patient, I was the first...best patient.

When I have had the later, I have been beside myself about it too. But I think the worst is when the demanding, nasty nurse is a family member of a patient! OMG....run for your life or call in sick!!

compassionresearcher · Sep 13, 2016

What is a "good" patient" vs. a "bad" patient? One who is too scared to speak their mind, ask questions, participate in the decisions regarding their healthcare... so they just go along with everything that is happening to them and make our lives easier.

allnurses Guide · Sep 13, 2016

I suck in that I never go to the doctor. Ever. I'm waaaay overdue for my mammo..

Aw Farowyn, do it for me! I skipped a year and ended up with a stage 3 and other nasty stuff. Go for it!

I'm the bad patient in also waiting, so that when I'm in I'm the "good patient" because by the time I'm admitted I'm too dang sick to raise a fuss. Like waiting over 3 hours to get my blood cultures drawn because noone wanted to access my port in the ER, and then getting my abx & fluids hung to gravity through my central line, very late, because noone could find a pump. Yeah. In my own ER.

Susie2310 · Sep 13, 2016

What is a "good" patient" vs. a "bad" patient? One who is too scared to speak their mind, ask questions, participate in the decisions regarding their healthcare... so they just go along with everything that is happening to them and make our lives easier.

Exactly.

caffeinatednurse, BSN, RN · Sep 13, 2016

I have probably been the best patient/family member (mother of patient) 99% of the time. Why? Because I know where the nurse or provider is coming from and can usually work things out if there is an issue. However, if I am met with condescending, argumentative, dismissive, and/or someone who I find completely incompetent and unable to resolve the issue I call it like it is and won't tolerate that type of treatment. It has to be pretty bad for me to come off as a PIA but when I do it's well deserved. Treat me as you would like to be treated and it will be a great day.

Exactly!

macawake, MSN · Sep 13, 2016

What is a "good" patient" vs. a "bad" patient? One who is too scared to speak their mind, ask questions, participate in the decisions regarding their healthcare... so they just go along with everything that is happening to them and make our lives easier.

Is the definition that you've provided one that you think describes a good patient? Or do you think that it's the definition that the OP thinks describes a good patient? Or are you asking the nursing collective if we think that it describes a good patient?

I appreciate patients who ask a lot of questions and show an interest in their treatment plan and actively participate in the decisions involving their own care. They are actually my favorite kind. Remaining healthy or regaining lost health usually requires an active/conscious effort and participation/cooperation from the patient so their involvement is welcomed. Also, since I'm a supporter of the concepts patient autonomy and integrity, it's a given that I want their participation and input.

In order to convey to you what I consider a good patient, I'll give you a few examples of the opposite; namely what I consider bad patients.

One was the patient of one of my coworkers back when I worked on a med-surg floor, who despite being offered a nicotine patch and being taught about the dangers of smoking in conjunction with oxygen therapy, decided to light a cigarette in his hospital bed while on a nasal cannula ~3 L oxygen. The result was a facial flash burn and some singed nasal hairs, but luckily enough not anything that required the presence of the fire department.

Another was one of my own (alert and oriented) patients in med-surg who was starting treatment with p.o. Clindamycin. There I was, diligent recent-graduate, telling my patient before adminstering the capsule that it's important to take this med sitting up with a full glass of water and not lie down immediately afterward and I explained the rationale for this. The patient looked at me like I was an idiot, scoffed and said that he'd taken penicillin before without a problem. I educated him on the difference between the medication he'd been on previously and the clindamycin capsule. He said okay, he'd drink it with all the water, only to swallow it with barely a mouthful. This was followed by a triumphant look on his face. Promptly, and contrary to the teaching I'd offered him, he laid down to take an afternoon nap and rang the call-bell about an hour and a half later complaining about what he described as a burning throat/upper chest pain and increased pain when swallowing. Pill-induced esophagitis anyone?

Or one of my more recent patients who showed up at 9am for his elective surgery scheduled for 11am, informed me that he'd had a breakfast of two turkey sandwiches, a four-egg omelette and hot cocoa with a generous dollop of whipped cream at appr. 8am. (Awful sounding breakfast, I know). Of course he'd received pre-op instructions but he figured since he always has a bowel movement right after he has had his breakfast that he has very fast "metabolism" (his words) and that his stomach would be empty. Surgery postponed.

So good patients, in my opinion, are patients who take an active interest in their own treatment plan but who also realize that occasionally healthcare professionals might actually offer some insights and sound advice worth listening to...

I also appreciate patients who'll show me common courtesy. It's the way I treat my patients and I appreciate when it's reciprocated.

JulieManey · Sep 14, 2016

It doesn't matter whether your a nurse or not, its one's personality that matters.

Rexie · Sep 14, 2016

To me, Good Patients are the ones who try to work with us. We're always about talking the patient's health care team. The most important person on that team is the patient himself. His attitude goes a long way in how well he will do. That doesn't mean that I expect him to blindly agree to everything - every test, every treatment, every medication - but if he refuses, to be reasonable and polite about it. Sometimes the patient is right. Sometimes he's wrong and if we're able to explain what we're doing and the reasons why, they'll agree. Sometimes they'll understand why and agree that they should probably go for a test but dammit, they've had enough. I get it.

We're all imperfect, but the good patient makes an effort. That doesn't mean they don't have bad moments or days when they're irritable or uncooperative, but overall they're trying. I appreciate that.

The bad patient is the one that makes no effort, undermines our effort, is abusive to staff, or totally uncooperative. The patient who is NPO that you catch in the kitchen drinking all the apple juice. The patient who will not put down the phone so you can assess or give meds. The patient who flips out because they have multiple orders for narcotics and benzos and wants them all at once. The patient who refuses all care but wants pain meds. The patient who is on the call button constantly for small things they can do themselves. The patients who act like perverts. The patients who otherwise abuse staff. The patients who sneak off the floor so they can do who knows what. The list is endless.

There are difficult patients who aren't bad patients - the confused ones who constantly pull at lines and try to get out of bed. Or are just so sick that you spend most of your time on them, probably neglecting the rest of your assignment.

In my experience, I've had only one nurse who was a truly bad patient.