nurses who are bad patients

[Mr. Murse]

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? How can someone who is in this field, who has had the nightmare patients and suffered through those terrible shifts having to deal with their horrid behavior, become one of those people themselves?

Also, to all my fellow healthcare staffers reading this, please be the kind of patient you would like to take care of should you ever end up in that position.

[rangerslady]

Yes, we have been nurses... however, we are also humans. Recently, I have had health problems. First, I was angry, because I had never had problems before even though job stress negatively impacted my health. I was cranky, at no time did I ever direct anger towards my care givers, but I was irritated. Remember, we are people first, with additional information in our memories and we know what the meanings of tests, diagnosis etc. mean. We become frightened, and I think that it is worse for a nurse to feel loss of control of the situation. We usually are on the other side of things, now it is "us".( as the patient). It is hard to cross the boundary from nurse to patient. So, please forget what profession the person is or what they have done. Approach health care professionals as patients, but don't let the gray hair or older age fool you. Many of us have been where you are, and will not tolerate an attitude. Speaking for myself, I know the system and I understand, sometimes that makes it harder. From my perspective, I have been treated with condensation, and arrogance from nurses. As a young nurse I often felt defensive, and threatened by a RN patient. Look inside, and see what you are feeling. If you shift your perspective often that shifts the situation.

[mmc51264, BSN, MSN, RN]

i have had "good" nurse patients and "bad" ones. I don't know what drives their behaviors. I work in a specialty, so I guess it might have to do with being unfamiliar with the process that might be very different than their experience

My favorite nurse was one who had terrible pain issues and was very patient (no pun intended) about the lack of response from her team (it was an off-service of my specialty, but I a pretty well versed in pain management). I advocated for two days and finally got her taken care of. She was very appreciative

When I was a patient, I was pretty easy going until the last shift that I was there. i had a Foley removed at 0530 and never say my nurse until about 0945-1000 and no one asked me if I had voided, I had to wait an hour+ for pain meds. It was overall a great experience, but all it takes is that one nurse, especially the last one you encounter, that can "flavor" the whole experience. I did not want them to know I was a nurse, but they had such good handoff, I couldn't escape it :) I WAS at a different health system than I work and that was much more comfortable to me.

[Kssrn404]

The anesthesiologist should have explained to you exactly what it was you were getting in your IV instead of just pushing a drug and saying "it's supposed to do that".

I recently had a bladder implant placed under general anesthesia. As I was wheeled into the OR, not one person acknowledged my presence or said hi this is so in so and I'll be your nurse. They started pushing drugs and then placed the inhalent mask over my face without a single word. They didn't know I was an ICU nurse. It shouldn't matter though. I was very nervous and I was relying on the OR team to help me through my surgery. The circulating RN never even said a word to me. I was treated like a case number.

[3ringnursing, BSN]

Having a gnarly chronic health condition I've been hospitalized a fair number of times. That being said, when I am so sick it affects my cognitive nature I have been … bad. I didn't recall much once I was better. humiliating.

Other times, when I've been in for surgeries I never put on the call light, never make a peep, and am up ambulating in the hallways (with permission) on my own ASAP. I'm neat, quiet and polite.

I guess it just depends on the circumstances of my illness. I pray to God never to be admitted again.

[Loracs72]

I am certain I have been labled the bad patient a few times. Once last December when I had an ORIF of my wrist. I was getting IV Vanco pre op and my scalp started itching horribly while the infusion was going. The ortho probably thought I was crazy. Then after being wheeled into the OR they were pulling me over to the table since my left arm was completely numbed (nerve block) anestheisa gave me something in my IV and it made my lips and tongue tingle. I started asking what it was. I was panicked. I remember just before I was put under anestheisa telling me it was supposed to do that. I still have no idea what medication that was.

I think that anesthesiologist thought I was crazy. I was panicked for sure before I was put under for the ORIF. Most of the time I try to be a good patient.

I would definitely ask the Anesthesiologist what I was given ! If you were given it again and had an allergic reaction it might be a worse interaction the next time. Perhaps the Ologist realized you were having a reaction and gave you something to counteract it.

[Ruby Vee, BSN]

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.

A "bad" patient is someone who is demanding ("I want some more ice -- the ice you gave me is too cold. And a diet soda, but not ginger ale. I know that's all you have on the unit, but I'm a nurse and I know they have diet root beer in the cafeteria, so go get me some.", rude ("where did you learn to draw blood? Vampire school? You're a fat, ugly ***** so I guess I shouldn't expect you to be smart") and entitled. "I'm a nurse, so I know all about this -- I don't care if your rules say only two visitors at a time. I want my whole family here including my eight siblings and their kids! I don't care about my roommate. I want what I want and I want it NOW!" Possible a know-it-all. "You're supposed to listen HERE, not THERE. Did you get your license in a cereal box?" "Studies show that YOUR protocol is outdated. I don't care about your protocol. I want you to do it MY way."

And yes, there are nurses out there who are that over the top. I've taken care of more than one of them AND their family members.

[Ruby Vee, BSN]

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.

This was probably the best description of good and bad patients on the thread!

[NursesRmofun, ASN, RN]

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.

To me, a good patient asks for what she/he needs, asks questions, follows most or all of the treatment plan, understands delays sometimes happen, understands that the doctor may not do exactly what it is the patient or patient family wants and not blame the nurse, etc. A bad patient may be one who is demanding, tries to get the nurse to run and fetch regarding many details of care that we normally prioritize, wants to be treated extra special above and beyond other patients, and picks at the things that are out of the nurses' control, even if you explain or apologize or, at least, there is a reason for the snafu. God forbid they think of an intervention before you do or before you educate on it and mention it. A nurse as a patient or family member of a patient may fall into either category....and yes, sometimes they are a little of both like everyone else.

[Housey]

I think it can come from fear. Fear of giving control over to someone else in a situation where we are normally in control. As nurses we know more about these issues than the general public so we ask more questions and notice things more, as well as speak up loudly and emotionally when we see things being done wrong.

[Ruby Vee, BSN]

To me, a good patient asks for what she/he needs, asks questions, follows most or all of the treatment plan, understands delays sometimes happen, understands that the doctor may not do exactly what it is the patient or patient family wants and not blame the nurse, etc. A bad patient may be one who is demanding, tries to get the nurse to run and fetch regarding many details of care that we normally prioritize, wants to be treated extra special above and beyond other patients, and picks at the things that are out of the nurses' control, even if you explain or apologize or, at least, there is a reason for the snafu. God forbid they think of an intervention before you do or before you educate on it and mention it. A nurse as a patient or family member of a patient may fall into either category....and yes, sometimes they are a little of both like everyone else.

This is a very good description of both "good" patients and "bad" patients. And much more succinct that mine!

[NursesRmofun, ASN, RN]

This is a very good description of both "good" patients and "bad" patients. And much more succinct that mine!

Nah...not better than yours', but thanks!

[nurseyblues, BSN, RN]

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.

Very well said. We have a saying at our hospital that "nurses make bad visitors worse patients." It's sad, but in most cases on my job, it's true. We always shake our heads and wonder how anyone who does this job, and knows how it feels to be undermined/abused/condescended to, can come in as a patient or visitor and constantly harangue the nursing staff.

For instance, we very recently had an elderly patient whose daughter happened to be a nurse--or had been a nurse, she was recently retired. I knocked on the door, walked in, started my introduction..., "Hi I'm so-and-so and I'm going to be--"

Nurse visitor: I certainly hope you plan on washing your hands.

Me: Oh, yes ma'am, we wash our hands before and after any patient contact.

Nurse visitor: Oh you do, do you? Well you must be the only one that got that memo. The CNA just came in here and took her vitals, and she didn't wash her hands before she put her gloves on.

Me: I'm so sorry to hear that. I'll mention it so that everybody is aware and remembers. She also may have used the Purel foam that's just outside the door, so her hands would be dry by the time she got to the bed and put on her gloves. I'm going to be giving some medication--

Nurse visitor: What drug? What's the dose? Did you plan to ask about her allergies, or were you just going to push the drug and hope it didn't kill her?

Seriously, this is the kind of nurse visitor/patients we tend to encounter. Nurses who know full well that they would be incensed if someone did that to them while they were working. Whenever I'm training new nurses, I always encourage them to be very careful not to develop RN-itis where they start to think that not only do they know everything, but that they're the only one who knows anything.

Sometimes it seems like nurses don't just eat their young, they eat anything that doesn't get away.