nurses who are bad patients

Nurses Relations

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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.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Anecdotally, I have also observed that family members who are nurses can be some of the worst visitors imaginable.

Then again, nurses are a part of society as a whole. And...society is becoming less gracious as time passes, it seems.

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I am a firm but undemanding patient. I tell you where to put the IV in (I know my veins) and then I want to be left alone - I will call you if I need you. I am pretty much self-care, and just don't want to be bothered.

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I am a firm but undemanding patient. I tell you where to put the IV in (I know my veins) and then I want to be left alone - I will call you if I need you. I am pretty much self-care, and just don't want to be bothered.

Yeeaahh... This may come as a shock, but you're just another kind of bad patient. The kind that doesn't want you to look at their veins, they just want to tell you to go in this one spot and that's that. And they don't care if you tell them that, in your professional judgement, they probably shouldn't be getting out of bed on their own right now -- they know best and they are going to do whatever the hell they want. The kind that is a total a-hole when you are just trying to do your job and get vitals and do assessments and give meds that you have to give because they "want to be left alone." You say "firm" -- I say "PITA."

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Specializes in Critical Care/Vascular Access.
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.

No, i don't consider the patients who just go along with everything to be good patients at all. That's not remotely a factor in how I would define a good or bad patient. In fact, I love patients who ask questions and participate in their care, as long as it's not accusatory or demeaning questioning.

If you can honestly say you've never had a "bad" patient then I'm curious as to where you work. I listed a few traits of what I consider a bad patient in my original post, but if I need to elaborate I can give many specific examples. I think most people on this thread know the kind I'm referring to though......

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Specializes in Oncology (OCN).

I've been a patient far more than I ever cared to be over the past several years. I have a chronic illness (RSD/CRPS) that has necessitated me receiving IV ketamine infusions for 4 hours for four consecutive days every 4-6 weeks for the past 2 1/2 years. I receive it in combination with Versed & Ativan in an effort to combat potential hallucinations. That said, ketamine is one hell of a drug and I have had some pretty wicked, persistent hallucinations from time to time. I'm not a very good patient during those times and I feel very sorry for the nurses who have had to put up with me during those brief moments of outbursts until additional doses of Ativan and/or Versed have kicked in. I would never intentionally act out in such a manner (I don't ever remember it but I'm told I've screamed, cried, cursed, flailed, and kicked and hit in the air). Luckily I have a good enough relationship with my infusion nurses that they know that. It's not anything I can control, but it's deeply embarrassing. I hate that I'm "that patient". I've wondered if the nurses cringe when they see my name on the schedule. I have considered discontinuing treatment on more than one occasion but the quality of life that treatment affords me right now far outweighs the side effects of occasional hallucinations and the embarrassment of being a bad patient. (And hopefully we have finally found the right balance of medications to prevent any further hallucinations.)

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Specializes in Med/Surg, Academics.

I have had many, many RNs as family members of my patients. The common thread I've seen is that they feel they aren't being listened to, and they have rather medically insignificant (meaning it's not going to kill you) but important-to-them issues that have been left unresolved.

I think that is rather common with many patients, but they trust the healthcare team more so they don't question it. In my opinion, nurses, in general, do not trust the healthcare system because we know how many things can go wrong or remain unaddressed for too long, even accidentally.

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Specializes in Med/Surg, Academics.
Yeeaahh... This may come as a shock, but you're just another kind of bad patient. The kind that doesn't want you to look at their veins, they just want to tell you to go in this one spot and that's that. And they don't care if you tell them that, in your professional judgement, they probably shouldn't be getting out of bed on their own right now -- they know best and they are going to do whatever the hell they want. The kind that is a total a-hole when you are just trying to do your job and get vitals and do assessments and give meds that you have to give because they "want to be left alone." You say "firm" -- I say "PITA."

I spent a few minutes trying to figure out why your response pissed me off so much, and I think I finally figured it out. You are one of those nurses who knows better than patients and is too busy ticking off your to-do list to be bothered with customizing care for your patients. Yes, it is inconvenient FOR US at times to change things up a bit to fit our patients' preferences, but that's also part of our job.

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Specializes in ER.
Yeeaahh... This may come as a shock, but you're just another kind of bad patient. The kind that doesn't want you to look at their veins, they just want to tell you to go in this one spot and that's that. And they don't care if you tell them that, in your professional judgement, they probably shouldn't be getting out of bed on their own right now -- they know best and they are going to do whatever the hell they want. The kind that is a total a-hole when you are just trying to do your job and get vitals and do assessments and give meds that you have to give because they "want to be left alone." You say "firm" -- I say "PITA."

You sound very burnt out.

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Specializes in Critical Care/Vascular Access.
I'm not a very good patient during those times and I feel very sorry for the nurses who have had to put up with me during those brief moments of outbursts until additional doses of Ativan and/or Versed have kicked in. I would never intentionally act out in such a manner (I don't ever remember it but I'm told I've screamed, cried, cursed, flailed, and kicked and hit in the air). Luckily I have a good enough relationship with my infusion nurses that they know that. It's not anything I can control, but it's deeply embarrassing. I hate that I'm "that patient". I've wondered if the nurses cringe when they see my name on the schedule.

I don't feel like this really falls into the category I was talking about. Drug and illness induced hallucinations and delirium leading to unruly behavior is not the same as a perfectly lucid nurse-patient just being a terrible, evil patient to their nurses when they're perfectly aware of it and capable of not being that way.

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Specializes in Med-surg, telemetry, oncology, rehab, LTC, ALF.
Yeeaahh... This may come as a shock, but you're just another kind of bad patient. The kind that doesn't want you to look at their veins, they just want to tell you to go in this one spot and that's that. And they don't care if you tell them that, in your professional judgement, they probably shouldn't be getting out of bed on their own right now -- they know best and they are going to do whatever the hell they want. The kind that is a total a-hole when you are just trying to do your job and get vitals and do assessments and give meds that you have to give because they "want to be left alone." You say "firm" -- I say "PITA."

Why are they a "bad patient" for telling a nurse where they can get a vein in their arm? I totally welcome that kind of input because I don't know ther arm, but they do. Especially if this isn't their first rodeo in the hospital, they're used to the process and know which can arm a nurse can usually access the quickest. I don't want to stick them multiple times while looking for a vein - and I'm sure they don't want the experience of that happening, either.

As far as wanting to be left alone afterwards, again, how does that make them a bad patient? Those are the patients I assess, give meds to, instruct how to use the call bell and then round on every few hours to make sure they're okay. Some people are very quiet and don't want to be bothered. I don't see how that makes them a bad patient, though.

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Specializes in Med-surg, telemetry, oncology, rehab, LTC, ALF.

I think something that is important to remember as nurses is that our patients have histories with other nurses, too. Sometimes bad things happen because of bad nurses (or incompetent ones, or whatever we want to call them) and then we get that patient and they're carrying those experiences with them. That can make them guarded and defensive, because they know what can go wrong. They've already seen the ugly side of healthcare.

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Explanation on the veins thing - I am a frequent blood donor, and I always tell the person that the best vein is in my left antecubital but it goes at an angle, and I show them this with the tourniquet on. I occasionally have a person who insists on going straight in, and then the blood flows but the needle hits the vein wall the whole time and I sit with my teeth gritted because it is VERY painful, but we are NOT doing it again! When I had my son, the nurse wanted to put my IV in my hand. I worked oncology for 23 years and I could put an IV in a turnip if required (still can, but that's beside the point,) and my hand veins are very full of valves. I preferred it in my LFA, and I have a vein there that you can hit with an 18 gauge without a tourniquet. No need to use my hands. I have not had multiple hospital admissions, but my mom did. My sister told me not to embarrass her, so I was a "good girl" and said nothing when at the premier hospital in Columbus, OH, after hip surgery the nurse drew a PTT in the vein ABOVE a heparin drip, no one knew 3 days after hip surgery mom had not had a BM and no one cared, etc. And away from work I am very introverted and prefer "alone time." So if all this makes me a "bad patient," so be it.

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