Share your "problem patient" stories!

[nitenite]

I know I've had pt's I couldn't wait to get rid of. Some are just plain boors. This is the thread to share your stories about THOSE pt's.

Wish I could find a magic book that tells me what makes an able-bodied pt suddenly incapable of basic self-care once they enter the hospital.

Recently I had a pt who could feed himself, brush his teeth, wipe his ass, etc(this was an older male who just had his toes reattached after cutting them off while edging his lawn barefoot) suddenly lay on his call bell every ten minutes wanting me to fix his hair, feed him jello or give him a drink of water. These were all things he could do just fine by himself. He was also really nasty to me if I didn't come the second he rang his bell. Sorry pal, I had a critically ill patient next door and getting her on the bedpan before she soiled her bed is more important than combing your hair. Anyway, he'd complain about the food, whine that he was cold(and then complain he was hot when I gave him a blanket), whine that nothing good was ever on TV and then he'd yank his hands away when I checked his vitals.

This man was NOT suffering any dementia btw, he was perfectly a/o the whole time.

But wait! It gets better! If his family was around, he'd be all sweet and polite to me only to turn right back into Captain Jerkwad the second they left. I've never been so glad to discharge somebody. From what I've heard....he isn't taking the antibiotics we sent home with him. He'll probably be back in the ER with a raging infection pretty soon. :hdvwl:

So, how about the rest of you? Ever have a pt who made you practically tear your hair out?

[nrsang97, BSN, RN]

Anyone labeled VIP! Especially admitted by a specific neurosurgeon. They make me crazy.

I would rather have taken care of the criminal in the next room. He was much much sicker and really needed our ICU care than this guy who flew up from Cancun and complained about EVERYthing.

[al7139, ASN, RN]

My lady who is chronic COPD, with severe anxiety. Try so hard to be sympathetic, but hard when she is on the call light every minute...I just left her room from repositioning her (BTW on contact iso for KPC in urine), and she's on the light again!!!!!

She screams out "Help me! Help me! I can't breathe", but once we get there, is fine, sats 100%, just wants a little attention...

AAARRGH!

Amy

[gentlegiver, ASN, LPN, RN]

Had a a/o older male who was capable of taking care of himself. Just in for Rehab and doing great at it. REFUSED!!!!! to get his lazy butt off the bed and walk the 5 feet to the bathroom. Insisted I send the little CNA in to put him on a bedpan and then wash his butt afterwards. When I told him he had orders to go into the bathroom from PT & DR he laydown on his bed and had a major code brown. He called me back and said I had no choise but to send someone in to clean him and the bed now. We had a PARTY when he went home!

[kermitlady]

We have a man who refuses everything! Well, I take that back - he let me do accuchecks today but then refused the insulin coverage.

His reason? Everything should come from the VA and go straight to him; he should keep all of his meds in his room and adminster them himself.

No matter how often we try to explain things to this man, he just will not listen!

Oh, yeah, b/c his PMD gives T.O.'s to us nurses instead of coming and seeing him personally for every freaking thing, he's trying to convince all the staff that the guy is "performing malpractice".

The best was the day that I asked him if he wanted his meds and he started his little tirade about the VA/malpractice and I just walked away. So, who did he go complain to? My LOL who is the epitome of "pleasantly confused"! I laughed my butt off.

[diane227, LPN, RN]

You know I had a guy in the ED one day who was a bigot. He hated anyone who had a different skin color from his own (he was white). He had SEVERE COPD and we were trying to get an IV started on him. We tried a few times and could not get it so we sent in the best IV nurse who was black. He started screaming all types of obscene language and yelling at her to get out of his room. She very calmly laid her supplies down and told him "thats okay, I am not the one who can't breath." and just walked out. After about 30 minutes of suffering and not being able to breath, he was screaming for her.

[diane227, LPN, RN]

A friend of mine had a guy that came in week after week with a "suicide" attempt/ gesture. She had finally had enough. She took him aside and told him "look, your trying to kill yourself but you are going about it the wrong way. We are all kind of sick of you so I am going to explain to you how to do this so you can kill yourself and get it over with". He looked at her with his eyes wide open and said " you mean you want me to die?". She told him no but that she was tired of his crap. He never came in for a suicide attempt ever again although he did come in for other problems so she knew he had not killed himself.

[mlolsonny]

We have a man in our SNF that refused to walk initially, until we took the w/c away. Now will walk to BR with staff and wait for them to pull down his pants and for them to pull them back up when he's finished. One of our sassy CNAs told him, "you can do it yourself." He says, "You're kinda lazy, aren't you?":smackingf {I don't think I've dealt with a lazier one... No wonder your wife doesn't want you back at home}

How about the son of a patient that calls at 2140 on Sunday evening to discuss his mother's appt in the AM (Van pickup scheduled for 0645 on Monday AM). Then after asking us to schedule rides for her appts 4 days this coming week, asks us to cancel the rides since he will have to go with her to the appts anyway. {"I told you so" before we even scheduled the rides.}

Daughter of a different patient who calls to ask about bruising to Mom's forehead (underlying fingernail scratch marks w/ pt. on ASA). "Well I called yesterday about 4:30 and talked to someone and they said she was coloring, but was really getting restless. I wonder if she bumped into something?" You talked to ME yesterday, and she wasn't restless, and the bruise is the result of her scratching herself with her dagger fingernails that YOU insist on trimming and filing yourself!!! {Why don't you open another bottle of your drink of choice, you're not slurring quite enough yet.}

Don't get me wrong, for the most part I LOVE and care for most of the people I give care to. As far as I'm concerned, the patients aren't usually the problem. If we could screen the family members before admitting the patients, we'd all be a lot happier.....

[nurse grace RN, BSN]

I had a patient last week that was in her 90's and wanted constant attention. If you didn't go to her room- she would beat on her bedside table with a tube of poligrip! She also, would scream nurse, nurse, nurse nurse- finally we had to have a sitter sit with her. She finally went to short term rehab.

[kermitlady]

As far as I'm concerned, the patients aren't usually the problem. If we could screen the family members before admitting the patients, we'd all be a lot happier.....

That is the truth!

[Jerimiah29:11]

I work in long term care where things started disappearing from the top of my med cart and that of the other nurse who works the floor with me. Pens, highlighters, paper clips, can of pop, you name it. Finally we discovered one of our confused resdents would snatch things right off the cart when we weren't looking.

[Ruby Vee, BSN]

had a a/o older male who was capable of taking care of himself. just in for rehab and doing great at it. refused!!!!! to get his lazy butt off the bed and walk the 5 feet to the bathroom. insisted i send the little cna in to put him on a bedpan and then wash his butt afterwards. when i told him he had orders to go into the bathroom from pt & dr he laydown on his bed and had a major code brown. he called me back and said i had no choise but to send someone in to clean him and the bed now. we had a party when he went home!

there was a demanding jerk of a patient in 4a and a 165 kg patient in 4b with weeping sores and 2-hour dressing changes to be done every six hours. they put me in 4b and a nurse i shall refer to as greenie in 4a. i could swear greenie's patient, jerkwad was deliberately soiling himself rather than ask for the bedpan, but i wasn't sure. the next night, the charge nurse assigned me to jerkwad and greenie to heavyweight in 4b. about 11 pm, i see jerkwad grunting and groaning and straining himself as if he's about to deliver a calf or something. i asked him if he needed the bedpan, and he said he didn't. but sure enough, a few minutes later, he's proud as punch and announcing "i $hit myself; now you girls are going to have to clean me up."

greenie sighed and reached for the gloves, but i said, "oh, no we don't, sir. we'll make sure that you get cleaned up, but we don't have to do it."

"what do you mean?"

"see that guy out there?" (i'm pointing to the shaved-headed, african american weight lifter taking care of the patient in the next room, clearly visible through the doorway.) "i'm going to ask him to clean you up. and there's a martial arts instructor down the hall to help him." and then i went and asked the two large, muscular and clearly male nurses i'd referred to to clean the guy up. both of them got it immediately and agreed to help -- as soon as they were caught up with their patients.

after waiting an hour for the guys to come clean him up, jerkwad wasn't quite so smug and started asking a bit more nicely if we would please clean him up. "you worked very hard to have that stool in bed," i told him. "just as soon as the guys are free, they'll come clean you up." he got the point and was good -- for about three days. then he tried the same trick on another female nurse.