Of your patient load..

BrandonLPN, LPN · Mar 29, 2015

The ones that really puzzle me are the patients who come to chat about politics. I am not kidding. There's a knot of old gents who sit in the waiting room of my ER on Friday evenings to watch the TV and chat about politics. If we ask them to leave, one of them will show a foot ulcer or a "suspicious" mole he's come to get checked out and of course the rest are just there to support him as family. (Everyone repeat after me: "The client's family is whoever they say their family is.") Last week they brought dominoes.

I guess it's a good place to people-watch....

NGYSUN, BSN, MSN, RN · Mar 29, 2015

I work in medsurg and just yesterday I was thinking in line with this post. Pts are soooooo grouchy. .. I.mean grouchily grouch... they've become more elderly with high acuity and I just sometimes don't get it...and oooohh families just expect you to perform miracles for them.... like really! !??

LobotRN, BSN, RN · Mar 30, 2015

The ones that really puzzle me are the patients who come to chat about politics. I am not kidding. There's a knot of old gents who sit in the waiting room of my ER on Friday evenings to watch the TV and chat about politics. If we ask them to leave, one of them will show a foot ulcer or a "suspicious" mole he's come to get checked out and of course the rest are just there to support him as family. (Everyone repeat after me: "The client's family is whoever they say their family is.") Last week they brought dominoes.

Wow. Just wow. Where is the administrator on call for this one? I was thinking triage and admit every time they show up, but then again I get the inkling that these folks don't respond to consequences, so the bills won't matter. Unplug the TV?

eroc · Mar 30, 2015

Most all problems are lifestyle induced, with genetics being a small factor.

I am sure many people and some "research" will disagree, but people's ability to look past what should be versus what is, has made it very difficult to prove.

calivianya, BSN, RN · Mar 30, 2015

I feel like the lifestyle "lazy" people are pretty much the same everywhere... but the patients' attitudes are different in different regions.

At one point, I worked in rural Georgia, and I'd say for every rude patient/family member I had, I had at least three who were nice/tolerable. I had plenty of nights where nobody was rude or hard to deal with. That ratio is very different in NC, where I feel like most nights half of my assignment has someone being totally obnoxious and the rest of the nights both of my rooms are full of obnoxious patients/families. There's definitely more obnoxious people here. I wonder if it's even worse in places that are known for their rude people, such as Manhattan or parts of New Jersey.

I worked in the exact same type of unit with the same relative age and same diagnoses in both regions, so it's not an age or diagnosis factor.

sistrmoon, BSN, RN · Mar 30, 2015

Just thinking about last weekend's shifts. I had one very pleasant/thankful but demanding patient(as in, I'm hanging chemo in the roommate's room and she's yelling through the curtain for a back rub and icecream), 2 very sick bed bound complicated elderly patients(chemo, TPN, pressure ulcers, breathing issues,) a young scared anxious but legitimately sick patient, and a "no maintenance"( aox3, independent, never calls for anything, i.e. The unicorn.)

I would say I typically never have more than one(out of 5-6) of the demanding types or the needs to be on comfort care but we continue with all interventions for the (sometimes rude, demanding and antagonistic) family. As far as noncompliance though? I'm sure that's up there, but the really horrific cases(like diabetes with necrotic limbs being amputated, blind, etc) are still the minority.

Libby1987 · Mar 30, 2015

I thought the domino thing was cute. Unless they were really taking up needed seats.

Libby1987 · Mar 30, 2015

I work in medsurg and just yesterday I was thinking in line with this post. Pts are soooooo grouchy. .. I.mean grouchily grouch... they've become more elderly with high acuity and I just sometimes don't get it...and oooohh families just expect you to perform miracles for them.... like really! !??

It's the opposite here. Most of the patients used to be in their 70s 80s and 90s, and centenarians weren't all that uncommon. Now about half of my patients are in their 50s and 60s.

imintrouble, BSN, RN · Mar 30, 2015

It's the opposite here. Most of the patients used to be in their 70s 80s and 90s, and centenarians weren't all that uncommon. Now about half of my patients are in their 50s and 60s.

Same here. It used to be the same 70-90 yr old patients week after week. They made up 80-90% of our census. I too have noticed the increase in 50-60 year olds. This winter for the first time, when admitting for respiratory problems, the middle aged people were equal to the geriatrics.

Most of our patients are Medicare and Medicaid. The Medicaid people weren't taking their meds as prescribed, or just not taking them at all. If patients couldn't get their meds for free, they just didn't get them. Even co-pay was too much.

This is not a political thread and I'm not responding in a political way.

More and more Americans are filing for disability. More people are out of work. The middle class is shrinking. I think that's part of what we're seeing.

macawake, MSN · Mar 30, 2015

..how would you divide your patients between the kind of patients you went to school for, the unreasonable and rude, the poor self care and not going to change, and the hopeless but family are in denial types? (Am I missing a major category?)

Your question actually made me reflect on why I chose nursing as a second career. The truth is that I didn't go to school for any particular kind of patients at all. My primary motivator was that it was a profession that I found interesting and thought

I could do reasonably well. I guess that I was clear on the fact that I'd meet, well... people. Warts and all :)

I honestly couldn't give you a percentage of the the various categories of patients that I meet. I generally don't think about people as belonging in categories anyway. I'm as capable as the next person of stereotyping individuals but I make a conscious effort not to. A rough guesstimate would be that 80 % of my patients are perfectly pleasant to deal with, 18 % are somewhat of a challenge and the remaining 2 % are genuinely unpleasant and would probably be that way whether they were sick/in pain/scared or not.

And what department do you work?

PACU and anesthesia.

Morainey, BSN, RN · Mar 31, 2015

I didn't really "go to school" to be a hero nurse every shift. A lot of my job is the same weary drudge, day in and day out, we have lots of frequent flyers and rude and entitled and people whose chronic condition is just worse than usual. It's all fine. I don't get bent out of shape anymore when people sign out AMA and then come back the next day. They're all patients, and they all deserve care.

Source: med-surg tele floor.

Libby1987 · Mar 31, 2015

When I went to school, very young, I did see myself doing the nursy thing, treatments mostly, and I didn't think of a patient type per say but I did imagine a certain environment and it didn't have people demanding coffee while they sat at their drug seekers bedside (an example I read about here).

Did any of you apply to nursing school thinking you'd know what you would be dealing with and then find out it was not all like you thought?

I'd think there would at least be a few who had a picture of patients they could make a difference with. I don't think that's all that far fetched. Especially for those who had no previous exposure.

The whole question was based on posts that would make you think half are drug seekers or belligerent or whatever.