On that call light every 5-10 minutes

You're not suffering alone! :^) I had one resident - who thankfully, is now torturing co-workers on another unit, who once wanted an aide to put her jewelry on her - while she was in bed, at approx. 9-10 pm. Another time she wanted one of them to brush her hair in bed, also late evening. The list of 'needs' was endless.

Just yesterday, I had a resident, who admittedly has a complicated mental/medical situation, but she kept calling verbally (didn't use call light) for me and the aides non-stop. I'd already been in there, and had put in a call to the doctor's office to try to get an order. What finally got me to go back in her room was 'Don't you even care?'. I dropped what I was doing, went in and explained that yes I DO care, that I wanted to help, and that I'd called the doctor but had not gotten a return call yet. That wasn't the end of it, but that's enough for here...

And then, of course, are the patients who want their head up a little or down a little, wait, up or down a little more, and ahhhhh, now it's exactly back to where it was when you came in the room.

I've gone in and reviewed the times for the next dose of any medications that the patient could receive, explained that we're in the process of ordering another bed because of a related circuit malfunction on the wall, leading to the need to unplug EVERYTHING on that wall, but would be back in exactly one hour to check on him/her.

For this patient, I even go in with one of the three remaining COWs that we have left so as to confirm the 'real' effect by not using the bedside computer. Before the end of my shift, I would (in theory for the benefit of the patient) "make a phone call to engineering":sarcastic:" to see what the holdup was with the bed, be instructed to plug everything back in to see if the problem had been repaired, instruct the patient to test it as I stood there, (miraculously, it worked...how 'bout that!), and explain that the solution is to unplug everything for a few hours if the problem persists until another room becomes available to transfer the patient into so that this room can be be blocked for rewiring.

I told the next shift what was done, and they could deal with it however they saw fit. My solution put that patient on that hourly rounding schedule just like everybody else.

All that to say, I LIED TO THE PATIENT, and did NOT feel bad about it,

Well, sometimes it is not QUITE lying but just... exaggeration. A bit of it.

One time, I pulled the concerned relative aside and told, like it was the greatest secret ever:

- that we are trying to find a good facility for the patient and close to home (true);

- that good SNFs are few and far between (well... kind of true);

- that even in good SNFs there is one RN for 20 patients (true, in general);

- that if the patient continues to hit the button every 2 min, presses it when nurse is actually in the room, etc., the good SNF will find a way to send the patient back to acute in no time (CAN be true);

- and that the SNF can refuse to take him back (not ​usually true, AFAIK)

- and then he will have to go to another SNF, which could be way worse than the first one (true again)

I have no idea what was said between those two, but the frequency of hitting button in that room came to screeching stop almost immediately.

I'm becoming less and less therapeutic over the years myself. I tend to address it head on, as in, "we have rounded on you frequently but have still not managed to reduce your need to utilize your call light often this shift. Are you lonely or worried? Can we call a family member or friend for you to visit with? Is there a favorite television or music channel you prefer to help you pass the time? Please remember that we are here to meet your medical needs and want you to have a successful hospital stay with also feeling well cared for but we are not able to stay at your bedside consistently when you are medically stable."

KatieMI said:

Well, sometimes it is not QUITE lying but just... exaggeration. A bit of it.

One time, I pulled the concerned relative aside and told, like it was the greatest secret ever:

- that we are trying to find a good facility for the patient and close to home (true);

- that good SNFs are few and far between (well... kind of true);

- that even in good SNFs there is one RN for 20 patients (true, in general);

- that if the patient continues to hit the button every 2 min, presses it when nurse is actually in the room, etc., the good SNF will find a way to send the patient back to acute in no time (CAN be true);

- and that the SNF can refuse to take him back (not ​usually true, AFAIK)

- and then he will have to go to another SNF, which could be way worse than the first one (true again)

I have no idea what was said between those two, but the frequency of hitting button in that room came to screeching stop almost immediately.

Presentation counts for a LOT with patients and families. This makes me think of the tramadol order we got for a patient and the way the tramadol was presented to patient had a miraculous way of completely getting rid of their pain. It was quite the healing moment...

Recently had a patient like this on our unit. THANKFULLY they transferred out but...only the call light every few minutes with ridiculous requests.

"Can you move the bedside table a bit closer?" "Fluff my pillow..." etc

the worst part was the WIFE was in the room the entire time. apparently she was incapable of tasks like moving the table as well.

I get them transferred out!! Lol. If you are able enough to hit that call light every 5 minutes, then you don't need to be in the ICU.

I truly don't mind it for about an hour. Then I get to the point of saying what else do you need before I leave, hint, hint. Then, it may take me longer to answer. Then, at some point I may just get flat out blunt with them and say, I am here to get you what you need and make you comfortable but I cannot continue to come in here. I have other very sick patients tonight and your charting to do. I will be glad to grab you whatever you need right now and then I will return at such and such a time to check on you. That usually takes care of it. I'm very disgustingly sweet about it at that point.

For the ones that I think are just lonely, I offer to call the hospital chaplain to come and chat with them. I'm fortunate that our facility has a chaplain on site 24/7/365, and they're happy to come and just spend a little time with someone who needs extra non-medical attention.

For those that just have what I call "Queen of England Syndrome" but no actual needs, I explain that I have five other patients and I need to spend time taking care of their MEDICAL NEEDS, so I'll need The Queen of England to ask for NON MEDICAL REQUESTS just once per hour, please.

brillohead said:

For those that just have what I call "Queen of England Syndrome" but no actual needs, I explain that I have five other patients and I need to spend time taking care of their MEDICAL NEEDS, so I'll need The Queen of England to ask for NON MEDICAL REQUESTS just once per hour, please.

I love it. Yes, contrary to popular opinion, there is not just ONE Queen of England - there are MANY. I had one lady who would act like I was INSANE, asking her to take a pill with an ordinary cup of water (I mean, can you believe I'd do something so 'common'?). She'd ask for apple juice, and if it was unavailable, oh boy, I might get her to take something, or I might not. I joked w/aides that we had to have freshly-squeezed apple juice, JUST flown in from Washington state, and that it was chilled to the perfect temperature with chips of ice (also just flown in) from a glacier. THEN, and only then, might the queen be able to take that pill, you lowly servants.

My Queen #2 *will* take pills with water, but if you merely pour some water from her bedside pitcher into a small cup, will make an awful face and declare that "It's WARM". So again, the interpid nurse must fly to Greenland, chip some ice into a gold-plated bucket, fly immediately back, parachute into the facility, and serve icewater in a crystal glass, on a lavender satin pillow, in order to get said pill taken.