Published Jun 24, 2010
Manatee111
49 Posts
How do you handle a patient who "abuses" the call light all night long? I had a patient the other night (for a 12 hour shift)who was mostly appropriate, but elderly with a lot of anxiety. She had 2.5 mg of Ativan in less than 6 hours, she was medicated twice for pain, her pillows fluffed, diaper changed, tissue within reach, curtain pulled so she could see the clock, TV on (because she gets paranoid in the dark), oxygen tubing adjusted, blankets pulled up & down, repostitioned 5X, etc... I personally answered the call light for her at least 40 times that night & that doesn't take into account how many times other nurses or our PCT answered the light. She would have been too much if it were 1:1. So seriously, how do you tell a patient to lay off the call light without ruining our customer service scores, of course!
Tait, MSN, RN
2,142 Posts
Sometimes you have to just remember it is just twelve hours.
(Or 8 or 10 )
Tait
Davey Do
10,608 Posts
It sounds like you did everything you could and then some, manatee111.
Some patients are just high maintenance. You probably already know how to prioritize, so if you want to keep your customer service scores high, you'll do what you have to.
It could always be worse. Instead of just one of them, you could have been assigned an entire patient load of them.
Good luck to you.
pers
517 Posts
When I have patients like that, I take the time to ask everything they need. When I finally go to leave the room I ask one last time if there is anything else they need because I have to see my other patients now and it will be x amount of time before I can be back in there so if there's something else I need to know before I go. I might spend 20 minutes doing 101 little things for them this way but it's easier to block out 20 minutes and then move on than to keep going in the room for 2 minutes every 10 minutes.
It doesn't always work (especially with the "I just want to tell you something else" patients) but it does work more often than not.
HappydayRn
76 Posts
In the vein of the above post you can try this:
Ask her what she needs, get it done, say I need to see my other pt's now I will see you in one hour. Tell her if she needs anything you can help her then.
I'm really bad about this, my coworkers sometimes use a code with me to rescue me from a room. They call and if I say a word to them they come grab me to "help" them with something.
fungez
364 Posts
But if we do the Studer hourly rounds, we won't have people on the their call lights!
For patients who are always hitting their lights, I take my time going in there. Rushing in evertime they hit the button just reinforces them hitting the button. Of course, that's when they start screeching "nurse! nurse!" every two minutes.
But if we do the Studer hourly rounds, we won't have people on the their call lights!For patients who are always hitting their lights, I take my time going in there. Rushing in evertime they hit the button just reinforces them hitting the button. Of course, that's when they start screeching "nurse! nurse!" every two minutes.
Oh, how I wish I could get through an hour without having to be in there 5,6,7 times! LOL
mamamerlee, LPN
949 Posts
These patients, as you noted, are anxious, frightened individuals. They need a firm but gentle hand. As PERS stated, tell them nicely that you will be back to check on them in X amount of time, and then be sure to get to them then, or a bit sooner. These are often trust issues, as well, and maybe a fear of abandonment. Make sure they have a pencil and some paper, so they can write down what they need in between time.
I have found that it often helps if you tell them that you will be seeing one or two of you other patients, and then you will be back to check in again.
Although these patients can be very aggravating at times, they will will often settle down if their perceived needs are met or anticipated as you tell them you will.
Best wishes!
Clear Morning
27 Posts
I had the same problem with a patient not long ago. Not only was she on the call light but she yelled and hollered out all night, disturbing all the patients in the hall, even after two doses of Ativan. The next day we asked a family member to stay the night with her and she was much better.
Freedom42
914 Posts
If my patient had that level of anxiety, I would alert her physician. The doc might want to reevaluate meds or request a psych evaluation.
NurseStephRN
110 Posts
what i sometimes do is repeat what they are asking me for to make sure i don't forget anything and still ask if they need anything more.
for example... "ok, so you need some water and pain medication? ok anything else? a warm blanket? great. i'll be back with those things."
depends on the patient and their personality, i might joke with them and say i'm going to take the call bell away. lolol.
however, sometimes i find that they're lonely, especially on the night shift. sometimes i try and take care of my more independent patients first, leaving extra time for my needy patients. taking 5 minutes to just talk, not about medical things, but personal things... do you have nay pets? harmless topics like that. sometimes i sit down and talk to them. it makes them feel like you're taking your time to tend to them and make them feel like their needs are important to you :)
good luck!
fiveofpeep
1,237 Posts
haha eventually I get to the point where I wildly gesticulate my arms as I poorly disguise my annoyance saying "Is there anything, anything...I mean anything, anything at all that I could possibly do for you now before I leave?"
they see the crazy in my eye and then they understand...works like a charm