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This is not a rant about staffing, we are horribly short staffed, but normally we are o.k. We're going through a rough, hopefully temporary time right now as some contracts have left.
I'm taking care of a patient who c/o of chest pain and was admitted, only to later refuse telemetry, leaves the floor to smoke. I see he's up at 5AM and ask him to reconsider the telemetry, as he told an aid, not me. I explained as a cardiac patient he needed to be on it.
"I don't like your attitude, just do what you got to do and leave me alone."
I'm tired, stressed, working overtime, caring for patients above and beyond the normal ratios.
So I say, "You're the one who came in here complaining of chest pain. I don't care if you wear the monitor or not. I'll go care for sick patients that need me. "
He said he didn't like my bedside manner. Well excuse me Mr. Customer I ain't in the mood for kissing ass today.
I DARE and DOUBLE and TRIPLE DARE anyone from management to say anything to me if he complains. Just dare them.
Thanks for listening.
I love it when they just come out and say "Isn't the customer always right?"
(Taking a deep breath, smiling and looking for the AMA papers, so that the dissatisfied customer can go to Wendy's where they will do it their way)
I think I had 2 AMAs from my LTC last year.... Lets face it.. an understaffed LTC center with a bunch of Alz pts is no retreat or spa where the semi sick should recover:D
I had a paraplegic patient who started having cardiac symptoms and the card came down to see him...the patient told the card "OK be right with you right after I take a smoke" The card actually jumped over the counter at him.
Tweety, be very careful with your documentation...this sounds like a lawsuit wanna be.
From the way you write your posts, you sound like a heck of a good nurse and a nice guy. So vent and get on with your life.
I'll probably get flamed for this, but here's my 2 cents:
As far as patients as customers, as someone who's not yet a nurse, I'd have to say it kind of works both ways from my view.
The patient, is the one who is paying for their stay at the hospital, at least in a normal situation. Yeah, they have insurance, but they pay for the insurance. That said, whenever someone is paying for a service, they are entitled to a certain level of service.
Now, on the same note, that doesn't give the patient license to be unreasonable or completely idiotic, but it also doesn't give the nurse permission to let them have it either.
In my recent profession of law enforcement, it was the same way. People call the police wanting us to bail them out immediately from a situation that took them years to get themselves into. These people would often get upset and sometimes irate, but we had to keep our cool and be courteous, because they still are taxpayers.
Now, if they start swearing or name calling, then that changed things a bit, but we always had to keep PR in mind because these people are not afraid to send letters to the editor talking about the big mean cop that refused to help them.
Anyway, I hope that all sounds reasonable, at least it does to me.
Tim
Originally posted by tmiller027I'll probably get flamed for this, but here's my 2 cents:
As far as patients as customers, as someone who's not yet a nurse, I'd have to say it kind of works both ways from my view.
The patient, is the one who is paying for their stay at the hospital, at least in a normal situation. Yeah, they have insurance, but they pay for the insurance. That said, whenever someone is paying for a service, they are entitled to a certain level of service.
Now, on the same note, that doesn't give the patient license to be unreasonable or completely idiotic, but it also doesn't give the nurse permission to let them have it either.
In my recent profession of law enforcement, it was the same way. People call the police wanting us to bail them out immediately from a situation that took them years to get themselves into. These people would often get upset and sometimes irate, but we had to keep our cool and be courteous, because they still are taxpayers.
Now, if they start swearing or name calling, then that changed things a bit, but we always had to keep PR in mind because these people are not afraid to send letters to the editor talking about the big mean cop that refused to help them.
Anyway, I hope that all sounds reasonable, at least it does to me.
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Tim
Well Tim, a policeman is a public servant. I am not. That is one big difference. And believe me we DO get cussed at routinely, called names, and even swung at. And too often administrators think taking abuse is part of the job and 'customer service.' Count me as another nurse who is sick and tired of this 'customer service' crap. We post policies regarding patient responsibilities along with patient rights...but these patients are not held accountable.
Hang in there Tweety...we know just how you feel. I don't know what bothers me most...customer service or pushy family members directing care. Both leave me completely drained and exhausted by shift end.
Hey Tweety,
I had a similar situation happen this past weekend. The guy ripped off his tele, put on his jeans and told me he was going for a smoke. He got in my face, and for a minute, I thought he was going to hit me. Called security, called his doctor (pt refused a nicotine patch), loaded him up with ativan, and things were good.
I talked to the doctor the next morning, and wouldn't you know, the patient was discharged less than 2 hours later (the night before he was NPO for surgery). The patient was just too non-compliant.
Kinda pointless for ppl to be in the hospital, refusing all meds, treatments, surgeries, and psych consults. To me they're wasting time that could be put towards people who choose to get those things done.
3 of our Frequent Flyers are back. One is peezed because she's not getting her Demerols like she used to, addicted, refused to admit it, ALWAYS gets admitted for hypotension, and we think she's taking extra ativan to make it go down that far down, because AMAZINGLY an hour after when she's finally admitted, gets no IV fluids, lab comes back normal, her BP is around the 134/81 mark).
Another one wants her decube treated NOW but absolutely refuses to remotely turn off of her *** whatsoever. And she continues to lay on it. Daughter throws a fit because that "dumb*** nurse, and the ***wiper aide (that's me ) are trying to force "Mummy" to turn. Not that easy, even if she WOULD let us. She is 498 pounds, and will not help turn, and pushes against us. I'm not throwing my back out.
The other one is another pain med seeker, the only person i've ever seen who comes to the ER with a suitcase packed, gets admitted for hypotension, and looks VERY disappointed when his BP reads in the 155-120 over 70-80 range.
And all three rang their bells every 15 minutes, no joke.
On top of 33 other pts. i had to deal with. I'd rather have the other 33, than just those 3 any day.
Take my grandmother for example. 80 years old, Type I diabetic with bleeding polyps, LONG cardiac history, CHF. Refuses to follow any kind of diet, refuses to make any kind of effort to control her blood sugar, refuses to follow any kind of bowel regimen.
I abdecated responsibility over her a long time ago, and as long as the system keeps insisting that she's competant there's nothing the family can do. Well this is a long and convoluted story, trust me.
She shops around for doctors and there's always one willing to accomidate her wishes. Keeps on thinking there's a quick "cure out there". So last time I checked, she was taking more than 100 units of insulin twice a day. Her diet (when she's at home) consists of orange juice, chocolate bars and KFC. Once a month she calls 911 and ends up in the hospital in CHF and requires a blood transfusion for her bleeding polyps. She's always severely constipated at this time. While she's in the hospital (and on a controlled diet), her blood sugar crashes (cause she's taking so much insulin and isn't eating chocolate bars and orange juice).
This happens over and over again. She keeps bouncing back and returning to her at risk enviromnent were she is not caring for herself adequately and refuses help. Nobody is refusing to treat her. Everyone keeps on humoring her demands. She is the consumer and they're afraid of being sued. And so the cycle and the drain on resourses continues..........
Originally posted by adrienurseTake my grandmother for example. 80 years old, Type I diabetic with bleeding polyps, LONG cardiac history, CHF. Refuses to follow any kind of diet, refuses to make any kind of effort to control her blood sugar, refuses to follow any kind of bowel regimen.
I abdecated responsibility over her a long time ago, and as long as the system keeps insisting that she's competant there's nothing the family can do. Well this is a long and convoluted story, trust me.
She shops around for doctors and there's always one willing to accomidate her wishes. Keeps on thinking there's a quick "cure out there". So last time I checked, she was taking more than 100 units of insulin twice a day. Her diet (when she's at home) consists of orange juice, chocolate bars and KFC. Once a month she calls 911 and ends up in the hospital in CHF and requires a blood transfusion for her bleeding polyps. She's always severely constipated at this time. While she's in the hospital (and on a controlled diet), her blood sugar crashes (cause she's taking so much insulin and isn't eating chocolate bars and orange juice).
This happens over and over again. She keeps bouncing back and returning to her at risk enviromnent were she is not caring for herself adequately and refuses help. Nobody is refusing to treat her. Everyone keeps on humoring her demands. She is the consumer and they're afraid of being sued. And so the cycle and the drain on resourses continues..........
Are you sure she and my Mom have not met?
Originally posted by mattsmom81Well Tim, a policeman is a public servant. I am not. That is one big difference. And believe me we DO get cussed at routinely, called names, and even swung at. And too often administrators think taking abuse is part of the job and 'customer service.' Count me as another nurse who is sick and tired of this 'customer service' crap. We post policies regarding patient responsibilities along with patient rights...but these patients are not held accountable.
Hang in there Tweety...we know just how you feel. I don't know what bothers me most...customer service or pushy family members directing care. Both leave me completely drained and exhausted by shift end.
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Agree.
jemb
693 Posts
Good for you, Tweety!
Isn't it amazing that people come to a hospital for treatment and then refuse the treatment but won't leave? Oh, yeah, I forgot -- it's just the magical atmosphere of the facility that will make them well...
I have this imaginary conversation going through my head right now:
"Excuse me, sir, you really need to be in your room receiving your treatment."
"You can't tell me what to do. I'm your customer."
"Sir, when you go to a hotel, do you hang out in the hallways or the lobby?"
"Of course not. I pay for a room!"
"Well, since you seem to think that this is a hotel, I'll humor you. Go to your room!!!!"
Wouldn't you just love to do that sometimes?