Patient who is on his call light every 3-5 minutes ALL night long

Nurses General Nursing

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This is a chronic patient, lives at a group home, came into hospital with vague complaints. Complaining about the "lazy ED nurses" and all other staff in general. on his call light ALL night long, wanting to be repositioned every 5 minutes, have the water on bedside table dumped, just anything. Told another staff person he was "dumb" when the staff person who didn't hear his request asked "Can you say that again?".

What is the best way to handle this patient?

Patient did receive pain meds for c/o discomfort.

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Specializes in Cardiology and ER Nursing.

May or may not be the case here, but sometimes patients will get on the call bell just to have human interaction. Then they'll repeat similar requests over and over every 3 to 5 minutes. Sometimes sitting and talking to a patient for 30 minutes goes a long way. Unfortunately in the world of nursing that's 30 minutes we just don't have.

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Hi, thanks for the response. That was my guess, too...but how do you HANDLE this?

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Specializes in Cardiology and ER Nursing.
Hi, thanks for the response. That was my guess, too...but how do you HANDLE this?

I edited my response above, but if you are able to find the time just talk to the patient. Other than that there are no simple solutions.

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Specializes in LTC,med-surg,detox,cardiology,wound/ost.

Ah, the disgruntled frequent flyer. Stay polite and keep a smile on your face. Before you leave the room, ask the patient if there is anything else that he needs. Document abusive behaviors toward staff but keep it professional and matter of fact. If you have a patient relations department then notify them. Also keep your supervisor informed of the issues. Sometimes situations can be defused before they get out of hand. In some of the bad cases, a patient may be requested to sign a behavioral contract for his care.

With that being said, is this patient unable to care for himself (is he a quad or para or otherwise has no ability for any self care)? My experience has been that when somebody has zero control over their body, sometimes they grab on to the only control that they do actually have. That control might be to get on the call-light every 10 seconds or to have the staff constantly running in to do the most insignificant of tasks. But it is all the control that the patient has so they will exercise that control. They need that control. And being in the hospital, they might be seeing more attention than they usually get at their group home.

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Fifteen or twenty minutes early in the shift may save you an hour overall. When does this pt sleep? Make sure he is kept awake on during the day so he is tired at night!!!

Does he have something for anxiety or sleep? Make certain he gets it.

Before you leave the room ask him if he needs anything else. Then tell him you may not be available for 30-40 minutes, and you will check in on him then. And try to get in to see him then!

This is hard, I know, but this pt is probably scared as well as lonely.

Best wishes!

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Specializes in Cardiac.

If it were me, especially if he was being nasty and calling staff members by derogatory names I would call him on his crap, but nicely of course! :D

Here's what I would say:

"Mr. So-and-So, myself and the other staff have taken good care of you tonight, I have met your needs by doing A, B, and C for you, I have spent as much time as I can with you, but I need to be taking care of my other patients and I cannot be in your room every 5 minutes tonight. If you need something don't hesitate to call, but for things like more water/ice, snacks, lights turned on/off, tissues, magazines, etc, etc, etc, I need you to think of all the things you need or might need and call me one time for them. As for calling staff members names, it will not be tolerated. It is rude and disrespectful and I will not stand for it. Don't let it happen again!"

Please remember that I would never just say these things to be mean to a pt, but if a pt is calling me or another staff member names or swearing at us, I don't let it go. It's ridiculous.

So, yes, I would say all of this to the pt, but in a nice and respectful way with a smile. :yeah:

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Specializes in ER.

A heart to heart is key, but it doesn't have to be 30 minutes. Just connect with him on something other than routine tasks. Encourage him to do what he can for himself, even if you have to stand there and cue him verbally, eventually he will do it himself, and you will praise him and reward him with extra 1-1 time (5 minutes matters.)

Explain that going back and forth takes more time than the actual tasks, and is hard for you, frustrating to him when he doesn't get a timely response. How about you go in Q1h and do whatever he needs- you are his for 10 minutes, even if you sit and talk. But otherwise if it's not an emergency you will answer his bell but keep a list of the little things to be accomplished for the next scheduled visit. This approach worked well for me on someone that needed constant attention, but you need to keep your word.

Another problem is if his short term memory is poor. He may forget he just spoke to you and calls again. I notice this in young people who have a history of drug abuse, and they are all for instant gratification so a lot of behavioral issues come out. Point out the clock on the wall, make them look. Then tell them how long they can expect to wait for you to get what they want. Explain it takes time to walk out sign out the supplies you need etc, so 30 seconds makes you a human yoyo, and they still won't get what they asked for. They will have to be reminded of the conversation, and you may decide writing a time on the white board so they know when you will be back- remember- no short term memory!

Keep reinforcing that they can use the bell for emergencies, but reinforce through your actions that nonemergencies don't get an immediate fix. It takes time for trust to build.

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Specializes in Acute Care, Rehab, Palliative.

Where I work we have a perfect solution for these patients. They get plunked in a geri chair/wheelchair and parked at the nurses station, sometimes in behind the station. You want to be up all night and have constant attention? You got it.They whine about wanting to go to bed they get told to stop ringing the bell and GO TO SLEEP.

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Specializes in LTC Rehab Med/Surg.

When we have a really difficult pt, we ALL take turns answering the light even if it's not our pt or on our team. Everybody keeps their sanity that way, even the pt.

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Specializes in Cardiac.
Where I work we have a perfect solution for these patients. They get plunked in a geri chair/wheelchair and parked at the nurses station, sometimes in behind the station. You want to be up all night and have constant attention? You got it.They whine about wanting to go to bed they get told to stop ringing the bell and GO TO SLEEP.

That's awesome. We've done that at work, too.

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Specializes in psych, general, emerg, mash.

their lonely!

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