Patient Complaint

[Anna Flaxis, BSN, RN]

So, I go to get a patient from the lobby. She's a chronic low back pain, low acuity, recently seen for same with instructions to follow up with her PCP, returning today.

Ambulates with steady gait to room. I ask if she'd like the head of the stretcher up, down, or somewhere in the middle. "In the middle", she says.

"Like this?" I ask.

She indicates this is satisfactory. "Does this stretcher go any lower?", she asks.

"No, that's as low as they go" I respond. "I'm going to put your chart up for a doctor to come see you."

"Okay" she says.

I walk out of the room, closing the privacy curtain behind me.

An hour later, after the doctor's exam is complete and discharge orders are written, I go into the room to discharge her. I hook her up to the monitor to take a set of DC vitals.

"I want to make a complaint", she says.

"Okay", I respond.

"The nurse who brought me back here didn't help me up onto the stretcher. I told her I needed help onto the stretcher and she didn't say anything and just walked out and yanked the curtain closed behind her."

Now I'm wondering if she realizes that *I* am the nurse who brought her back.

"She left me standing here, and I couldn't get on the stretcher until my son came in and helped me. I could have fallen or something!", she continues. She then gives a physical description of this nurse, which is nothing like what *I* look like.

At this point, I'm not sure how to respond. Do I tell her that I was that nurse, and that she did NOT, in fact, ask me for assistance? Am I just supposed to automatically know that "Does this stretcher go any lower?" is interchangable for "Will you assist me onto the stretcher?"?

Also, there are two chairs in the room. Why couldn't she just sit in one of those if she couldn't get on the stretcher? Or, why couldn't she do what everyone else does and come out into the hallway and ask for help?

Clearly, if it were someone with an obvious physical limitation, such as an elderly person, or someone suffering weakness, or a person that uses assistive devices, I would assist them to the stretcher without even being asked. But this was an otherwise healthy, physically capable middle aged woman.

When I went to the cafe on my lunch break, she came into the cafe a short time later, walking without any difficulty, ordering food, sitting at a table and eating it, in no acute distress whatsoever.

People! Sheesh!

[caliotter3]

Wow. When a person thinks they have enough to convince themselves that they are going batty!

[JeneraterRN]

Fun, fun, fun in with the actors, er, I mean, patients. Glibness aside, most patients in the ER do have something wrong, but a percentage play it up to make certain we know about it.

[SuesquatchRN, BSN, RN]

Acute thespianism.

[TheCommuter, BSN, RN]

This might sound insensitive of me, but I cannot stand AOx4 patients who lie, tell phony stories, manipulate, embellish their problems, and turn staff against each other. Do these dishonest patients not realize that they're playing games with peoples' jobs and livelihoods?

[mama_d, BSN, RN]

Amen to what TheCommuter said.

Honestly, I think some people get off on the fact that they are screwing with someone else's job.

Had a pt not too long ago like the one Stargazer described...wanted to tlak to "the CEO" claiming that no one had been in to help him. He was one of those patients who we alternated so no one got him two shifts in a row and had been with us for over a week.

I told him that we'd have to hold up his discharge as he was obviously having an acute onset of short term memory loss, as at least three nurses had been in his room addressing his needs over the last hour...a full neuro workup was clearly in order. He straightened out for most of my shift after that.

[Davey Do]

"She then gives a physical description of this nurse, which is nothing like what *I* look like.

This is such an interesting situation, Stargazer. Your situation reminds me of a similar circumstance I read about in Daniel Gilbert's book, Stumbling On Happiness.

Dr. Gilbert talks about an exercise done at a College. Basically, one of the People involved in the exercise would approach a Random Student on the Campus and ask directions. While the two were standing there, another couple of People also invovled in the experiment, posing as Maintenence Men carrying a door, would pass between the two People. A third involved Individual would be on the side of the door away from the Random Student, and exchange places with the original Person asking the question. The majority of the time, the Random Students did not notice the Person they were speaking to was not the same Person who had originally asked them for directions.

So, as indicated by this exercise, the majority of People do not really pay attention to those with whom they fleetingly come into contact.

And sometimes, it's to our advantage.

[pitapita]

Sounds like a psych patient to me....LOL!! Don't worry too much about it - sometimes you're going to come across people in this job who are INTENT on being miserable. If nothing is wrong, they will COME UP with with something that's wrong. Good for you, holding your tongue!

- Pita

[GM2RN]

I have had something similar happen to me a couple of times. Pts complained that they hadn't seen anyone for period of time or claim that something wasn't done and they clearly didn't remember that I was the one that had seen them or done what they claimed was not done.

I confront them with the truth. I don't get nasty or rude, but I do clearly point out to them where they are mistaken and don't take their crap. In your situaton, I would have confronted her and educated her on how she could have communicated her needs instead of assuming that you are a mind reader.

[Kittypower123, BSN, RN]

I work in an LTC/SNF and my favorite was the resident with PRN pain med (who wanted it the second she could get it) who told me she was going to call the administrator because she shouldn't have to wait just because someone fell in the next room.

[Esme12, ASN, BSN, RN]

My radar would have been up on having to retrieve the patient from the lobby. Really? you couldn't find it on your own? What could possibly be wrong that they can't "make it to the department" and they were just seen recently. Me, personally, I would not allow this patient to get onto the stretcher all by themselves. One can never tell how many "falls" occur when a patient who is in such "significant pain" attemos to "jump" onto the stretcher "with out any help" in their condition. :icon_roll I would take "Does this go any lower?" and code for "I'm in such pain and I need your help....I might fall and hurt myself"

I wouldn't trust this person to keep themself from "falling" and injuring themself enough that a good out of court settlement couldn't cure. It is unfortunate that we need to protect ourselves from people in general, but we really do....especially manipulative ones that are out looking for a problem, and there are quite a few. Man it drives me NUTS.

I would have confronted the patient politely and showed all the proper concern about who this mystery person is and when did this happen becasue I was the one who escorted them to the room and helped them be comfortable by adjusting the head before leaving to have the MD to see them and how I just can't imagine who the person is that she described as no one working bears that description.

It's all a game and one I intend on winning by always being the better player....

[SHGR, MSN, RN, CNS]

At first I was sympathizing with the patient, since I have gone to the ER and the urgent care several times for back pain and yes, it can be very difficult to maneuver one's own stiff, spasming, painful body onto.

However, then I realized that I would have simply stayed standing or, as one commenter mentioned, come back into to hallway to ask (whimper?) for assistance.

However, I don't think I was walking with anything near a normal gait any of those times.