Patient Keeps Asking for Another Nurse

[purplegal]

So, about a week ago, a rather "interesting" patient was admitted. From calling the ambulance herself not once but three times to accusing the facility of giving her a UTI that was likely already present the day she was admitted, this patient has, from day one, expressed her dissatisfaction with the care she has been receiving.

I have been this patient's nurse every day that I'm working there, and while there haven't been any actual issues between us, almost every time she puts on her call light for a nurse and I go into her room, she asks for another nurse, even giving a specific name of a particular nurse she wants. This patient does allow me to give her medications, but whenever she has questions, she always requests to speak to this other nurse instead. Even during situations that she calls "emergent," whenever I ask if I can help, she says, "Oh, no, I'll just wait until so-and-so is available." She also frequently comes to the nurse's station, and even if I'm the one sitting there, she always asks to speak to this other nurse.

I'm not terribly offended, because it sounds like the nurse she keeps asking for is the only one in the facility that she likes. Other nurses have had similar issues, even worse issues (I would hate to be the nurse that she accused of giving her a UTI!). However, my thought is, it seems like this patient does not really want me as her nurse, for whatever reason, even though she has not specifically said "I do not want you for my nurse."

However, there are some options that I have been thinking about and wondering which may be the best:

1. Remind the patient that while I'm there for my shift, I'm her nurse, and that the nurse she is requesting is busy with other patients.

The main reason for this option is that it involves not bothering this other nurse with issues that I, as this patient's nurse, should be taking care of. However, doing so may also cause further resentment in this patient, and if there's someone that the patient finds more suitable, it may not be in anyone's best interest to force her to keep working with someone she is reluctant to work with. The only problem is, sometimes this specific nurse is not available, so at one time or another, she will have to work with a different nurse.

2. Continue to take this patient as part of my med-pass assignment, but whenever she has a question, find the other nurse.

With this option, I would be taking care of the medications for this patient, so the other nurse would not have to worry about that, but would also be accommodating this patient's request to work with someone she feels more comfortable with. At the same time, this may be unfair to the other nurse, who has her own patients to take care of.

3. Change assignments altogether. Since there are 20 patients that we split into two groups of 10, maybe, until this patient is discharged, I should take the group of patients that this one particular patient is not a part of.

This may be the best option so the patient can have the caregiver she provides and the other nurse would not be "bothered" since it would be her patient anyways. This may also relieve frustration on both of our ends. For the patient, it is frustrating when the nurse who seems to be able to answer her questions the best is not available. At the same time, the constant "rejection" is frustrating for me, and I feel guilty about passing on my work to this other nurse.

Honestly, I feel that this has more to do with this patient "connecting" more with this other nurse than it has to do with mine, or the other nurses', abilities to be a nurse. In the past nine months that I have worked at this job, this has been the only patient that has repeatedly asked for a different nurse, and there have been many times that I have been the preferred nurse.

However, I am just trying to figure out a way for this patient to receive the care she needs in the way that is most comfortable for her. If that means that I am not her nurse, I am willing to step back and let someone else do it. At the same time, this patient seems to have unrealistic expectations that this one nurse that she favors will always be there for her.

What are your thoughts?

[Extra Pickles]

My thoughts are that this is being WAY too over-thought. She wants Nurse Lovely, so give her Nurse Lovely. Otherwise, you are wasting valuable time and so is Nurse Lovely, who undoubtedly has her own patients to contend with and is being dragged away to deal with Mrs. Difficult.

Assign Mrs. Difficult to Nurse Lovely. You get off the hook. End of problem until Nurse Lovely is off for the day, in which case Mrs. Difficult is told without any room for discussion that Nurse Lovely has the day off and she now has Nurse Ratchet, period.

This kind of behavior is bad for everyone.

[Sour Lemon]

This has happened to me on occasion. I've been the requested nurse, and I've been the primary nurse who is "unwanted" in favor of someone else (typically the charge nurse). In both cases, I favor your #1 strategy.

The requested nurse typically is busy, so it's not inaccurate to say so ...and the patient is also made aware that I am available even sooner if they have a pressing concern. When I am the requested one, I generally don't want to be assigned as the patient's primary. They might be the easiest patient on the unit, but I don't want to encourage the imaginary "special" relationship they've dreamed up in their mind. I don't mind popping in on occasion, though.

[Libby1987]

Nurse Lovely has contributed to this problem. If there was a patient of another nurse who always insisted on having me at her whim due strictly to some connection amd not a legitimate complaint, I would have told the patient that purplegal is her nurse, and a very good one, and that if there was anything that she couldn't manage she had her team to consult with.

If this were my patient, I'd figure out a way to gain her confidence both clinically and as a human. Although it is always the patient's right to refuse care from an individual I have longed worked in an setting where it would be a hardship for both my employer and coworkers to assume responsibility for my patients therefore when the rare patient has requested a different nurse I have gotten very comfortable with falling on the sword, telling them I am committed to their care, they are stuck with me and that we will resolve whatever conflict developed when I got off on the wrong foot with them in the first place All said with 100% sincerity and confidence because that's how I regard these issues.

As a last resort, this patient needs a room change because in no way is it reasonable for a complete changing of the guard affecting all of the other patients.

[Been there,done that, ASN, RN]

You are describing Borderline personality disorder. Do not take this personally. She wants control and attention.

Go ahead and set limits, give her everything she wants, she will not change.

[AliNajaCat]

Dollars to doughnuts she's telling Nurse Lovely that you're a Class A ******* who never does anything right and she's the only good nurse in the shop. Divide and conquer is the M.O. here.

The two of you can go into her room together and explain reality to her, or you can kick this can down the road and make it a problem for the nurses who are working the next time she gets admitted. Your call. She'll pitch a fit either way, but you'll know what's going on and she'll know you know.

[loriangel14, RN]

She's being manipulative. Tell her flat out she needs to deal with you and the other nurse is busy with her own patients.

[blondy2061h, MSN, RN]

Bet you if Nurse Lovely was her nurse several days in a row she'd only want to talk to you

[Cat365]

What does she do when her preferred nurse is not present? Her preferred nurse cannot be there 24 hours a day 7 days a week.

[MrNurse(x2), ADN]

I totally agree that your coworker is enabling her. Nurse Lovely is getting her ego stroked by this manipulative patient and you are getting thrown under the bus. Stop this immediately.

[Everline]

You are describing Borderline personality disorder. Do not take this personally. She wants control and attention.

Go ahead and set limits, give her everything she wants, she will not change.

This^^^^

BPD was my first thought when I read this. It has nothing to do with you personally. A safe bet is that she does a variation of this wherever she goes and with whomever, including in her personal relationships. You can't fix this. Don't be surprised if Nurse Lovely goes from saint to sinner in her eyes one of these days.

[la_chica_suerte85, BSN, RN]

As others have mentioned, there's something weird here that she always wants this other nurse but you always seem to be the one assigned to her. If it were the other way around, she'd be asking for a different nurse, probably even you, especially if she convinces herself that you're sick of her **** and now she is the one who is getting rejected.

You're overthinking this. There are some weeks where it seems I keep getting the same patients and, while it may be cool at first, me and the parents could eventually use a change of scenery and I may ask for a switch up of the assignment. Helps to get more experience.