Patient Keeps Asking for Another Nurse

Nurses Relations

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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?

Specializes in Critical Care, Education.

Coming at this issue from a different frame of reference..... Staff nurses have enough to deal with. OP's manager needs to weigh in on this. Hopefully S/He is rounding on patients and is aware of what is going on. Managers need to step up and help staff proactively deal with these 'interesting' patients before they escalate (which they usually do) and get the C-Suite involved.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
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.
I concur. When I worked the floor, I made sure to 'elevate' the status of other nurses that patients may have disliked or not clicked with: Mary is an excellent nurse with 20 years of experience. She is an expert at her job and will take great care of you.

However, constantly accommodating the whims of a patient who has not been assigned to me will only contribute to the problem.

Now I think I want a t-shirt printed up that says I'm Nurse Lovely lol lol!

Specializes in Psychiatry, Community, Nurse Manager, hospice.
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?

I would just take the path of least resistance here and switch assignments. Then I would promptly let it go. Perhaps I would dance joyfully in the hallway and give Nurse Lovely a big, thankful hug. I would not even dream of criticizing Nurse Lovely for having a better rapport with the patient. I would be so grateful that someone did, and the onus was not on me any longer.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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?

My thought is that there are some people who just cannot be pleased, WILL not accept any substitutes for exactly what they want when they want it no matter the rationale and are not worth your time and effort to TRY to make them happy. They can't be MADE happy. They don't want to be happy. Patient safety you can do; accept that you cannot make everyone happy.

I'm also wondering if the favored nurse actually WANTS to deal with this patient . . . my guess is probably not. Some patients are so toxic that no one wants to be saddled with them. But someone has to be. This time it's your turn. Next time she comes to the hospital YOU may be the favored nurse. Are you going to want to take care of her needs (in addition to the needs of your own group of patients) just because she "isn't comfortable" with the nurse she's assigned to?

Every ICU or floor I've ever worked on has their own philosophy about this sort of patient. Some places rotate nurses every shift because the patient is NEVER happy and no nurse can be expected to put up with this bovine dung for multiple shifts in a row. Some places assign a "primary nurse" that can put up with the patient (and the patient will accept) and that person gets them every shift that they're there. Some (wonderful) places have the manager and/or intensivist have a "come to Jesus" meeting with the patient and explain that "Purplegal is a competent and compassionate nurse and we're sure that she can meet all your needs as well as Other Nurse who has her own patients to keep her busy." YOUR workplace probably has a preferred method of dealing with this sort of thing -- it would be good if you discussed it with senior nurses and charge nurses to find out exactly how they normally deal with this.

It sucks to get stuck with a patient who would prefer another nurse, but it happens to all of us at one time or another.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I have had patients like that and nurses who contributed by being their "hero" nurse and allowing it by being "their favorite". They would say "Oh I will take that patient" and then agree with the patient that " no one else could do anything right" and do everything she could to please such patients. This is absolutely crossing boundaries and makes the problem worse. I would tell such patients when they said they wanted "nurse B" that I was their nurse that shift and I would be tending their needs and no, they could NOT have "nurse B". I did not cave and give them what they wanted because that made it worse and I would tell "nurse B" to stay out of the room and let ME answer the call bell when they rang. Nurse "B" got it after a while. She LOVED being the "favorite" nurse, especially with difficult patients, but failed to see this behavior made such patients worse. And it made ME crazy.

Specializes in Cardicac Neuro Telemetry.
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.

You hit the nail on the head, Been there, done that!

To my knowledge, and going back to what I was taught in nursing school, a patient can legally refuse care from any caregiver for any reason, just as they have the right to refuse any type of care/treatment.

Nursing care is about the patient not the nurse.

Specializes in Psych, Corrections, Med-Surg, Ambulatory.
I have had patients like that and nurses who contributed by being their "hero" nurse and allowing it by being "their favorite". They would say "Oh I will take that patient" and then agree with the patient that " no one else could do anything right" and do everything she could to please such patients. This is absolutely crossing boundaries and makes the problem worse. I would tell such patients when they said they wanted "nurse B" that I was their nurse that shift and I would be tending their needs and no, they could NOT have "nurse B". I did not cave and give them what they wanted because that made it worse and I would tell "nurse B" to stay out of the room and let ME answer the call bell when they rang. Nurse "B" got it after a while. She LOVED being the "favorite" nurse, especially with difficult patients, but failed to see this behavior made such patients worse. And it made ME crazy.

This behaviour is notorious on psych. (I mean Nurse Lovely's, not just the patient's). A psychiatrist once said "If a borderline patient can make you think you're the worst nurse in the world, you're in trouble. And if a borderline patient can make you think you're the best nurse in the world, you're in REAL trouble."

Specializes in Cardiac (adult), CC, Peds, MH/Substance.

I was once fired by a patient because her controlled substance was the wrong color. I am often the favored nurse, which I believe often has more to do with me being male and in the old enough to be a grown up but not old enough to be old category, than with my clinical skills. I've also had many patients prefer me if I've had them many times, mostly because they're comfortable with me. I've seen some patients fire other nurses and request the specific nurse who will keep them high as a kite the entire shift with no questions asked. Don't think too much into it.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
To my knowledge, and going back to what I was taught in nursing school, a patient can legally refuse care from any caregiver for any reason, just as they have the right to refuse any type of care/treatment.

Nursing care is about the patient not the nurse.

While this is true, the patient is engaging in something we call "staff splitting". It is not something to encourage. A patient refusing care because the nurse is his brother-in-law, ex-lover, part of her AA group or the identical twin brother of her rapist is one thing -- recreational staff splitting is something else again.

Specializes in Psychiatry, Community, Nurse Manager, hospice.
While this is true, the patient is engaging in something we call "staff splitting". It is not something to encourage. A patient refusing care because the nurse is his brother-in-law, ex-lover, part of her AA group or the identical twin brother of her rapist is one thing -- recreational staff splitting is something else again.

It's on the staff to not be split.

How do you not get split?

By not making a big deal out of it. Check your ego. Don't try to prove it has nothing to do with you, simply know it has nothing to do with you. And most importantly: never, ever, ever believe anything negative about the favorite nurse. Make a bond with that nurse.

Then no splitting happens.

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