Patients who don't use their call light....

[Virgo_RN, BSN, RN]

....but instead "save up" their requests until you go in there to do something, are just as annoying as patients who are on their call light all the time, IMO.

I *hate* it when I'm just going in to get some vitals or pass a pill, and the patient has saved up all of their requests. They need more water, another blanket, some jello, to go for a walk, to take a shower, and on and on.

Last night, one of my patients' tele said he was in V Tach. Well, since monitors do lie, and I knew the patient well, in my heart of hearts I knew he was probably just scratching his belly or something. But, as a good nurse, I could not ignore it, and got up from where I had logged in on the computer and had all my charts piled around me, trying to catch up on documentation before doing my last rounds, and went in there to make sure the guy was still alive. Sure enough, he was sitting on the side of his bed, just fine and dandy. One of his leads had come off while he was moving around, so I fixed it, and as I'm trying to get out the door to go back and finish what had been interrupted, he says he wants his pills, some new bedding, a snack, more water, etc. I told him I had something to finish up and that I'd be back in a while, and left (I'm learning to prioritize my work; as a former CNA, it's hard for me to not respond to patient requests like this immediately).

So, I went back, logged out of the computer, then went and took care of my two elderly "turn Q2" and incontinent patients, made sure they were clean, dry, and pain free, then went and took care of my isolation patient, since he had only one med pass left for the night and I hadn't checked on him for a while, and saved this guy for last so I could give him the attention he was seeking.

Of course, he complained that I had kept him up "past his bed time". Then he took my hand, and would not let go, while he apologized for being such a difficult patient and thanked me for my hard work, and went ON AND ON, all the while holding onto my hand, which I kept trying to pull away, all about how when you die is when people say all the nice stuff about you, and how you should say nice stuff to people while they're still alive, and on and on and on ad nauseum. I mean, I agreed with what he was saying and appreciated being thanked, but it felt really disengenious, and the way he wouldn't let go of my hand made me really uncomfortable.

[racing-mom4, BSN, RN]

Not that this suggestion would help with some of the above problems. But I always say to the patient before I leave the room "What else can I get for you?" I then myself, check their water to make sure they have some, ask if they are warm enough and ask them "are you sure you dont need to use the bathroom while I am still here"

Also about an hour to half an hour before I leave I go into my pts rooms and tell them I will be leaving in the next hour, tell them Suzy is going to be the nurse replacing me, is there anything I can get for you before I go?

As I have found it never fails, I am trying to get ready for report and the call lights start buzzing.

[Virgo_RN, BSN, RN]

I do that too. It doesn't seem to matter with these types of patients. They will have no requests when you have the time and make the offer, but whenever you are really busy and don't have the time is when they want/need something.

Another example, I was in the shared bathroom gloved up and cleaning pee off the floor with a towel, when this guy asked me for a warm blanket. Hello, I'm in the bathroom cleaning up pee, which he could clearly see from his bed! Your warm blanket is not on top of my list at the moment! Another time, while changing the patient in the next bed with the curtain drawn, the patient we were working with said he wanted some ice cream (which was great news because we had been trying to increase his PO intake), and the guy in the next bed (this same guy) piped up that he wanted jello, a popsicle, and fresh ice for his water, oh, and his back scratched. Whenever I asked him if he needed anything, he never did, just wanted to talk about religion or politics. In fact, whenever I'd get the blood pressure cuff around his harm and my stethoscope within an inch of my ears, he'd suddenly start talking and talking and talking without taking a breath or giving me any opportunity to politely interrupt. I finally just took his blood pressure while he talked, because otherwise I'd just be standing there for ten minutes with my stethoscope an inch from my ears waiting for him to stop talking.

Anyway. I just had to vent. Not looking for solutions or advice. I thought others might have had this type of personality to deal with.

[barefootlady, ADN, RN]

Unless I am passing meds, I always plan on giving my patients a few minutes for those extra requests they seem to always have when I enter the room. Sick people are afraid to be too much of a bother because they are afraid no one will come back to the room, so they do save requests and needs up for awhile until they

see a friendly face.

As I get older, I appreciate kindness more, so do most of my patients. Nursing is not an easy job, but being sick is no picnic either. We need to remember that several times a shift. Blessing to everyone.

[Virgo_RN, BSN, RN]

Unless I am passing meds, I always plan on giving my patients a few minutes for those extra requests they seem to always have when I enter the room. Sick people are afraid to be too much of a bother because they are afraid no one will come back to the room, so they do save requests and needs up for awhile until they

see a friendly face.

As I get older, I appreciate kindness more, so do most of my patients. Nursing is not an easy job, but being sick is no picnic either. We need to remember that several times a shift. Blessing to everyone.

Yes, I agree with this. I think with this specific patient, there was an underlying control issue going on. Any time I was available and offered to do anything to make him more comfortable, he said he was fine and didn't need anything. It was only when I was visibly busy that he had not only one simple request, but multiple requests, many of them very specific in the way he wanted them done.

I can understand the feeling of loss of control that one experiences when they are sick with a serious illness such as heart disease. However, some people tend to cope with this feeling of loss of control by manipulating the nurse. I don't think this is a very healthy coping mechanism, and it does make my job harder as well as take time away from my other patients, who are often too sick to be playing these manipulative games.

[racing-mom4, BSN, RN]

Nancy Nurse--I can appreciate the need for venting...I couldnt agree with you more, yes I have had countless patients and families make requests and I think "oh ok--after I am done getting the pt with a 45 blood sugar some juice and sugar- I will be right there to scratch your left toe"

My biggest--and I mean BIGGEST..is the morbidly obese who want you to wipe for them. Now I will wipe them, but I must think to myself, OK how do you do this at home???

One time after wiping a 30 something year old womans front about 15x one night I did finally ask, "How do you do this at home?"

Answer---she has a cloth toilet seat cover that she sits on and rocks back and forth and she just washes it every night.

ewwwaaaaa----hint--when your arms no longer reach below your belt, it is time to take action.

[flightnurse2b, LPN]

Last night, one of my patients' tele said he was in V Tach. Well, since monitors do lie, and I knew the patient well, in my heart of hearts I knew he was probably just scratching his belly or something. But, as a good nurse, I could not ignore it, and got up from where I had logged in on the computer and had all my charts piled around me, trying to catch up on documentation before doing my last rounds, and went in there to make sure the guy was still alive. Sure enough, he was sitting on the side of his bed, just fine and dandy. One of his leads had come off while he was moving around, so I fixed it, and as I'm trying to get out the door to go back and finish what had been interrupted, he says he wants his pills, some new bedding, a snack, more water, etc. I told him I had something to finish up and that I'd be back in a while, and left (I'm learning to prioritize my work; as a former CNA, it's hard for me to not respond to patient requests like this immediately).

omg i couldnt agree with you more about patients being silly about not using their call light.

we had a FF that learned a horrible trick. she was homeless and always in and out for dialysis from smoking crack. for some ungodly reason, one day she decided to tap on her leads. and when she tapped the green one, monitor tech called vfib and we all ran in there with the crash cart.

so this chick got smart, and instead of using her call light, when she felt she wasnt getting the "service she deserved" she would tap her green lead just enough, and in would come the whole code team. so inevitably, one day she was actually went into vfib while waiting to get up to PCU, and the monitor tech didnt believe it..

[Virgo_RN, BSN, RN]

so this chick got smart, and instead of using her call light, when she felt she wasnt getting the "service she deserved" she would tap her green lead just enough, and in would come the whole code team. so inevitably, one day she was actually went into vfib while waiting to get up to PCU, and the monitor tech didnt believe it..

OMG. Did she make it?

Just an addendum: I can understand the little old ladies who don't want to "be a bother" and so never put on their call light or ask for anything. Those people, I really go out of my way for and let them know that they are not a bother, and that it's my job to take care of them, and that I am happy to do it. It's the people that use this as a power/control tactic that drive me nuts!

[squeakykitty]

Yes, I agree with this. I think with this specific patient, there was an underlying control issue going on. Any time I was available and offered to do anything to make him more comfortable, he said he was fine and didn't need anything. It was only when I was visibly busy that he had not only one simple request, but multiple requests, many of them very specific in the way he wanted them done.

I can understand the feeling of loss of control that one experiences when they are sick with a serious illness such as heart disease. However, some people tend to cope with this feeling of loss of control by manipulating the nurse. I don't think this is a very healthy coping mechanism, and it does make my job harder as well as take time away from my other patients, who are often too sick to be playing these manipulative games.

Not only was this an unhealthy coping mechanism, it's also a very annoying one. He knows that you are busy, and there does need to be some limits set.

[flightnurse2b, LPN]

OMG. Did she make it?

Just an addendum: I can understand the little old ladies who don't want to "be a bother" and so never put on their call light or ask for anything. Those people, I really go out of my way for and let them know that they are not a bother, and that it's my job to take care of them, and that I am happy to do it. It's the people that use this as a power/control tactic that drive me nuts!

nope. she had done it so many times that the MT didnt bother calling the nurse because it was always her way of trying to get attention. she had been down for about 25 minutes when we finally got in there, transporter came to pick her up for CT scan and found her pulseless. big big big drama.

i guess the boy who cried wolf story came to life that day...

[Virgo_RN, BSN, RN]

I did end up setting limits, albeit indirectly just by telling him that I'd be back in a little while, then going back when it was convenient for me. I wasn't going to drop whatever I was doing to fulfill a non-urgent request, when I had a very sick man next door that really needed my attention. He was far too sick to ask for anything, and when he was finally able to express that he was in pain, I was so happy that he had shown that much improvement. This is a guy that I wasn't sure was going to make it through my shift.

The manipulative patient was acting like such a nice guy, but I felt it wasn't genuine. It was like he had read "How to win Friends and Influence People" and was trying to use those techniques on me, and it was more irritating than anything to feel like he was only acting so nice just to try and get me to do what he wanted. I wanted to just say "Dude, drop the act. You're in the hospital. Yes, you are a sick man, and I'm sure you must be a nice guy, you don't have to prove it to me. But the good news is that if I am not constantly hovering in your room, it means you're not dying right now. If I was *really* worried about you, the big shiny red cart would be parked right outside your room. You will be taken care of, your needs will be met, but you cannot nickel and dime my time. I have a patient next door who actually might die very soon, and you are not going to die if I am not at your beck and call.", or something to that effect.

[Virgo_RN, BSN, RN]

nope. she had done it so many times that the MT didnt bother calling the nurse because it was always her way of trying to get attention. she had been down for about 25 minutes when we finally got in there, transporter came to pick her up for CT scan and found her pulseless. big big big drama.

i guess the boy who cried wolf story came to life that day...

Just goes to show we still need to check, even if we know it's probably not real. Bummer that patients can use it to manipulate, though. Fortunately, I don't think many of them are aware of this little trick!

Before anyone accuses me of being insensitive to the acutely ill patient, I should say this guy had a history of MIx5, stentx7, CABGx4, and had been hospitalized about 45 times. He was very familiar with hospital routine, and well aware of how busy the nurses are. To deny any needs when directly asked, but then flag down a busy person while they are visibly in the middle of another task is about control.

Anyway, I have a few days off now, just needed to vent somewhere safe, where I know others will understand and not judge. One of the frustrations of being a nurse, IMO, is having to be very careful about how/when/who you vent to. The general public really does not understand all that nurses do. I'm thankful for this site!