Patients We Love to Hate

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Well, it's finally happened........I've met her at last.......the only patient I have ever truly disliked.

I've long been famous for getting along with some of the most aggressive, petty, mean, combative, rude, hostile, nasty, abusive patients ever to come through our hospital doors. "Kill 'em with kindness" is my motto, and even if I couldn't make such a patient turn into a pussycat, I could at least keep them from killing ME. I've never been hit, and other than having a man who wasn't allowed to see his crack-addicted newborn threaten to shoot me, I've rarely been scared at work. (That's not to say I haven't dodged a few kicks, as well as a telemetry unit that was thrown at me by an 80-pound LOL.)

But now I've experienced it: caring for a patient I can neither stand, nor get along with. She came in over a week ago, this middle school teacher (who happens to work at my 12-year-old's school:eek: ), for an open cholecystectomy.......should have been no more than 3 days, but her pain was a 12 out of 10, so she ended up with an epidural. Then her legs were numb, so she couldn't walk. So we turned the epidural down, and the pain came roaring back, and in the meantime she's whining about the room temperature, the bed, the food, the nurses, the roommates, the visiting hours, the physical therapists, on and on, ad nauseam.

OK, I thought, I can deal with this. But I spent over half my shift in that room and STILL couldn't do anything right......she accused me, as well as the rest of the nursing staff, of being clumsy and incompetent and uncaring. (Me, uncaring??! I've NEVER been accused of that in my entire career.) I busted my hump doing everything I could to make her comfortable, and nothing was enough.

Then yesterday, I was caring for her roommate, a perfectly nice TKR patient (I'd assigned Ms. Complainer to another nurse) and this woman just kept going on and on to her visitors about how all of us were just "unbelievable" and the care "terrible". I put my patient on a bedpan because I didn't have the time or the help to take her out of the CPM machine while serving dinner, and off the woman went again: "God, these people are so lazy, my roommate couldn't get up to the bathroom because the nurse wouldn't unhook something!" A few minutes later, she demanded that I not touch her food tray since my hands were dirty from handling the bedpan (DUH), then told me to spray some room freshener around because of the "urine smell". I had to look in four different rooms to find some, then when I went to the middle of the room to spray, she yelled at me, "DON'T SPRAY THAT STUFF IN MY FOOD!! GOD, ARE YOU PEOPLE COMPLETELY STUPID?!"

Well, I wasn't anywhere near her OR her food when I was doing this, and I couldn't help gritting my teeth when I said, "YOU were the one who asked for the spray, and as you can see, I'm over HERE." I had to leave the room just then, because I was about to explode, and she was proceeding to show off again to her visitors how disgusted she was with the hospital, how NOTHING had gone right, etc. "I know I'm just being b****y", she sighed, and her visitors just petted her and told her she had the right to be, because of all she'd been through, poor thing, yada, yada..........:angryfire

Where's that puking smilie when you need it?

All I know is, I'm sure glad she's not one of my son's teachers.......I'd like to think she's not that way at work, but I'm afraid that if he ever does end up in one of her classes, I'm gonna pull him out of there!!

Thanks for letting me rant. I feel better now.:)

I totally feel you when we as nurses have to deal with mean, selfish, ignorant people. I don't understand why people even bother to go to the hospital. We are keeping them alive for god sake?!!

The other thing that they never prepares us in nursing school was how to deal with the families! I mean, gosh, I think I got burned out in the other hospital because the families were just impossible, so demanding, SO UNREALISTIC! I mean, I know it hurts to see your love one in bed, in a vent... I think its a lack of education. First, I don't think society know how much school it takes to be a nurse, one time they asked me if it took me 6 months or 8 months to get my license!???? I am like?? do I look like a waittress????

I was soo mad.... I don't put out with rude patients, i have learned how to deal with them. I can be the nicest person but I can rude also, I found out that for those rude patients, if you are rude to them, they became nicer for some reason. I hate being rude sometimes, but I cannot tolerate people being mean and disrespecful towards nurses.

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Patient complain form

Please check appropriate box as your complaint is important to us.

1. Nurse perfomed procedure that was uncomfortable. Please specify if this was a ng tube, foley placement, IV placement, shot, or other. ____

2. Nurse asked you to wait while assisting other patient. ____

3. Nurse refused to, please specify- fluff your pillow in a timely manner_____, assist you to ambulate outside to smoke____,

allow visitors to stay past visiting hours______.

4. Nurse refused to give your aunt____, friend____, sister/brother_____, your personal health information.

5. Nurse refused to give you pain medication that was, please specify, over the allowed amount_____, before the allowed time_____, not ordered by doctor_________.

6. Nurse refused you to freely express yourself by, please specify, shouting______, hitting_______. Please specify if nurse humiliated you by calling security_________.

7. Nurse was not available immediately because he/she was, please specify, assisting another patient,_________, in the restroom,_________, performing CPR ________.

Thank you. Management will review your complaint and we hope to serve you better in the future. Please accept this gift certificate for one free meal in the cafeteria for completing this form.

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Specializes in Oncology/Haemetology/HIV.

:roll :roll :roll

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Oh I can't wait. And to think I'm just starting school.

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Here's a question, though. How does management handle complaints? Ours is immediately with the patient, with a little nasty gram to the employee without even asking for their side. Customer service is the name of the game - used to be a "head Nurse" stuck up for her staff as long as she could depend upon them. Those days are long gone, I think, which adds to alot of our frustration with these kind of patients.

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Specializes in LTC, assisted living, med-surg, psych.

Oh yeah, there's no way a nurse can win with this "the customer is always right" way of thinking. The patient is right, and we're wrong---it's black and white. :rolleyes:

The patient who was the subject of my original post never did bytch to the management, as far as I know........at least, I've haven't seen any fallout, and it's been a couple of weeks since her discharge. Frankly, since her stay was so awful, I hope she'll never set foot in my hospital again, and that she'll go to another facility (not that I'd wish her on the nursing staff of our competitors!) the next time she needs medical care. :angryfire

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Last week I took care of a patient that fell and fx her hip. She was c/o unbearable pain during transport so in the ambulance received 15mg of MS04 and 5mg of Fentanyl. By the time she arrived in the ED she was cyanotic, unresponsive with an O2 sat of 60% (she was only 53). She received Narcan and ended up going to a respiratory unit for 2 days and then went to the OR for hip repair. I took care of her POD 1 for 12 hours; each time I was in the room she spoke VERY LOUDLY to her visitors, saying things like "this is the most disorganized hospital I've ever seen, these people are incometant!"Her family treated her like she was dying "you've been through so much, etc." I agree it's unfortunate that she was overmedicated, but they were trying to treat her pain, not kill her! Not to place blame, but it wasn't the hospital that administered those meds anyway. Halfway through my shift she called the CEO of the hospital from her room to make a complaint, next thing I know my HN and AHN call me into their offices asking me what was going on and the CEO sent a social worker to talk to the patient. Needless to say, I made sure to document thoroughly the care and conversations I had with this patient. :rolleyes:

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This is why I work in the OR. They happily travel to the OR coutesty of Versed and before you can snap your fingers.....they're unconscous!!!!! Peace and quiet. :chuckle

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Can I ask a question?

As indicated by my name, I'm not a nurse. I found this website while I was researching strokes and analgesics, following my mother-in-law's massive CVA on 1-1-04. Happy new year. Since then, I've found the posts (other than the very technical ones) extremely interesting.

Anyway, my question involves "Pamelita's" statement that "families were just impossible, so demanding, so unrealistic."

How do you nurses feel about the families? In my (limited) hospital experience, there seem to be two sides, with no middle ground:

That is, either the hospital staff expects the family to be there, essentially all the time (and, since hospitals are so short-staffed, this isn't entirely unreasonable). Alternatively, the staff seems to feel that the families are sort of a bother and a nuisance.

How DO nurses regard the families of patients? I'd be interested to know.

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Specializes in LTC, assisted living, med-surg, psych.

I can't speak for everyone, of course, but I personally have had very few truly horrible experiences with patients' families. Sure, like everyone else here at allnurses, I come here to vent about my frustrations---that's one of the many things this site is for!---but there have been few situations I couldn't handle. I work hard to make patients and family members comfortable, thus they tend to trust me, which means fewer hassles; many times, I have been grateful to have those family members there to assist me with the admitting process, as they know the patient's medical history as well as his/her quirks! They also can help comfort the patient who is confused or agitated, and perform the little tasks we often don't have time for, such as swabbing out a dry mouth or wiping a feverish brow.

I also have been on the other end of the equation, as a family member myself. I've experienced the fear of not knowing what was wrong, and the frustration of not being able to find out what kinds of tests and medications and treatments were being planned. I think that's what is behind a lot of the behaviors we see from families.......not only are they NOT in control of the situation, they are in an unfamiliar environment, they're hearing a lot of technical language from staff who are often too busy to answer their questions, and they're seeing their loved one in pain and distress.

On the other hand, there ARE some who are just hell on wheels.......the ones who get in the way when you're trying to do something for the patient, who are verbally, and sometimes even physically, abusive to staff members, who loudly proclaim to anyone who'll listen that you are stupid and incompetent, who are nosy and question every single thing you do for their loved one, or who are on that call light every two minutes wanting you to fluff Mama's pillow, bend her straw, turn off the TV that they just asked you to turn on, turn the heat up, turn the heat down, get another blanket, take off the blanket, give her another drink of water etc., etc., etc. :rolleyes:

I don't know if that answers your question, MG. Each of us is different, and each patient situation is different......you'll probably get different answers as well. :)

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Specializes in HIV/AIDS, Dementia, Psych.

MG~

I work in Long Term Care and fmailies are an integral part of my day at work. I LOVE it when families come visit and take their loved ones minds off of their problems. I love it when they are able to give me info and tips on handling their loved ones. For the most part, families of my patients are wonderful people who I am glad to have around.

However, there are the few that are really terrible. I don't like it when family members argue with my patients. That makes things difficult for us and for the patients. I don't like it when families expectations are unreasonable. Like when I have to inform Mr. or Mrs. so and so that their family member isn't my only patient and you cannot expect me to sit in their room and be at their beck and call all shift. I do not like it when families think nurses and aides are waiters/waitresses asking for all sorts of things for themselves and their kids. I don't llike it when they get angry at me because of things that are/aren't happening on other shifts, in PT, in OT, with the doctor, etc. I am definitely there to hear concerns and rectify them, but it isn't nice when things get taken out on the nurse when it isn't our fault.

Most family members are wonderful and they realize that nurses are professionals who have a job to do. Please don't ever feel like you're in the way. Your job as a family member is just as important as mine as a nurse. Your loved one needs you there for support. If you are courteous, we are always glad to have you around :)

I hope your mother is doing ok after her CVA.

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MG,

I'm just starting out in nursing school, but I've worked in hospitals for a long time. Families can be wonderful, especially in Long Term Care when a patient might be confused or agitated - they can orient the patient, calm the patient, etc. When my dad had a horrible infection from a tick bite (tularemia), he was so very confused. He was totally different from his normal, sedate, conservative self. He'd be so embarrased how he came on to one of the nurses, I haven't told him to this day what he did - he'd be mortified. My mom and I would come down and sit with him all night, and it was greatly appreciated by the hospital, otherwise they'd be in his room every two minutes. He was actually convinced that my brother and I had "committed" him to the hospital and tried to escape several times. In your case, a CVA is a life-altering experience (to say the least) and I'm sure the hospital appreciated you being there, even though they may not have directly said that to you.

On the other hand, I've found some family members to be a problem. I was assisting at a birth a month ago by doing general comfort measures. The mom was a drug user (out of her mind really) and probably didn't realize she was in labor. She was in terrible pain, and I suggested an epidural for her pain. Her mom (or whoever she was) insisted that she shouldn't have an epidural, that she only wanted IV drugs (surprise, surprise). In her coherent moments, the patient requested an epidural, but the family member said "no". I mean, this other lady might have had an easy labor, but who was she to say that this woman shouldn't have an epidural? I was pretty upset. Fortunately, she was passed the point for an epidural so it didn't really become an issue.

There are always two sides to an issue. Family members can be a problem with demands, interfering with patient care at times, being angry at us because we can't give them information, etc. But most of the time I see the family as an asset. Their presence comforts the patient, and distracts them from their pain.

For the most part, I welcome the presence of family. Does this help with your question? And I, too, hope that your family member is recovering from the CVA.

Katherine

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