Patients We Love to Hate

[VivaLasViejas]

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.:)

[LydiaGreen]

MG

My experience is limited as I am just about to graduate from nursing school but after two and a half years of practicum placement in the medical/surgical setting I can tell you that MOST families are wonderful and that nurses appreciate them. There are, however, some families that are beyond difficult. When there are family difficulties, family visits can actually be a problem for the patient's health (anxiety causes blood pressure, pulse to rise, etc.). I have seen families smuggle in chocolate and candy to their diabetic grandmother, we have no idea and then wonder why Granny's blood sugar is through the roof and she requires four times the insulin to bring it down until we "catch" them several days later. I have seen patients walking laps in the hallway, feeling fine, no pain whatsoever and as soon as the family arrives they are lying in bed writhing in pain claiming that they have been in this terrible state all day and that their pain medication isn't enough. This leads the family to cry foul to the doctor, doctor looks at med cardex and wonders why client hasn't received any pain meds (because during their every two hour pain assessment they stated that it was a ZERO). The doctor isn't about to tell the family that the patient is playing them for sympathy and attention because they haven't visited Granny in six months and only call her once every three months. So, we continue to have to deal with this on a daily basis because Granny knows they are concerned and wants to keep them concerned so they'll keep visiting. These are just a couple of examples.

But, as I said earlier, MOST families are absolutely wonderful and we appreciate them very much. You might not hear about the wonderful families a lot because it is human nature to talk about the problem situations, and not talk about the non-problem situations. On the average, most families are just terrific and make our job MUCH easier.

[Stitchie]

I think most families are incredible and I have seen genuine care and concern for their loved ones, as it should be, as we all hope it will be. Then again, I have a saying "if a family is weird it's usually about money".

I have heard a patient's family to "keep her alive until the first of the month, so we can get her monthly check" and "if she dies we lose the trailer" (note --these were NOT the same family.) :chuckle

To be a wonderful support for your loved one, the rules are simple: be polite, be genuine, be interested. Know that the nurse is busy and is doing her/his best for you. If the nurse tells you something like "come find me if she's agitated/expresses pain" -- please do so.

When there are successive spouses and step- and half- siblings, all rules go out the window. Then it just gets ugly.

Bless you for wanting to be kind to nurses. There's a special place in heaven for people such as you.

[Purple Princess]

Hi MG, so sorry to hear about your mother in law. I was a student nurse until this week but anyway. When family was in the room it did make me nervous only because I am a student. But if a relative was concerned about the patient I would briefly discuss my assessments like their blood pressure and then make sure they were able to talk with the primary RN. Family is very important especially if the patient is really sick or very young and scared. And actually family are encouraged to be involved in the care. But nurses must still do their work. Family can help by talking to their loved one , bathing them, and be there to ask questions during the teaching process. Sometimes visitors need to be limited to immediate family. But yes I agree, hospitals need to be a little more accomodating to both the patient and family.

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.

[ktwlpn, LPN]

Hi MG, so sorry to hear about your mother in law. I was a student nurse until this week but anyway. When family was in the room it did make me nervous only because I am a student. But if a relative was concerned about the patient I would briefly discuss my assessments like their blood pressure and then make sure they were able to talk with the primary RN. Family is very important especially if the patient is really sick or very young and scared. And actually family are encouraged to be involved in the care. But nurses must still do their work. Family can help by talking to their loved one , bathing them, and be there to ask questions during the teaching process. Sometimes visitors need to be limited to immediate family. But yes I agree, hospitals need to be a little more accomodating to both the patient and family.

I don't agree-I think we are very accomodating to families within reason. I believe the real problem lies with administration and sometimes the docs when they fail to back us when we try to set limits with a family with un-realistic expectations and a bad case of the "me-me -me -s"......With privacy laws we now have to be VERY careful who we are teaching at the bedside.Visitors and family members will crowd around the desk trying to get your attention and violate other patient's privacy-and then get offende when asked to step away and wait.....We have to prioritize all day-we can give everyone there equal share of us but sometimes they have to be triaged to the bottom of our list...especially when they want to ask me "what does the doctor think about this?" or "Did my sister visit mom yesterday?"

[MG-NotANurse]

Thank you to everyone who responded.

As I say, I've never been an in-patient and I hope that it stays that way, but my experiences as a patient's family member seem to split down the middle:

One, the staff making less-than-polite comments if my wife and/or I weren't there to help, more or less constantly. (I'm not exaggerating: one nurse was incredulous that my wife couldn't assist in the "recovery room" after a relative had had hip surgery - there was one nurse overseeing numerous patients in various stages of coming out of the anesthesia, with equally numerous relatives and other people present. Some were coughing or sneezing; some had obviously not washed their hands. Another time, my wife advised the nurse that she had been diagnosed with Graves Disease, and had to schedule her own thyroid surgery. The nurse flatly told my wife to postpone it.)

Two, the flip side: identify yourself as the closest relative and health care proxy, and have no questions answered.

You guys sound like caring individuals; the kind of people that would have made our recent hospital experience a lot better than it was.

And a special thank you to HerEyes73, BabyRN2Be and PurplePrincess for your kind thoughts. Unfortunately, my mother-in-law's outcome was not good. I apologize if some negative emotions have come through in my posts, but 2004 can only get better.

[Purple Princess]

yes I do see your point too. I remember about the hipaa laws in PA. We had to be very careful with the charts and where we laid papers down especially if they had the patients name on them and the patients name is not on the door anymore. And any time I talked to the patient I closed the door and was restricted as to who I could share any info with even my teacher! Some family members can't seem to respect visiting hours or will get roudy and disturb other patients. And limiting visitors is done not only for the patient's well being but so visitors don't bring in more germs to spread. And the receptionist can't really speak for the doctor anyway, neither can the nurse. But I can see where you're coming from since you've been there. Privacy is very important.

I don't agree-I think we are very accomodating to families within reason. I believe the real problem lies with administration and sometimes the docs when they fail to back us when we try to set limits with a family with un-realistic expectations and a bad case of the "me-me -me -s"......With privacy laws we now have to be VERY careful who we are teaching at the bedside.Visitors and family members will crowd around the desk trying to get your attention and violate other patient's privacy-and then get offende when asked to step away and wait.....We have to prioritize all day-we can give everyone there equal share of us but sometimes they have to be triaged to the bottom of our list...especially when they want to ask me "what does the doctor think about this?" or "Did my sister visit mom yesterday?"