Frustrations understood. I think that as nurses, we are encouraged to be supportive and understanding, and that we are frowned upon if we speak up about certain pts.
If you find that this situation has become a daily thing and it is starting to affect you adversely, I would probably suggest a change. Have you considered another area of nursing?
I have had similar experiences with "difficult" pts. I have found that the combination of being understaffed, overworked, scheduling problems, rotating back and forth between days and nights, no resources/preceptors available, lack of team work, and high level of acuity has started to affect me poorly. I stay late at work, don't sleep well or enough, have not been running/exercising, and cancel plans with my friends b/c I am so tired, and as you stated, my back HURTS! I have a change of venue next month, and am so excited for just something DIFFERENT.
Plus, I lack the patience and tolerance for the folks who feel it is okay to throw a tray at me because of???? never ok to throw things at me, unless the pt is demented/ can't help it and then anything goes.
And yes, having a pt back who was discharged the day before who fluid overloaded themselves AGAIN b/c they ate a bag of potato chips?? And has the nerve to tell you who completed their chf core measures with them that "I didn't know I couldn't eat that. You never told me." Zero accountability. ALWAYS FRUSTRATING.
LOL-I also think a gentle swift kick to the rear that is well meant and well placed is effective. Many pts push the limits b/c they can. Sometimes it is necessary to remind someone that they are in the hospital, not a hotel, and some of their freedoms are limited here because they have direct adverse effects on their health. CHF/DM/PE is not getting a donut and a smoke break. And no, I am not sorry it hurts when you breathe if you take your heparin gtt into the bathroom to smoke. GIMME A BREAK!