sticknurse

There's just something in nurses I guess. We keep our eyes on others, like it or not! Once I went to my neighbor's house and since the weather was warm they had the screen door only closed...anyway I knocked on the door but no one answered, ( I didn't know this lady very well, just casually) Anyway, these legs were visible from the door, and they were not moving at all, no matter the knocking I was doing. Just two legs lying across the hallway, I freaked out and entered the house to help the fallen one and it was my neighbor's teenage daughter who apparently didn't realized she'd scared me half to death and thought no one in their right mind would just enter their house anyway! She screamed and it's a miracle they didn't call the police to take me away! Still amuses me after all this time.

I agree with the above poster, the best bet is to remove any reward she may be receiving as a result of the behavior. Good luck.

Thanks everyone for your input. I am an independent nurse and he is a medicaid client. The case manager is an RN and well aware of the situation, however since he "fired" (he thinks) her the last time she tried to remind him of his responsibility she is not too happy with him either. His own mom is a social worker and she is fed up with him as well, even though she is listed as the back up caregiver, she has stated that she doesn't want to be his go to person because of ongoing abuse she has experienced. He is difficult on a good day. The doctor is aware of his noncompliance, yet it goes on. I am pretty sure I just need to get myself off this case. Thanks for the input and advice again.

I am trying to care for a young man in him home. He is considered to be his own responsible party. The problem I'm having is he is not good about taking any initiative with his own health needs. For instance, he constantly refuses assessment, "no one takes my vitals", also, he has fired other nurses for calling the doctor with legitimate concerns. He fails to maintain the supplies necessary to adequately care for him ie. gloves, catheters, etc. There is almost no family support, only a mom who we may or may not be able to get hold of. He denied her existence at first, then another nurse told me about her. I thought he had no back up caregiver at all. He has sort of a reputation and only one nursing agency is even willing to send staff in to see him, he has also been known to send a nursing assistant away or tell her her services won't be needed, then turns around and expects his homecare nurse to perform the aides job, which wouldn't be so bad except we are only authorized to spend an hour with him and only allowed to provide a specific NURSING service, not everyone's duties. Further problems arise when he surprises us with these requests and we must choose to make him happy or keep other client's visits on time. He has become a problem also due to his failure to be honest with us (the nurses) about new orders and refusing to answer legitimate nursing questions as in "Have you been eating?" Or 'How is your pain?" This client's attitude ranges from ignoring the question altogether to outright hostile responses. I am at my wits end. Any suggestions? Sorry so long.

I was an "Electronic Warfare Signals Analyst" and that's all I can tell you!!

Thanks to all for your informative responses. I am "covering mine" with education and lots of charting! I also try to let the new nurses (he goes through them like cheerios) what they will be facing. I don't work for an agency so there's no policy i can use to get out from under this. I work for myself, and as a "prudent nurse" I try to do what I can to make him aware of any possible consequences he may face if he continues to refuse care. As far as a lawsuit claiming staff didn't assist him, well, he has a long history of this type of behavior from what I gather. He's been in and out of rehab, mom is fed up, dad is in prison, and friends that I've met are questionable as far as intervention potential....thanks for the advice. I will keep trying to convince him to change, but I fear to no avail.

I am providing him with educational material which will explain his risks, and charting all the responses I get when I attempt to enlighten him. He's very intelligent, but stubborn as well. We are concerned that one of his wounds is infected now and he's refusing to go to the doctor so far. I've never taken care of a more challenging patient....thanks for the advice!

Hello everyone, I am working with a challenging young man who suffered a spinal cord injury. He is 27 and preferes to sit up in his wheelchair for hours at a time despite our admonishments. I am looking for advice because he's refusing interventions and education attempts we've made so far. I am trying to find a way to impress upon him the risks he's taking and help him understand his risk. We also suspect ( I work in the home with another nurse) that he may be abusing his prescription valium as well. He is a recovering addict by his own admission and sometimes apprears to be "under the influence" of something when he is assessed. He also refuses vitals and asks us "don't write that I refused vitals." A nurse who works with him told me recently he threatened to fire her if she reported a new area of pressure she noted to the doctor. He basically told her if she called the doctor she need not return. What do you do with a patient like this? There's virtually no family support in place, his own mom stated "I don't want to be his back-up caregiver anymore, I've had it with his verbal abuse and manipulative behavior." (Mom is a social worker!) What would a prudent nurse do?

I congratulate you on furthering your education!! So someone got the wrong impression. I remember getting flack when I thought I was just doing my job, (my first job as a nurse, I was a cna too) and all I did was review some of the issues I found while making rounds...well you'd think I hollared and carried on like a drill sgt. That's not even my nature. I tried to let the ladies I worked with know that I meant no harm, I only wanted what was best. I apoligized. Well, it took some time, but they finally accepted me when they realized I would answer lights, and help out whenever I could. It just takes time. One of my favorite mentors at that job was a nurse I absolutely hated the first 6 months. I'd ask her a question and she wouldn't even respond...it turned out she was practically deaf. I felt like an idiot for being mad at her for so long when i finally found out...just never know. We're still friends today 12 years later.. P.s. Don't be so hard on yourself, k? It causes wrinkles and stuff.

Call me paranoid, but I don't think I'd want that. Just think about the "confidential" stuff people let slip already....no way, not me.

Her behaviour was unacceptable. She's an adult. We have a responsibility to protect the vulnerable ones. We don't need nurses with abusive attitudes. I wouldn't feel bad about her departure. Too many times we enable these people. Wouldn't that "we feel bad we didn't include you" possibly reinforce to her that she was not that bad, and therefore wouldn't feel it necessary to change her behavior in the future? Don't prevent someone from feeling the natural consequences of their actions!!! How will she learn? Honesty Honesty Honesty!! she's a stinker.

Check with local better business bureau. Check the facility itself in person. Look for residents who are actively engaged in activities, and "interview" these folks if they're willing to speak with you. There will be other family members around, ask them about the facility. Are they happy with the place? Look on the internet for healthcare surveys which are conducted periodically by an independent entitiy. These surveys show information about problems the facility has been asked to address. Don't judge a facility based on the beautiful decor whatever you do, judge it based on the safety of its clients, and their overall well being. If you know a nurse, ask her or him to come with you and "check it out" you don't want to take "the tour" that the facility will offer, you want to investigate on your own. As a businessman, you realize I'm sure that they will be on their best behavior when they know you're coming...I've worked in several nursing homes and wasn't terribly impressed I'll admit. There are good ones out there too, but they're in my opinion, hard to find. Another consideration, would it be possible to let them stay home with nurses/aids doing visits? Some states allow clients to remain in their homes and recieve visiting staff. It saves the state money, and most people stay healthier when they stay at home. Less risk of facility acquired infection for instance, and more personalized care. I highly recommend that you ask about that if it's feasible. In Ohio medicare will pay for the homecare and so do some of the private insurance companys. I work as an independent nurse myself, and my boss IS the client, they can hire and fire their own staff. This allows the client to be in control and they love it. In a nursing home, on the other hand, mom and dad get whoever's on that day. It may be an agency nurse, (unfamiliar with the facility itself, never mind your parents) or a recent grad who has little experience and no support in her first job. You could get lucky with a nursing home, but in my opinion your loved ones would be happier and better off in their own home. Good luck and pm with any questions if you like. If you want to check availablity of home care in your situation, talk with a social worker or the doctor and see if you can find out about it. Hope this helps. Good luck.

I now have a very sweet and supportive husband. He owns his own business and understands the demands my business places on me. I recently started my own business and it can be a difficult thing at times. The reason I wanted to start this discussion is out of concern for anyone who may not have fallen in the proverbial hole yet. Let's help them recognize they are at risk at least. When I met the guy who ruined me for awhile, I noted that he had a college education (business major) and a very good job....but then he'd quit and be unemployed (playing golf all day) for 6 months at a time....waiting on the "right opportunity" he was a true con artist, and good salesmen. He knew the book "how to win friends and influence people" by heart and it was very effective. I don't assume that all the intelligent white collar guys are angels please. Knowledge in and of itself does not a good spouse make....thanks again for the advice. Btw, I took a class about boundaries in the midst of my divorce and surprise!! It was chock full of therapists, nurses, and other helping types....interesting....someone posted that she is happier being single and I agree, it's much nicer to be "alone" and happy than married and miserable. I've encouraged more than one coworker when they've decided to leave their abusive spouse, one that comes to mind had been beaten up and called a "fat cow" several times by her husband. she would come to work with the bruises, and crying alot...well, another nurse and I ended up going to court with her when she finally got a restraining order. This poor woman had no idea what her rights were, she thought she'd be destitute (they'd been married 14 years) if she left him. She's now happily remarried to a good man. I just hate to see some of the nicest people (nurses) get crapped on, it burns me up. we should help each other when we can. Thanks to all.

Thank you for your input. I am inquiring because I feel like I've learned the hard way personally, how to look out for myself. I used to allow my ex to cause me all kinds of problems. I finally let him go. I would have advised a client to get out, but I stayed and put up with it for a long time. I finally took a class about boundaries, where I learned to stand up and protect what was good about myself. I didn't have to be understanding when others abused me at home. I didn't have to make excuses for them ie. well, he's had a rough time, and he's emotionally compromised due to his childhood etc. There's no way I would go down that path again, but I did. Here I thought I was smarter than that!! Met alot of nurses along the way who had similar situations. Just wondered how you all have coped...keep em coming!!

Hey just taking this to the people. What's your opinion? Are nurturing types like us often attracted to the wrong types? Do you do "everything for everyone" at home as well as at work? How do you cope with the situation? Where do you draw the line? Any advice?