epicnurse

Hi all! I'm an LPN with 3.5 years of experience in long-term care settings. I'm not totally new, but I'm still a little green around the edges. Today my question for everyone is about how to deal with difficult patients. Normally, I work on a long-term wing of a residential facility and deal with your run of the mill older residents - dementia, Alzheimer's, diabetes, hypertension, CVA, CHF, and the lot. For the most part, I've figured out how to work with my residents and their individual behaviors. However, this facility also has a rehab wing which I float to every other weekend. These patients are much different than the people I normally work with. They are, for the most part, alert and oriented, and they know what's going on with themselves (which is not something I can say for my beloved long-termers). I haven't had much of an issue with this (other than the clock watchers... better not miss a PRN norco...) until recently. A short-term rehab patient was admitted post heroin overdose, and he is extraordinarily behavioral and demanding. He's a player, he's an attention seeker, a drug seeker, he's a thief (and has been caught red-handed going through staff members' purses and bags if left unattended), and he's doing his level best to get someone fired. He's turned more nurses into the higher-ups for trivial things than I can count. I've only dealt with him for one weekend, and it was HELL. Out of 20 patients I was responsible for, he caused me more stress in two nights than all the other 19 patients put together. And, woe is me, I'll be working on his wing with his patient group this coming up weekend. I'm so stressed! I'm already dreading going into work on Saturday and Sunday nights. Best case scenario... he'll just sleep through the night, and I'll only have to deal with him in the morning for his 6 am meds. I have a feeling that's not going to happen though, and that I'll be dealing with this man for my entire 8 hour shift. My supervisor is aware of his behaviors and issues, and there'll be another nurse working the opposite group of this wing with me, but I'm still very nervous to go into work and deal with this patient. My plan right now is to treat him very, very professionally, make sure I don't have any conversations (work related or not) where he could possibly overhear, keep my nursing practice air-tight over the weekend, and rely on my supervisor's opinion for any incidences that may come up. But, to any nurses who've had experience dealing with difficult patients like this one, do you have any advice?

Hello nurses, I'm a semi-new LPN working in a LTC facility. This is the first job I've had as a nurse... I came to this job straight out of nursing school, and I've been there for about a year. As a brand new nurse, I was kind of thrown to the wolves by the management. Granted, they were desperate for nurses - I'm not sure they had much of a choice. But I was regularly the only nurse on a floor with forty residents who I had to pass meds to, do treatments on, call doctors, get orders, and also be in charge of several nurse aides who were very new to the job and had some serious attitude problems. Along the way, I was offered minimal assistance by my supervisors. Most of the time I wasn't sure what I was supposed to be doing or whether or not I was doing it right, and needless to say I picked up a few bad habits along the way. This brings us up to the present, when I recently had a pharmacy audit. The results weren't pretty, and the way it made me feel was even uglier. It's like if I don't do every little thing the perfect way, I get slapped with an audit, but when management leaves me on a unit by myself with supervisors who can't be a$$ed to help me when I ask for it, there's no kind of repercussion. And it's not like I'm sitting on my laurels. From the time I get to work at 2:30 until I leave at 11, I'm running to get everything done. How much more am I expected to squeeze into an eight hour shift?? I really just needed to vent and get some support. What was your first job like? Your first pharmacy audit? How have you dealt with situations where you're in over your head? What are your limits at a work place, and how do you decide whether to stick it out or look for a new place to work?