I had a patient tonight in her late teens, had a C-section back in May and spent some time in ICU recently due to an abscess and came to our floor (med/surg) a few days ago. This patient is morbidly obese and obviously very spoiled or just a brat. Her call light was on literally every 10 minutes....you would go in her room and she would want ice, or graham crackers, or want you to rub lotion on her. You would spend a half hour in there and AS SOON AS you walked out, she would have her call light on and say "can you send in my nurse." REALLY?? I was just in there. Then she would want to know why her food tray hasnt come yet or when was it time for pain medicine.
She is supposed to go home tomorrow but she asked me to wash her crotch and to scratch under her skin folds of her belly. I so wanted to say your arms arent broke! But I figured it would be less of a battle to just do it myself. Then 2 of her friends came....2 boys in their late teens, early 20's. The patient called me into the room to ask me if I could get them something to drink. I told her that there was a cafeteria and a vending machine room. She said they were broke as a joke. Hmmmm thats funny because they have a ton of tattoos and I can smell cigarette smoke on them but they cant afford a $1 bottle of pop or water?? I ignored it and walked out. Next time I came in to do something she said "did you ever find them something to drink??" I was about to blow a gasket....I calmly went and got them 2 glasses of ice water. Next time I came into the room theres the empty glasses sitting on the bedside table. The trash can was right beside them and they couldnt even clean up after themselves.
Next I am in the process of flushing the patient's PICC line with saline and heparin....I dripped a drop of saline on her and she says "umm thanks for making me wear it." I said "its saline, its not going to hurt you." Another friend drops by....theres a sign on the bathroom door saying it is for patient use ONLY. theres a visitors bathroom literally 2 doors down. The friend is in the patient's bathroom using it....I ask the patient where the friend is and she says shes using the bathroom. I tell her that theres a patient bathroom right outside and she gets huffy with me and says her friend "really had to pee." Come on you're not 5 years old!! Last but not least after I catered to this little brat all night she asks me to tuck her dressing into her skin fold because its uncomfortable....as I'm doing this as gently as I can she starts to scream...literally scream. And then bursts into tears and tells me I'm being too rough with her and she should have never let me do it. I honestly wanted to ask her what the hell was wrong with her. And the worst part about people like this is that they can treat you however they want and you cant say a dang thing back to them or you get in trouble! Its ridiculous that patients are allowed to get away with that stuff...I kind of neglected my sicker, more grateful patients because of this demanding immature girl. Thank you for listening to my rant, I feel a little better now
OMGosh. Please tell me you have learned from this. I've done things just to appease my patients or because it is easier to jut do it myself, but this patient takes the cake.
Next time...stand up to her, be firm and just say no.
OMGosh. Please tell me you have learned from this. I've done things just to appease my patients or because it is easier to jut do it myself, but this patient takes the cake.
Next time...stand up to her, be firm and just say no.
that's true. A patient needs to understand a nurse's role, and it's a nurse's job to teach that to a patient, not misinterpret their role as a waitress or handmaiden. Most people (I find) are surprised that nurse's are responsible for so much and have many patients with many needs. Inform them of that. I do. How else will they know? By watching medical fiction shows on T.V?
I'm sorry that this happened to you. However, in my experience, this type of behavior is not limited to the younger generation. I've seen older people (50 and up) go crazy with the call bell, demand drinks and food for visitors, and expect personal maid/cable/heating service from myself and other nurses. (And I work in LTC.)
Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
You did well.
I would've done things a little different. First, she would have to clean herself since she was going to be discharged the next day. Self-care comes into play here. I would've also set limits on her call bell. Once an hour unless she is dying.
As for her friends, I would've waved and said hello and walked right out.
As for the saline on her arm, ignore.
The girl has issues; she has no support. I feel sorry for the baby.
I don't think I would've been mean, but limit setting from the get-go would've been placed.
Specializes in acute care med/surg, LTC, orthopedics.
Well... you were enabling the behaviour especially with the fetching of water and washing the crotch and scratching the belly... really, patients only walk all over you if you let them.
I would have told her that she needs to wash up herself, provide her with the cloths, and to take her time, but that will be what she does at home: Taking care of herself. Yep, sounds like she walked all over you. Everyone deals with problem patients their own way, but I would've said - I have other patients to tend to, if we can group all of your requests together, then I'll check back on you when your medication is due. As far as medical care, please feel free to call on me, but to bring drinks to your visitors is not part of my job. They can leave the hospital for food/drinks and return to visit you later. Sometimes kids this age feel they can be pampered, maybe never having been pampered. You said she had a c-section, right? Where was the baby? Why was she admitted? Did you discuss her baby? Teaching regarding care for herself, her nutrition, etc?? Sounds like an out of control teen, in many ways.
And P.S. I have dripped (or rather squirted) many a drop of saline on patients. When I have a flush, I squirt out a bit before I flush the line, sometimes I make the trash, sometimes it squirts out a bit. I just say "oops, a little saline wash might be coming your way!" No biggie.
Amen!! I think it's that ER attitude and experience you get from dealing with some of the lowlifes of society everyday because they are the worst manipulators that want everything done for them.
I had a similar experience in the ER with a 16yo that had come in for abd pain and come to find out she was pregnant and had an abcess in her arm. She and her family were thrilled she was pregnant (which I couldn't understand), but the patient was obese and a huge baby. She told me she could not take the abx because "they are too big". I then proceeded to question her on how she planned to take her prenatal vitamins if she couldn't take these tiny pills? Then I was thrown out of the room by her mother and told I have an attitude problem. It will never cease to amaze me the type of people that are out there breeding.
You should have set boundaries with this patient from the get go.
When I work the floor, I start my shift by going in, introducing myself to my patients, and stating MY plan of care. I tell them they have such and such meds due at 21:00, labs after midnight, and vitals. I then tell them I will be back in such and such time to do all these things together so I do not keep having to wake them. I also tell them how many patients I have or if I will be getting a new admit so I need to get them squared away so they won't feel neglected when my new admit comes. This usually works.
Also, when I get request to "wash me", I ask them who washes you at home? If you can feed yourself, you can wash yourself and private area. I will set you up for a bed bath or better yet, I'll call the doc and see if we can get an order to get you off the monitor and into the shower since you have no problem walking outside to smoke.
And for vistors, it depends. For things like ice, I may get them a cup because they have no access to the nutrition room. But if that patient they are visiting is NPO, they will get kicked out the room if they have food. It's disrepectful to be eating infront of a pt who is NPO and is hungry.
I let patients know you need to try to help us help you, we want you to be as independent as possible, especially if you are going to be discharged. If you still have issues with bathing yourself, then I'll speak with the doc in the AM and see if you may need a consult for a nursing home. Next thing you know, the patient is doing ADL's without any issues. This seems to work most of the time.
Specializes in Med-surge, hospice, LTC, tele, rehab.
Nobody is doing that girl any favors by pandering to her (I wouldn't have). BTW "they" can't treat you any way they want to; that's up to you how far you're going to let someone walk all over you.
I think in theory, this is the way it should be, but at my hospital if I don't cater to idiots like this and they complain about me to my manager, I will be written up and get in trouble for it.
well the problem is that as soon as the patients dont get their way they call in the patient advocate whose name and number is given to all the patients when they are first admitted and told if they have any complaints to contact her. so as soon as you dont do what the patient wants they complain to the patient advocate that you are not compassionate or are rude. last week one of our nurses got a complaint from one of the patients that she wasnt "compassionate or caring." This nurse happens to be a great nurse who never gets complaints like that but probably because she made someone bathe themselves or didnt cater to their every want she got written up and scolded by the nursing director.
Specializes in Med-surge, hospice, LTC, tele, rehab.
KSU-SN said:
well the problem is that as soon as the patients don't get their way they call in the patient advocate whose name and number is given to all the patients when they are first admitted and told if they have any complaints to contact her. so as soon as you don't do what the patient wants they complain to the patient advocate that you are not compassionate or are rude. last week one of our nurses got a complaint from one of the patients that she wasnt "compassionate or caring." This nurse happens to be a great nurse who never gets complaints like that but probably because she made someone bathe themselves or didn't cater to their every want she got written up and scolded by the nursing director.
Exactly. If you do stand up to patients like this and be firm with them, they will call the patient advocate and the nurse is in trouble.Heaven forbid you tell the visitor "bringing you a drink is not part of my job". Lucky you if your manager will actually have your back because most likely they won't. You'll just be in trouble. This is part of why I have really been disheartened by nursing.
well the problem is that as soon as the patients don't get their way they call in the patient advocate whose name and number is given to all the patients when they are first admitted and told if they have any complaints to contact her. so as soon as you don't do what the patient wants they complain to the patient advocate that you are not compassionate or are rude. last week one of our nurses got a complaint from one of the patients that she wasnt "compassionate or caring." This nurse happens to be a great nurse who never gets complaints like that but probably because she made someone bathe themselves or didn't cater to their every want she got written up and scolded by the nursing director.
I work in ER and got a couple of complaints about me when I didn't give pain meds fast enough. Excuse me, but there was a trauma going on and I was circulating that day. The patient was highly upset that her pain med was "late", although it was PRN, and wrote all kinds of lies about me in her complaint. My director looked at my charting on her, as well as my charting for the trauma, correlated the times, and decided he was not gonna do anything with the complaint.
When I worked the floor, I got a complaint because the doctor d/c'd the pt's morphine and put the patient on Ultram. This patient was hell bent on thinking I was the one who "changed" his pain med. The doctor even came in and spoke with him and told her I have no authority to change his meds because I am the nurse, he is the doctor and he is the one who changed his meds. The pt complained about him too. That one got thrown out as well.
Makes me glad I dont work in the hospital! I work in a LTC setting with severely disbabled children and young adults :). When my hubby was in the ICU (for a severe Mallory-Weiss tear and severe blood loss) I was with him from early in the morning till about 7pm. I cleaned him up because he was very weak and unable to do this himself, he was also embarassed, and I hate sitting around doing nothing lol. He was also in DKA (type 1 diabetic) due to the tear as well and he was on an insulin drip which required hourly blood glucose checks. I got the accuchecks too, b/c his fingers are all heavily calloused from doing construction work for 20 years. Heck when I was a patient in the hospital for removal of my gallbladder, I even offered to change out my IV fluids myself b/c I knew how busy my nurse was!!! My point is: some people think that nurses are there to be their personal handmaidens, and anything that they could do independently flies out the window the second they are admitted. Now granted, there are some folks who truly can not take care of themselves, and those are the ones that need us the most. Not the call-bell kings or queens ding-donging us to death to fluff the pillow, or move the cup a 1/3 of inch......
CoffeeRTC, BSN, RN
3,734 Posts
OMGosh. Please tell me you have learned from this. I've done things just to appease my patients or because it is easier to jut do it myself, but this patient takes the cake.
Next time...stand up to her, be firm and just say no.