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
Regarding the saline wash, I am going to assume that she needed a bath anyway. Those types of patients usually do. No harm no foul.
People that can do for themselves and choose not to are pathetic IMO, and usually get a swift response from me. Requests such as 'fluff my pillow', 'reposition me' (from a patient that will likely be discharge within an hour or so) or 'change my TV channel' are met with the response 'How do you complete these tasks for yourself at home?' When I had a completely ambulatory alert and oriented x3 patient that messed in her bed on purpose, I requested (and got) a psych consult for her. She was not happy when the psychiatrist arrived to evaluate her for defecating in her bed on purpose, but I made my point and she decided that she would walk to the bathroom after that. Do not give these types of patients an inch or they will walk over you. I will walk to the ends of the earth for a patient that has real needs, but not these types.
Specializes in Med-surge, hospice, LTC, tele, rehab.
maxthecat said:
I don't think it has anything to do with whether the OP is a newish nurse or easily intimidated. I think it has everything to do with where she practices. I hope those of you who work where patient complaints are actually impartially investigated and where nurses are backed if they have a sterling reputation realize how lucky you are. Not all of us practice under those conditions. Where I work, there is no investigation. If a patient makes a complaint you are written up for "poor customer service." One recent example is a nurse who was reported for rudeness by a patient. A co-worker who overheard the exchange that caused the report stated that nurse had been perfectly appropriate. Everyone, and I mean everyone, knew that this particular patient was lying. Nevertheless, management wrote up the nurse and reassigned her to a different unit for a while, gave the lying patient an apology and gift card. We are constantly reminded that the patient is a customer and we cannot afford to have any customer unhappy, whether or not their unhappiness is justified. Also, waiting on family and visitors is an expectation of good customer service where I work. We are never to direct a visitor to the soda machine, we are to fetch a soda for them.
I would love to work in an environment where I could set limits without fear of reprisals, and up until a few years ago I did.
I post this because I want those of you who cannot imagine getting in trouble for settling reasonable limits in a polite way to know that not every facility treats complaints in a reasonable way. The OP is not just being paranoid--these places really do exist. From another post I see that the OP is leaving her facility, so I hope she will find a place that operates in a reasonable way.
I agree completely. As a new nurse, I didn't think jobs would be as you described here, but the job I am in now is just like this. We have to take all kinds of crap from patients and families or will risk getting in serious trouble with management.
I don't think it has anything to do with whether the OP is a newish nurse or easily intimidated. I think it has everything to do with where she practices. I hope those of you who work where patient complaints are actually impartially investigated and where nurses are backed if they have a sterling reputation realize how lucky you are. Not all of us practice under those conditions. Where I work, there is no investigation. If a patient makes a complaint you are written up for "poor customer service." One recent example is a nurse who was reported for rudeness by a patient. A co-worker who overheard the exchange that caused the report stated that nurse had been perfectly appropriate. Everyone, and I mean everyone, knew that this particular patient was lying. Nevertheless, management wrote up the nurse and reassigned her to a different unit for a while, gave the lying patient an apology and gift card. We are constantly reminded that the patient is a customer and we cannot afford to have any customer unhappy, whether or not their unhappiness is justified. Also, waiting on family and visitors is an expectation of good customer service where I work. We are never to direct a visitor to the soda machine, we are to fetch a soda for them.
I would love to work in an environment where I could set limits without fear of reprisals, and up until a few years ago I did.
I post this because I want those of you who cannot imagine getting in trouble for settling reasonable limits in a polite way to know that not every facility treats complaints in a reasonable way. The OP is not just being paranoid--these places really do exist. From another post I see that the OP is leaving her facility, so I hope she will find a place that operates in a reasonable way.
Very similar where I work. We are expected to cater to the patients' and visitors without question. The patient is always right, no matter what.
Specializes in Professional Development Specialist.
Part of what I love about sub acute rehab is that it completely appropriate to tell patients that it is part of their therapy to do as much for themselves as possible.
Maybe you could have suggested that it may be a possibility that she would have to be discharged to a skilled nursing facility for rehab and/or occupational therapy after she was discharged from the hospital. You know, if she's so unable to care for herself that she can't even wash her own crotch and all.
She sounds like an emotionally immature girl. My guess is that she has a huge need for attention and this is how that need manifested itself. She probably had a very dysfunctional childhood and learned to make her self feel better/safer by eating. No doubt this situation was annoying for you, but I can't help but feel sorry for her and her new baby. She will probably be dysfunctional all her life because she doesn't have the emotional maturity to realize that she IS dysfunctional and thus evolve a desire to change. If you think of this patient from the Maslow perspective she is obviously trying to fulfill either Safety needs (she's afraid of the situation she's in - either physically afraid because she had the infection OR afraid of being discharged and feeling overwhelmed about dealing with the baby so she tries to project an air of "neediness" to her caregivers) OR Psychological needs (insecure and needing emotional reassurance in the form of your attention). I wish that mental health resources were readily available to all those who need them! So says my A from Psych 101 LOL!
Scary thought is the fact that this person will probably go out and spawn again! I can't help but think the "bend over and kiss the @ss" of every patient that walks through the door culture does nothing but contribute to these types of behavior. Sadly in many cases, if a nurse would try to set limits on this type of behavior and the patient complains...the nurse involved would get in trouble or worse.
Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
NurseFrustrated said:
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.
There are ways to communicate without being rude.
Limit setting doesn't have to hurt peole's feelings.
oh, let them complain. your reputation will cover you (assuming you are a good nurse with a history of strong communication skills, etc.) at my hospital people complain all the time, but the character of the complainer is taken into consideration, LOL. no one at my place would give the chick you describe anything other than a "there there, sorry it wasn't what you hoped for" with pat on the head and send her on her way.
unfortunately some of us work where it's not just the patients that think we're at a hilton lounge & spa resort, but management as well that thinks we're just overpriced room service attendants.
Where I work, there is no investigation. If a patient makes a complaint you are written up for "poor customer service." way.
I got written up for bad customer service, because even though I kept a patient from going to PICU in respiratory failure, and told the mom everything that happened as it was happening, getting the language line to do so... Well the dad (who I NEVER EVER met) said that I hadn't checked on the patient.
I got written up because I didn't get a bed for patient's mom's boyfriend of the moment (frequent flyer, we'd met a few of them) immediately. Never mind that I was getting another nurse in the room to look at the patient because I was thinking this baby was about to go downhill really fast. When I argued that one (and even had witnesses backing me up) I was told that next time I need to get the bed. So apparently, the W of waitressing unrelated guests comes before ABC.
Also written up for giving smoking cessation literature to cigarette smoke scented parents of a kid that came into the hospital in respiratory distress. I learned from that to never mention the literature, just sneak it in with other handouts and pray they can read. (Because while JC or Magnet or someone says I have to assess the family learning difficulties, including illiteracy, customer service says that I'd better not offend them by asking if they can read.)
Specializes in Peds/outpatient FP,derm,allergy/private duty.
All of this quite frankly makes me glad I'm closer to riding off into the sunset of nursing than just starting out. There's a certain level of disrespect I can't bring myself to tolerate, and now, thank God my kids are grown and won't go hungry if I lose my job because I refused to wash the crotch of someone who could do it herself, ditto for scratching under her skin folds. But at least with that the possibility of excoriating her skin would be a further reason not to do it.
Working in home health I run across this all the time where patients on medicaid think the nurse is there as a domestic for the whole family and agencies cater to that crap. I just got yelled at about that a few weeks ago. Yes I stood my ground and yeah I had to gulp for a sec thinking - how will I pay the bills? Do I have to bend o---- for that or be on the street? Apparently the answer to that is yes, oh well. Somebody else mentioned this a while back and I agree 100%. All of the "promote professionalism" five point plans and talks and studies and etc etc have put us behind where we were 30years ago. It makes me sad and really really tired.
Wow, reading this post makes me kinda scared to move to the States...Where I work, we frequently have to remind patients that the 'H' in front of the building does NOT mean hotel...Ive also had the A&O patient in her 40s asking for bedpan when she was fully able to go to the bathroom. She threatened to wet the bed if we didnt give it to her, then got insulted when we suggested a diaper if she really 'couldnt hold it in', said she didnt belong in a LTC center yet so didnt need a diaper. Just blows my mind sometimes, and I dont even HAVE to cater to them! My job is to take care of their health and promote autonomy, not waitressing or scratching your back lol...
''I hate it when the younger pt population thinks that nurses are waitresses. I see this trend more and more often and it is concerning. When I come home and vent to my husband about it, he just tells me that since we are getting older, we notice the generation gap more easily and reminds me that OUR parents shook their heads and said, "Kids today...sheesh!"''
I just wanted to say that having worked mother-baby and med-surg(where most of the patients are elderly), most of the 'do everything for me' patients are older patients, not the younger ones. Most of the younger ones are embarassed and feel bad for bothering you, where older patients feel you owe it to them...just my two cents...
Specializes in Acute Care Cardiac, Education, Prof Practice.
I had a patient last week, young, chronic pain from Chron's. The patient had been raising all kinds of heck during the day over the Dr. not coming in, pain management, etc. When I got there, after hearing the terror tales from the offgoing nurse, who had cried most of the day, I straightened my collar, and walked in the room like I owned the place. I asked the patient compassionately and with honest intent how the pain was, was the PCA helping. I told the patient exactly what meds I had to hang, fluids etc, and talked to them about the GoLytely prep. Encouraged the patient to call for nausea medicine if needed. I then told them I had a fairly unstable patient to attend to if they didn't see me for awhile.
I never had a problem all night. I was prompt and courteous, but I never went out of my way.
Sounds like the next day was heck again, screaming and tantrums. Perhaps I got lucky? Perhaps I set the rules my way. I really won't ever know.
A lot of times I hate when other nurses pass along "this patient is a PITA" or "ugh this guy I tell ya" reports, but on one hand it sometimes gives you a heads up on how to approach them.
It is definitely all a learning curve, and some days it really isn't worth the battle.
pinksugar
243 Posts
Regarding the saline wash, I am going to assume that she needed a bath anyway. Those types of patients usually do. No harm no foul.
People that can do for themselves and choose not to are pathetic IMO, and usually get a swift response from me. Requests such as 'fluff my pillow', 'reposition me' (from a patient that will likely be discharge within an hour or so) or 'change my TV channel' are met with the response 'How do you complete these tasks for yourself at home?' When I had a completely ambulatory alert and oriented x3 patient that messed in her bed on purpose, I requested (and got) a psych consult for her. She was not happy when the psychiatrist arrived to evaluate her for defecating in her bed on purpose, but I made my point and she decided that she would walk to the bathroom after that. Do not give these types of patients an inch or they will walk over you. I will walk to the ends of the earth for a patient that has real needs, but not these types.