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
The worst part of all of this is that management is so worried about patient satisfaction that they never, ever stand up for the nurse to a patient, no matter how egregious the behavior is. It is very, very discouraging.
Specializes in Med/surg, ER/ED,rehab ,nursing home.
Sounds like a major need for mental health intervention. When I have had demanding patients, it has worked pretty well for me to tell them I WILL stop by in an hour or other set time. I usually have to do this only hourly a couple of times before the patient calms down and trusts that I WILL BE THERE AS PROMISED. With pain control issues, I will stop what I am doing and give it ON TIME. With other issues, I may have to ignore the petty stuff. Go in with a professional attitude. Teach WHY the bathroom is for patients only. Such as infection passing on to your visitor. As for placing a dressing, this can be taught,too. I am surprised some one that is so obese was able to conceive and carry a pregnacy. I do feel concern for her child.
And I'm really NOT loving all of you who say how "great" you are at setting limits, how NO one gets away w/ any crap with you, etc, etc -- many of you may not have worked at these types of facilities ... Press Ganey and all that ...where I work we are HAMSTRUNG by customer service mentality ...no matter what these little demons do, they get away w/ it and we have to cater to them ... it's all about competition in the field now -- patients are not patients ...they are "clients," or "customers." One wrong move and you ARE written up and counseled.
Trust me when I say that my facility is in it for the money. We use Press-Ganey in addition to two other customer service evaluations. In addition to that we personally call every patient that leaves our unit. I am still not going to let myself get dragged through the mud by these people - it doesn't do them any favors in the long run.
This is the way it is at the hospital I work at as well. We are expected to fullfill their every need/desire no matter how absurd they are. As far as bunching everything up into one or two visits, we have to make "purposefull hourly roundings" EVERY hour so you're constantly in their rooms. We've all had those patients that could have qualified as a one on one nurse to patient ratio patient!
Sorry about your experience. I can relate, I'm currently in the Accounting field trying to get into Nursingand I have to deal with a "pmsing" 46 yr old male co-worker on a daily basis. My boss constantly conveniently "forgets" his previous instructions to change data so it's always my mistake.
It's everywhere, not to make light of your situation but at least you are dealing with genuinely sick people instead of overpaid old babies.
My hospital is all about customer service. And screw how many patients we have, dressing changes, meds & what education we have to do. It's all about customer service. My patients constantly call out for water, ice, coffee, they dropped the remote control, & the pillow needs to be fluffed & buffed. We do alot of education & dressing changes on our floor, its hard to do that when I keep gettin calls from the front desk that my patient is calling & I go runninng in & they want the head of the bed up.
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.
I would have become very "concerned" and told her I will have to contact Social Services regarding he inability to care for herself let alone a baby, and perhaps they could both be placed, her in a nursng home and the baby in foster care. She would have shut up immedialtely because my experience is the baby will be her lifelong excuse for sympathy help and financial aid.
Specializes in Plastics. General Surgery. ITU. Oncology.
I am appalled by reading these tales. The NHS does not pander to over-demanding patients. Certainly a patient can complain but a senior nurse (Sister or Matron) will look at complaints and will 99% of the time defend the nurses.
Patients are not "customers" healthcare isn't McDonalds. Patients need to actively engage in the process of care and comply with the requirements in so far as they are able.
For example we recently had a known alcoholic patient on my ward. He was appallingly rude to the nurses up to and including using the most offensive racist language imaginable to some of my colleagues who were African or Asian.
Matron was having none of that. She gave him a strongly-worded warning. Whereupon he ripped out his IV (spilling toxic chemotherapy all over the floor) and stormed off the ward. Only to return drunk at 4AM demanding treatment.
In the morning his consultant refused further treatment and referred him to another oncology unit. End of.
I agree with you about being appalled reading many posts in this thread. I would be terrified to work in the US - I have to take my hat off to all of you for keeping your sanity working in these hospitals that pander to customer service like a hotel - no matter what.
I trained in the UK and from the outset learned that it was the culture to set limits for patients like these and as long as you are not rude and maintain professionalism, management would always support you. We are there to provide medical care, not pander to whims, unreasonable demands and arrogance.
I now work in Australia in a private hospital where the management are fairly suppotive of staff but it is becoming increasingly focused on customer service, feedback questionnaires, patients are encouraged to name staff they really liked and didn't etc. Now we have to start doing these hourly ''roundings'', to see if they need anything, more pain medication perhaps, a drink, another pillow for comfort? It's like your entire working day is controlled before you start. I can manage my time and patient acuity thank you very much - I've managed for 23 years without a problem.
Now, I work on a psychiatric ward - how the hell are hourly roundings supposed to work there? For goodness sake these people are mostly young and physically fit and are not in bed. Do I have to leave a distressed person or a new admit, someone feeling suicidal or someone hypomanic and being intrusive around the ward unless they are skillfully distracted (we are a voluntary unit - not locked)? We have a lot of patients with borderline personality disorder - oh are they going to love the idea of hourly 'roundings' not to mention the oxycontin addicts!!!!!!
Not only do we have to do the hourly rounding, it all has to be documented every time too!! I believe that these rounding ideas were developed for med/surg wards which are incredibly busy and the workloads the nurses have astound me - I would never cope, I don't know how they do it now, never mind with this new hourly thing. Our management seems to think one size fits all and that this system will be just perfect for every speciality so that we can evidence more accountability and patient contact.
I work with some great nurses but the increasing culture of having to watch your back causes tension on the unit. It's not the type of culture I want to work in and if I can find something else, I'm off!!
Specializes in Critical Care, Forensics, Management.
I know what your feeling. Patients are behaving like children who don't get their way. I wish a hospital would put up a big billboard saying" I f you want to get well come to our hospital, if you want a 5 star hotal go across town".
The government is making impossible to practice medicine in a hospital, everything relies on how happy you make people not how well they get. Your reinbursement depends on getting high satisfaction scores, not getting your patients well. We live in an intitlement country, with people holding their hands out asking for everything for nothing. They will do everything possible to get more, no matter how it hurts others.
The price of health care will continue to go up, reinbusements will go down, nurses will leave, doctors will refuse to acept medicare, medicade and charity care. The bottom line hospitals will close and people will die.
I don't know how much longer I can be a part of it. I'm tired of living in fear for myself and my family because a gang member didn't like how he was treated and theatened to take care of it.
We need to get this information out, and try to save our fellow human beings from the "give me's "
Last week we had a nightmare of a patient on my Med/Surg unit. Male, 40's, and a former prisoner. Tested my patience level to the max. He would demand milk, juice, water....we'd fetch it for him and then he'd nag and complain. He accused me of trying to sexually assault him because "I smiled at him". He would leave his room and go into other patients' rooms and barricade himself in there. Then he got combative and hurled the milk carton and the juice boxes at us in the nursing station. He would scream every curse word and called every female the "C" word.
The team leader on duty that night is a great guy (he know's his stuff) but he is known for being VERY soft, weak, timid, and passive. He tried to please the demon with a private room and all the frills. It just made the situation worse.
Finally, collectively as a team of nurses working - we had enough. We called security and they came up and handled the demon.
Our security guys are ex cops....you don't want to mess with them cause they carry tasers, billyclubs, and pepper spray.
The demon made some dumb choices and attacked the security gaurds. The demon got a nice dose of reality. It got a little out of hand but like the saying goes "What Goes Around Come Around".
tipsplease
19 Posts
The worst part of all of this is that management is so worried about patient satisfaction that they never, ever stand up for the nurse to a patient, no matter how egregious the behavior is. It is very, very discouraging.