Published Apr 21, 2001
You are reading page 2 of "Send my girl down here now"...(Please.....)
I wish more people would handle situations like this. Perhaps if they would patients would get the idea that this type of behavior is inappropriate.
Last week I spent three days taking care of the most noncompliant, PIA patient I have ever had in 10 years of nursing. He is old ETOH abuse, as well as past herion addict. Paralyzed from the waist down with AKA on one side. He is with us to heal huge hole in his coccyx, this is his third flap on it. In my ten years I can count on one hand the amount of patients I have had that were actually drug seeking and he is one of them. He has demerel PRN, scheduled toradol, diludid PRN, ativan PRN, vicadin PRN and ambien PRN at night. He is well aware of everything he has, never has he displayed anything I could call pain symptoms. The last day I had him in my assignment all I could do was groan, he is incredibly rude and obnoxious. Anyway I gave the scheduled toradol, within 45 minutes he was also asking for demerol, vicadin and the ativan. I refused to give it all in that time span, I gave the demeral IVP as ordered, 15 minutes after the toradol, like the patient requested, but then would not give the ativan and the vicadin as he wanted. He had requested them together. He had just gotten the toradol IM, not giving it time to work effectively before asking for the demerol, now I know the toradol is not a narcotic, but he got 75 mg of demerol only 15 minutes later. When I refused to give the ativan(10 mg) and two vicadin half an hour after the demerol, I was called many things including a fucking ***** . At that point after having dealt with this for 3 days I refused to take care of the patient anymore. Told him I would not be back to the room, went to the charge nurse and told her what had happened that day, she was familiar with what this patient had been pulling, not only on me but the other nurses. She ended up taking care of him because not one other nurse would take care of him. The day before he had thrown his coffee cup at me because I took 20 minutes to get to his room after he had called for me. God forbid, I was doing a dressing change on someone else. I called his physician and let him know what was going on, that I would not be taking care of this patient anymore, and we were having difficulty with having anyone take care of him because of his behavior. The physician tells me that the patient has the same pattern wherever he goes, and that the reason he is in my hospital is because he was denied admission to the other area hospitals, and that the last group of physicians that took care of him had refused to do so again. The physician then told me he would be coming in shortly. When he got there he told the patient that if he continued to behave this way he would be discharged home and that would be that. That none of us had to put up with his abuse, and would not. I about fell over. This is not a physician that normally cares about the nurses in the least, I don't even particularly like him. However at least since then the patient has been decent to work with. Some of these people simply have to be told their behavior is inappropriate and will not be tolerated. So kudos to you Jason, I think that patients that behave like this should be told in no uncertain terms that it is not going to be tolerated.
GREAT JOB JASON.
I am all for not taking abuse from patients. It is not tolerated. I have had to go in afew times and tell patients point blank that their behavior wont be toerated. I too will usually use a very low voice when I tell them, just so I have their attention.
You remember the saying dont you:
"The truly sick, don't B***H!!
Originally posted by Joanm:I wonder where the public gets the idea that we are handmaidens. Did anyone see Jay Leno last night? One of his "jokes" was that he had seen on CNN that there was a nursing shortage. And we can't do without nurses, because without nurses there would be no more porn movies.
I wonder where the public gets the idea that we are handmaidens. Did anyone see Jay Leno last night? One of his "jokes" was that he had seen on CNN that there was a nursing shortage. And we can't do without nurses, because without nurses there would be no more porn movies.
This is so, so sad. I can't even respond other than just shutting my eyes and hanging my head in heartfelt disbelief and hurt.
Jason, I applaud the way you handled this patient. Regardless of what he was going through, whether it be fear,lonliness, whatever, is no excuse for degrading another human being, one, might I add, that is there to help this "gentlemen." His attitude towards nurses, and women is disrespectful and should not be tolerated under any circumstances. We cannot continue to allow behavior like this without consequences.
Good job. I wish I had you on my floor.
I practice family centered care in the NICU I work in, and I believe the family is a very important part of the team when you work with sick children. I believe that their concerns are valid. I believe that familes need to be listened to, and be involved in the decision making regarding their babies' care. They need to have truly informed consent about treatments. They have a right to know the qualifications of the staff that are involved in their babies' care. We have to work with families, as they are the ones that have to eventually take their baby home and deal with outcomes either good or bad. Does this mean we accept abuse? Absoulutley not!!I have been sworn at and threatened by patients. I had one Mom tell me that essentially it was "my job" to take her abuse., this coming from a supposedly well educated individual. It is not our job to take abuse. Yes we need to have empathy and compassion, and to realize that very often people's reactions are a result of the incredible strain they are under. We need to keep communication lines open and to treat indivduals with dignity and respect. However, we are not door mats. People need to know this, and we should call them on their behaviour if we feel we are being abused or treated in a disrespectful manner. Respect is a two way street. I have often found that if I am open with a family about their behaviour that we can then work through the issue. As a profession we also need to support and respect one another. I agree that often we are portrayed very negatively by Hollywood. We are also often not given a lot of respect by administration and the physicians we work with. We need to educate people about what we actually do. This seems like a huge task to undertake, but I think we should start by treating each other well, and talking to people , schools etc about we do. Let's all email Jay Leno. And just for the record, when David Letterman had his bypass surgery, he had nothing but good things to say about nursing and had a good sense of what we actually do. Let's continue this vein and share ideas about what we need to do. Thanks, Jan
I agree with everything you have said. I think that part of the problem is that at times it may be difficult to differentiate disprectful behavior that stems from fear/apprehension vs. manipulative, condescending behavior. It is also very difficult for some nurses to confront this behavior, and thus many times it is easier to dismiss the behavior as fear, or just ignore it completely. Whether it is fear or just manipulative, disrespectful behavior, it should be addressed. The patient may need help in working through the fear, and it will allow seasoned nurses to assess whether the pt. is acutally apprehensive, or just manipulative.
Also, as you pointed out, education is a key point in addressing the gross misperceptions of the "general public". People outside of nursing/medicine can not begin to phathom the roles we embrace. Education by nurses is key. As one person pointed out, we have to do this on our own. We have to fight our own battles and clean up the tarnished perception of nursing. To begin, we do need to treat each other better. I know of no other discipline that belittles one another such as nurses. That's part of the reason I left the mainstream. It seems to be a vicious cycle. Open communication is the key. Open commmunication with each other, with patients, with physicians, and with the general public. (By the way, as you know, condescending physicians are inexcusable and should not be tolerated. If open communication does not work with them, then make a firm stand. Don't be afraid. What can they do? Fire you? Please... You may find that they begin to view you in a differnt light).
The nursing shortage is not going to get any better. Thus, nurses need to band together. As the nursing shortage continues to grow, the news media will pay more and more attention. I imagine that local news casts and newspapers will eventually give a great deal of time (and print) to this issue (such as a lengthy segment, which would give nurses the opportunity to paint an accurate picture of nursing. I woujld like to see Wildtime sit down with Ed Bradley from 60 Minutes or Ted Kopel from Nightline, or the host of Talk Back Live with CNN, etc. Personally, I would jump at the chance. I would love to introduce America to the critical thinking skills and talents that nurses illustrate everday. "This is not General Hospital". However, make no mistake. I am a very strong proponent of the 3 day (or more) walkout that has been proposed. I am going to discuss it locally with my colleagues.
Finally, I do remember Dave Letterman addressing the nurses who provided his perioperative care. Good for him. It's a damn shame that comments like Leno's probally leave a lasting effect (even if it is subconcious). I think that what he said (along with an email address or a mailing address) should be distributed on a flyer to each floor/unit within your hospital to encourage your colleagues to respond. Why not? It takes only a couple of minutes.
I wished you worked with me. Thank you for standing up to the double standard.
Like an obidient dog, nurses have been trained to allow the abuse. "I be nurse, kick me, I not bite back." I am sure we could find justicfication for this person's rudeness, that is because nursing remains in the dark-ages when it comes to conduct, and we can rationalize any problem away. I am sure you will hear about this although.
Damn.. that is unbelieveable. (Well, I believe it, but it is truly sad.) That is a perfect example of what I am talking about. How many millions of viewers saw that monologue? I feel that a comment such as that that which reaches millions of people diminshes does a significant amount of damage. Unfortunately, as the nursing shortage continues to expand, you will see more and more negative publicity such as that. Speaking of porn, a physician made the following comment a few weeks ago. "Whores receive more respect than most nurses, and until nursing makes a stand, maybe they should". I quickly reminded him that nursing is the backbone of this hospital, etc, etc,. His reply is "Of course you are right! Nurses have more power than they could ever imagine! They may be the backbone of this hospital, but they are lacking a backbone, which is why nursing is in the shape it is in". Case in point. I went to see Jay Leno (the Tonight Show) this past August. While my girlfriend and I were touring Beverly Hills, I was listening to Danny Bonaduce (?), the former television personality who is now a radio personality. He was discussing the nursing shortage in CA, and stated, "Nurses are being offered $5,000 SIGN ON BONUSES!!!! HELL, FOR THAT KIND OF MONEY, I COULD PUT ON ONE OF THOSE NURSING CAPS AND PASS OUT BED PANS!!!"
I agree with the person who suggested a 3 day walk-out nationwide. As callous as it sounds, I wish it could be done. Acutually, a seven day walk-out would be better. Especially during a time that Jay Leno needed open-heart surgery.
You have a valid point. I've seen many patients who have not handled the thought of having a cardiac cath (or other procedures) very well. I can certainly understand that. However, this was not the case in this particular situation. This patient is a frequent flyer (with a history of numerous admissions for unstable angina, acute exacerbations of COPD, and other problems from a lack of compliance). He has been deemed a "cantakerous old fart" by his cardiologist. He truly is a red-neck Neanderthal who has little regard for nurses, and he enjoys the attention he receives from them.(And he has been cathed before). But again, your point is well taken. However, I do feel that this type of patient (and their family) is a growing problem that stems from a lack of respect for nurses (vs. fear or anxiety from a procedure,etc.) In most cases, I would address the patient's fears, while making it clear that the patient should think long and hard before he or she starts to spew condescending rhetoric and/or demanding orders to their nurses. Thanks for your reply.
QUOTE]Originally posted by lkushen:
OK, I fully agree with the emotions and anger you experienced. However, the question that comes to mind is this: Is this man always like this or just today, maybe there was an ulterior motive to getting the nurse to the bedside before you rightfully let him have it. Maybe this patient was not coping well with the thought of undergoing a cardiac catherization. Just a thought. I will admit though that I have been in similar situations by abusive and demanding patients before and it just makes you want to SCREAM!!!
Thanks for the info. Although I enjoy watching Jay on occassion, I'm going to let NBC know that his remark was "over the top".
Originally posted by Robin61970:I did a search on Jay leno and found the website to NBC....It's easy to find...anyway I wrote a letter to Jayo leno about his joke.....you should all do the same...stand up and be heard....not that he will pay a whole lot of attention, but It made me feel better! And I have to say Kudos to Jason...I might have handled it a bit differently, but to the same end effect...as for the dog? Oh NO! I would have had to say something pissy about that one....
I did a search on Jay leno and found the website to NBC....It's easy to find...anyway I wrote a letter to Jayo leno about his joke.....you should all do the same...stand up and be heard....not that he will pay a whole lot of attention, but It made me feel better! And I have to say Kudos to Jason...I might have handled it a bit differently, but to the same end effect...as for the dog? Oh NO! I would have had to say something pissy about that one....
What?????????? Now I've have heard it all. That is truly amazing. Tell her that on behalf of nurses everywhere, I say
Originally posted by nanablue2:Jason, I wish you had been on our unit tonight to respond to the most outrageous request I've ever heard by a patient and their family. The nurse was called to the room to clean up the dump left on the floor by the patients' visiting pooch. The nurse refused of course, but can you beleive it? Of all the nerve...and I thought we'd seen it all.
Jason, I wish you had been on our unit tonight to respond to the most outrageous request I've ever heard by a patient and their family. The nurse was called to the room to clean up the dump left on the floor by the patients' visiting pooch. The nurse refused of course, but can you beleive it? Of all the nerve...and I thought we'd seen it all.
I agree that we need to unify as a profession to fight our battles. However, I disagree that we should not get the government involved. Legislators are there (in theory) to serve the the public (including nurses). Legislators aren't going to support us based on how well we fight our own battles. They do however look at two things. A.) How much PAC money your organization can offer, and B.) How many people are within your organization (votes) Case in point. While there are much fewer MDs than nurses in this country, the AMA is the nation's most powerful political organization (bigger than the NRA). That's because most physicians do belong to the AMA (at a cost of $5,000 to $10,000 per year depending on their specialty) so that they can have their interests protected. A huge chunk of those dues goes to build up PAC money. The POTENTIAL advantage in nursing is that there is approx. 2.4 to 2.5 million nurses in this country. If we could band together and come up with common goals, then we could make significant changes at both the state and national level. In the end, if you can generate enough support within one group of people, then you will see favorable legislation. Politicians seem to have a strong affinity for the power they wield, and thus will go where the votes are. If it wasn't for our state nursing organization being politically active, then APNs in our state would not have prescriptive authority. I know that there is a big debate of whether the ANA is effective or not, but I won't get into that. Just remember, there is power in numbers, and legislators clearly know this. For instance, is mandatory overtime against the law in your state? It isn't (or wasn't) in all states. Kind of scary. Thatis an issue that you (if needed) could address to your legislator. If 20,000 of the 28,000 RNs and APNs in my state emailed their legislator, then mandatory overtime would not be a problem. They would tell hospital administrators, "Hire travelers at whatever the cost, because we aren't having mandatory overtime..I like my job too much to be voted out".
Originally posted by wildtime88:I get to see this type of behavior all the time in the ER. Yes, there are some people who react this way because of their disease process, but there are many people who are just plain rude. Patients and their families who come in with a stubbed toe or the flu who demand immediate service because they have somewhere important to be. The ones who are brutally honest and say they do not want to wait. I think the best ones are the V.I.P.s either by position in the community, their relative, or someone they know who expect to go straight back and get right out. I also concur with the physician said about nursing and a lack of back bone as well. If we will not face the people who we have a problem with directly without getting everyone else to fight our battles for us then we get what we deserve. We are being told that we have to get the public and the government on our side to fight our battle for us. That they will change things for us. Maybe we should fight out own battle and earn the respect of the public and the government first. Then we could use that new found respect to advance nursing forward.
I get to see this type of behavior all the time in the ER. Yes, there are some people who react this way because of their disease process, but there are many people who are just plain rude. Patients and their families who come in with a stubbed toe or the flu who demand immediate service because they have somewhere important to be. The ones who are brutally honest and say they do not want to wait. I think the best ones are the V.I.P.s either by position in the community, their relative, or someone they know who expect to go straight back and get right out.
I also concur with the physician said about nursing and a lack of back bone as well. If we will not face the people who we have a problem with directly without getting everyone else to fight our battles for us then we get what we deserve. We are being told that we have to get the public and the government on our side to fight our battle for us. That they will change things for us. Maybe we should fight out own battle and earn the respect of the public and the government first. Then we could use that new found respect to advance nursing forward.
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