I know I've had pt's I couldn't wait to get rid of. Some are just plain boors. This is the thread to share your stories about THOSE pt's.
Wish I could find a magic book that tells me what makes an able-bodied pt suddenly incapable of basic self-care once they enter the hospital.
Recently I had a pt who could feed himself, brush his teeth, wipe his ass, etc(this was an older male who just had his toes reattached after cutting them off while edging his lawn barefoot) suddenly lay on his call bell every ten minutes wanting me to fix his hair, feed him jello or give him a drink of water. These were all things he could do just fine by himself. He was also really nasty to me if I didn't come the second he rang his bell. Sorry pal, I had a critically ill patient next door and getting her on the bedpan before she soiled her bed is more important than combing your hair. Anyway, he'd complain about the food, whine that he was cold(and then complain he was hot when I gave him a blanket), whine that nothing good was ever on TV and then he'd yank his hands away when I checked his vitals.
This man was NOT suffering any dementia btw, he was perfectly a/o the whole time.
But wait! It gets better! If his family was around, he'd be all sweet and polite to me only to turn right back into Captain Jerkwad the second they left. I've never been so glad to discharge somebody. From what I've heard....he isn't taking the antibiotics we sent home with him. He'll probably be back in the ER with a raging infection pretty soon. :hdvwl:
So, how about the rest of you? Ever have a pt who made you practically tear your hair out?
Specializes in Management, Emergency, Psych, Med Surg.
We have a lady on our floor right now that we are trying to discharge. She has some dementia and she is OK as long as her husband is not there. But when her husband is there, who also has dementia, they just get each other going. But he really worries about her and he just tries to to everything for her. So the other night after he went home he called back up to the unit to talk to her but he was asleep. So he starts telling me that he is trying to do the laundry but he can't figure out how to use the washing machine. So I sit there on the phone with him for about 15 minutes talking him through how to do the laundry, how to do the settings on the machine, how much soap to use etc. And I would bet that he screwed it up, even though I was talking him through it. This of course is part of the customer service that we now offer.
Had a LOL come in today claiming pain. The pain is related to a bowel impaction. She's impacted because she's having an affair with Vicodin. The Vicodin is constipating her. She swears the Vicodin helps her pain.
Trying to wean her, but every hour she's on her call bell crying for drugs. All orders point to NO VICODIN. We're putting an enema in her tonight because laxatives haven't worked.
Ugh. I'd like to smack her doctors!
Ah yes, the med-seeking patients hold a special place for me. I think it's because I feel so used and my intelligence gets insulted, but I am often forced to go along with helping them feed their addiction. I have no problem treating addiction, withdrawal from any variety of substances... at least I'm treating the patient's condition. But when I'm being used as an instrument to feed a patient's addiction and being manipulated and lied to just to feed said addiction, it really burns me. It becomes even more frustrating when you believe that the patient probably does have pain of some kind and you do wish to compassionately treat that pain. I have one patient now, a F in her 50s with Crohn's and general FTT. When I gave her the minimum dose of her oxycodone PRN, she was so completely stoned that her head kept falling forward to her knees while sitting on her bed. Given that she weighs about 80 lbs, I requested that the minimum dose be adjusted downward and began giving her that instead. She was livid at first, but I had the MD explain her pain regimen to her and the rationale for the dosage, and hadn't had a problem with her until another RN who was new to the pt had given her more (higher in the range). When I resumed my earlier dose, the battle restarted, complete with slow, slurred speech... in between moments of her falling asleep, askew on her bed. Fortunately, I will have a few days off as I have reached my limit with this pt after about six shifts in a row with her.
ok, we had a 65 year old alcoholic come in. first night, he was as lucid as could be. knew where he was, why he was there, his history as an airline pilot. etc. This would be the last night for the next 2 weeks. Every night he would get up about the same time, stumble into the day room (and he had NO business to walk-he was as stable as a warm jello mold) and demand why the hell we were in his house and where his dogs were and why he would be in such a place.
two weeks.
the only amusing part was in the beginning we were taking care of the poor guy and to encourage him to NOT get out of bed we gave him a urinal. The poor man also informed us how thirsty he was, so i gave him a cup of orange juice and a coffee lid over it (again, really shaky). So we went back in to check on him later on that night. Well, he was still really thirsty so i handed him his cup reminding him of his oj.
"This doesnt taste like juice.... this tastes like salt water..."
I looked at the other tech ... O_O and just calmly excused myself. I managed to make it to the bathroom before i fell on the floor laughing. the man had taken the coffee lid off the cup, peed in it, and replaced the lid. totally ignoring his urinal. and yeah. i just died right there. Thankfully I had a few days off before i had to see that man again.
my "favorite" patient was back when I was an aide on a med surg floor. She was a 20 something beauty pagent contestant. She bullied her dermatologist into admitting her for a medium sized zit on her cheet b/c it was MRSA+. According to his NP it could have been treated at home with abx but she wanted some time in the hospital to be "pampered."
Miss America brought her own pink sheets for us to put on the bed for her. She made sure her laptop was playing movies of her pagents each time we went into the room (as if i was going to be impressed?) About 10 minutes after her mommy left for the night her IV was found to be infiltrated and the RN told her they would have to start a new one. Well, mommy called back screaming about how we just wanted to hurt her baby unnecessarily. (remember, she could have been treated at home with ORAL abx). Mommy also somehow called the NP at home to complain about our treatment. (NP called the floor and told us to "stick the little b***h as many times as possible,and make it hurt.")
The patient was 100% independant and amublatory, just needed help to the bathroom with her IV pole. Another aide took her to the bathroom, told her to push the button when she was done so we could assist her back to bed. A few minutes later the call light goes off (different from the button in the bathroom) and when we answered it she was screaming "help me!" We go tearing in there to find her on the toilet sobbing about being left all alone. Um...to push the call light she had to go back to her bed and push the button...then go back to the bathroom where we found her.
I kind of hope that zit exploded and scarred her permanently....
I used to work in LTC subaccute units as an aide. One of my fav patients was a LOL about 80 y/o who for the most part was confused. She was in the rehab wing after a fall in her bathroom, and had the reputation from LTC as being demanding,rude,and downright annoying. I was blessed with being her aide. Our first night together, she constantly would be on the call light, and if I didn't get into her room soon enough, she'd yell my name down the hall, until I came to see what was wrong. It was usually minor things, adjust my pillow, turn the tv off, etc... By the time the shift was over, I had been in there for everything under the sun. Before beginning my next shift with her, I was getting report from her am cna, and was told that she had started yelling obscenities when people would pass her room. I laughed. That evenin, we always knew if anyone was by her room because you would hear her yelling. The staff just figured it was part of her delightful confusion. She stayed on our wing for a while, and I learned that she knew what she was doing by yelling swear words out. I'd be in the room with her, talking, and someone would walk by, and she'd shush me point to the hallway and start yelling cuss words. I asked why she did it, and she said "This place needs to be kept on it's toes every now and then, and whats funnier than hearing a little old lady swear?" I'd think that maybe she wasn't as confused as we thought, but one night she confided in me that someone had taken all her clothes, put them in boxes, and told her they were throwing them out because the beer she gave them was moldy. I tried reassuring her that none of that had happened, but it was a battle lost, so I just started going along with her tales, no matter how obivously false they were. She kept my mood light when I had to take care of her.
I had only had exp with subaccute patients, and one day was called to the LTC side of my building to cover a shift for a cna no show. Quite a different world over there. Besides being late with my vitals and getting my people up and ready for dinner, I also had to put up with the residents who werent familiar with me, and knew I wasn't used to their routines. One man, who's name slips my mind, was the biggest pain. Weight sized and attitude wise, he was an ogre. He was a 2 assist, so anytime he had to be moved or changed, id have to hunt down another cna or nurse. I was getting him cleaned up for bed and had given him a warm rag to wipe his face with. he took it, started wiping his face and then muttered, in German, "what would you do if I threw this rag at you?". Mr. Ogre didn't know I spoke German, so when I answered him in German,saying that I would throw it back at you, his whole demeanor changed. I had no problems with him for the rest of the shift, and later on, when I seen him in the hallways, we'd always taKE a few mins and talk to each other in German.
Had an IVDA my last shift in for cellulitis of the leg and on isolation for MRSA. The MD wrote orders to wean her off the Dilaudid but it just wasnt happening. She was on the call light constantly, asking for pain meds, blankets, adjustments, food (per the report I got she had poor PO intake- HA!)- anything and everything she could think of. Alot of the time she would use the call light but if she heard anyone in the hallway she would be yelling out for them. I would give her the Dilaudid & then she would be zonked for about 30min, wake up & call for more pain meds. Then she wanted a sleep med. I gave her the dilaudid & ambien, 30 min later she wanted something else for pain. I told her that I had just given her the dilaudid and it wasnt due for another hour & a half. But she insisted that she was still in so much pain. I then gave her percocet & ativan thinking that she would hopefully go to sleep for the night... NO SUCH LUCK. She was on the call light an hour and a half later asking for the dilaudid. I consulted with my charge who told me to explain to her that if her respirations dropped below 12 that we would have to Narcan her & she wouldnt have ANY pain meds for a few hours. She didnt care, she said "I can breathe!". So I had to go ahead and give it to her. We didnt have to narcan her fortunately. She could barely keep her eyes open and she was talking all kinds of nonsense... but she still managed to call throughout the night every 30 min to an hour for pain meds. Gotta love those pain med seekers! I was so HAPPY when my shift ended. :)
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
two patients in the icu, waiting for beds on the floor. one of them is from europe and speaks several languages. he's chattering away in french and the other guy keeps yelling at him "i can't understand you!" eurodude kept switching languages, and the other guy kept shouting -- in english -- "i don't understand you." finally, i said "you can't understand him because he isn't speaking english. he's speaking spanish right now."
"holy $hit! we're in mexico! i gotta get outta here!"
one guy shouting "ma-ma! ma-ma!" and tapping his sat probe on the bed rails. i asked him what he wanted and he said "i'm just making noise." when asked why he was just making noise, he said he couldn't sleep because the other guy wouldn't shut up. (actually neither of them shut up all night.) other guy yells at him to "shut the **** up!"
"no, you shut up."
"you shut up!"
"i can talk if i want to. you shut up."
that went on until a couple of hours later when one of them pulled out his art line. as i'm holding pressure on his radial artery, he's yelling "it hurts, it hurts. my arm hurts. you're hurting me," meanwhile trying to yank his arm away while i'm trying to keep pressure on the spot where the blood has been spurting out. the other patient starts screaming. from the other side of the curtain, i hear footsteps come running into the room, and another nurse asking "what's wrong."
"he's got my dick and he's pulling on it!"
"that's your foley, sir. leave it alone."
"i'm not touching it. it's that other guy."
"whose hand is it with the catheter wrapped around it?"
"oooooh! that is mine."
i was never so happy to see 7 o'clock roll around!
I was always a happy go lucky young CNA. I loved what I did, loved helping people. We got this one guy, A very large man, but also very capable, just very lazy. Slept all day, would ring to say he was soiled, got up and urinated on the floor because he did not feel like reaching over the counter for the bottle (his words not mine) One evening he had decided he would not even attempt to call us to take him to the bathroom he would jsut go in bed., my co worker and I were getting him cleaned up, finally after begging him to roll he did, cleaned him up and he farted in her face and laughed at her. She left because she was going to snap. I finished cleaning him off and asked if he needed to go now, and if he would please ring the bell when he did have to go. Well he rang, but because he needed to be cleaned up, at this point we gave him a bed bath, during which time i had to endure him essentially saying I probably sleep with the whole town and by my race hes shocked I dont have six kids by now. Then him asking me for oral sex, and other gross requests, I just ignored him and did his bed bath, reminded him to ring and left. Not 10 minutes later he is screaming in his room, I flick the lights on and ask whats wrong, and he says, I crapped myself, and I was like why didn't you ask I was just here I could have taken you to the bathroom, and he laughs and goes concider it a gift just for you. And I said excuse me? and he says, Listen I know what your job is no matter how many times i poop myself, you are going to have to clean it up, that is all your job is. I left, and refused to go back into that room again. When he left after 2 long months, i felt like organizing a parade to see him out.
my "favorite" patient was back when I was an aide on a med surg floor. She was a 20 something beauty pagent contestant. She bullied her dermatologist into admitting her for a medium sized zit on her cheet b/c it was MRSA+. According to his NP it could have been treated at home with abx but she wanted some time in the hospital to be "pampered."
Miss America brought her own pink sheets for us to put on the bed for her. She made sure her laptop was playing movies of her pagents each time we went into the room (as if i was going to be impressed?) About 10 minutes after her mommy left for the night her IV was found to be infiltrated and the RN told her they would have to start a new one. Well, mommy called back screaming about how we just wanted to hurt her baby unnecessarily. (remember, she could have been treated at home with ORAL abx). Mommy also somehow called the NP at home to complain about our treatment. (NP called the floor and told us to "stick the little b***h as many times as possible,and make it hurt.")
The patient was 100% independant and amublatory, just needed help to the bathroom with her IV pole. Another aide took her to the bathroom, told her to push the button when she was done so we could assist her back to bed. A few minutes later the call light goes off (different from the button in the bathroom) and when we answered it she was screaming "help me!" We go tearing in there to find her on the toilet sobbing about being left all alone. Um...to push the call light she had to go back to her bed and push the button...then go back to the bathroom where we found her.
I kind of hope that zit exploded and scarred her permanently....
I would not have been able to maintain my professionalism. Even a tiny bit. Holy cow.
I had a male post-op patient that had his foley removed. He had apparently learned that if he did not pee in 8 hours he got catheterized again. Over the next week, I had to catheterize him repeatedly, because he would hold his pee. I knew he was doing it on purpose. He enjoyed being catheterized way too much.
I was always a happy go lucky young CNA. I loved what I did, loved helping people. We got this one guy, A very large man, but also very capable, just very lazy. Slept all day, would ring to say he was soiled, got up and urinated on the floor because he did not feel like reaching over the counter for the bottle (his words not mine) One evening he had decided he would not even attempt to call us to take him to the bathroom he would jsut go in bed., my co worker and I were getting him cleaned up, finally after begging him to roll he did, cleaned him up and he farted in her face and laughed at her. She left because she was going to snap. I finished cleaning him off and asked if he needed to go now, and if he would please ring the bell when he did have to go. Well he rang, but because he needed to be cleaned up, at this point we gave him a bed bath, during which time i had to endure him essentially saying I probably sleep with the whole town and by my race hes shocked I dont have six kids by now. Then him asking me for oral sex, and other gross requests, I just ignored him and did his bed bath, reminded him to ring and left. Not 10 minutes later he is screaming in his room, I flick the lights on and ask whats wrong, and he says, I crapped myself, and I was like why didn't you ask I was just here I could have taken you to the bathroom, and he laughs and goes concider it a gift just for you. And I said excuse me? and he says, Listen I know what your job is no matter how many times i poop myself, you are going to have to clean it up, that is all your job is. I left, and refused to go back into that room again. When he left after 2 long months, i felt like organizing a parade to see him out. 
diane227, LPN, RN
1,941 Posts
We have a lady on our floor right now that we are trying to discharge. She has some dementia and she is OK as long as her husband is not there. But when her husband is there, who also has dementia, they just get each other going. But he really worries about her and he just tries to to everything for her. So the other night after he went home he called back up to the unit to talk to her but he was asleep. So he starts telling me that he is trying to do the laundry but he can't figure out how to use the washing machine. So I sit there on the phone with him for about 15 minutes talking him through how to do the laundry, how to do the settings on the machine, how much soap to use etc. And I would bet that he screwed it up, even though I was talking him through it. This of course is part of the customer service that we now offer.