Things you'd LOVE to be able to tell patients, and get away with it.

[AngelfireRN]

Hi, my name is AngelfireRN, I'll be your nurse tonight.

I am not a waitress, nor am I your slave.

Yelling and hurling obscenities at me will not get you your pain meds any sooner than they are ordered. Nor will having your family member or entourage do the same.

Threatening lawsuits and having umpteen family members camp out in the halls or hold up the nurse's station will not get you preferential treatment.

Physically grabbing me as I go down the hall is NOT a good idea.

I do not give the orders, but I do have to follow/enforce them. This is something that you should take up with your doctor.

No, I will not call him again to ask him for more pain medicine. He has been called twice and has said no both times.

No, I will not give you his number so you can "straighten him out".

No, you are not my only patient, and I highly doubt that you are single-handedly paying my salary. On the off chance that you are, let's talk about a raise.

NO, NO, NO, I most empahatically will NOT come get you when it is time for your next pain shot while you are having a smoke break. I also will not bring it to you in the smoking room. (Have actually said that, I am allergic to cigarettes. I did it once, had an asthma attack, desatted to 83, and turned blue, according to the patient and my charge nurse, after the patient had to help me back to the floor).

No, I don't really care if your family has not eaten all day, they drove here by themselves, they are not sick, and no, I will not call for 6 guest trays. (This of course, is if the patient in question does not need all 6 family members present, and is not at death's door).

No, you may not have 3 six-packs of soda from the kitchen, there are other people that would like a snack, too.

No, they will not open up the kitchen up just for you, at 1 in the morning, because you don't like the snacks we have on the floor.

I could think of hundreds, but those will do for a start. I know it sounds mean, but this is why I got out of bedside nursing. When a hospital becomes the Hilton, I'm gone!

Have fun!

[SoundofMusic]

To Ms. so-called "chronic pain" patient who demands her dilaudid right on time and undiluted, along with her methadone, her lyrica, her vicodin and her daily percosets for her 400 lb 5' 1" body -- YOU are a disgrace. You are NOT sick -- you are obese and a heroin addict and you refuse to take care of yourself, bathe, or complete any of your tests the doctors has ordered. You are lying here in an expensive hospital bed, of course with no job and no insurance in you are in your mid 50's, (not your 90's) and DEMANDING care and treating all your nurses and doctors like crap, whining and crying and dramatizing -- because you know damn well you can get away with it.

I'm sorry, but I don't believe your stories. I think you are faking it. If it were up to me, you'd be sent home to detox on your own -- If you die -- well, that's too bad. YOU are the one who decided to do heroin all your life instead of facing up to life's problems. Perhaps you should pay the price for this -- not me, not society, not the U.S. taxpaying, hardworking citizens. Perhaps if someone should hear of your plight, they would decide against doing heroin because perhaps they'd realize no one was going to bail them out of it.

It's people like you who will put me out of nursing. I can take the mean docs, the crappy co-workers, the hard work -- but I can't take you -- and I refuse to continue to be YOUR servant. If you were actually paying for your healthcare, it might be one thing -- but to lie there and demand that society does this for you because you have ****** up your life so badly, -- I can't even stand it.

If this is who Universal Health Care is going to take care of -- I'm leaving this country. Heck, it already IS UHC as we continue to take care of these losers, allowing them to work the system and suck it dry. It's not fair and we should be ashamed of ourselves and our government for allowing it.

Someone shoudl follow these people home and see to it that their stories are true or false, or whatever the case may be. Right now we have to take them for their word, and I have a feelilng their "word" is not worth much.

[AngelfireRN, MSN, RN, APRN]

SoundofMusic said:

To Ms. so-called "chronic pain" patient who demands her dilaudid right on time and undiluted, along with her methadone, her lyrica, her vicodin and her daily percosets for her 400 lb 5' 1" body -- YOU are a disgrace. You are NOT sick -- you are obese and a heroin addict and you refuse to take care of yourself, bathe, or complete any of your tests the doctors has ordered. You are lying here in an expensive hospital bed, of course with no job and no insurance in you are in your mid 50's, (not your 90's) and DEMANDING care and treating all your nurses and doctors like crap, whining and crying and dramatizing -- because you know damn well you can get away with it.

I'm sorry, but I don't believe your stories. I think you are faking it. If it were up to me, you'd be sent home to detox on your own -- If you die -- well, that's too bad. YOU are the one who decided to do heroin all your life instead of facing up to life's problems. Perhaps you should pay the price for this -- not me, not society, not the you.S. taxpaying, hardworking citizens. Perhaps if someone should hear of your plight, they would decide against doing heroin because perhaps they'd realize no one was going to bail them out of it.

It's people like you who will put me out of nursing. I can take the mean docs, the crappy co-workers, the hard work -- but I can't take you -- and I refuse to continue to be YOUR servant. If you were actually paying for your healthcare, it might be one thing -- but to lie there and demand that society does this for you because you have ***** up your life so badly, -- I can't even stand it.

If this is who Universal Health Care is going to take care of -- I'm leaving this country. Heck, it already IS UHC as we continue to take care of these losers, allowing them to work the system and suck it dry. It's not fair and we should be ashamed of ourselves and our government for allowing it.

Someone shoudl follow these people home and see to it that their stories are true or false, or whatever the case may be. Right now we have to take them for their word, and I have a feelilng their "word" is not worth much.

WOW!. We should meet. I think you and I would get along really well. We seem to be of a like mind. Those people drive me up a wall, too.

[leslie :-D]

SoundofMusic said:

To Ms. so-called "chronic pain" patient who demands her dilaudid right on time and undiluted, along with her methadone, her lyrica, her vicodin and her daily percosets for her 400 lb 5' 1" body -- YOU are a disgrace. You are NOT sick -- you are obese and a heroin addict and you refuse to take care of yourself, bathe, or complete any of your tests the doctors has ordered. You are lying here in an expensive hospital bed, of course with no job and no insurance in you are in your mid 50's, (not your 90's) and DEMANDING care and treating all your nurses and doctors like crap, whining and crying and dramatizing -- because you know damn well you can get away with it.

I'm sorry, but I don't believe your stories. I think you are faking it. If it were up to me, you'd be sent home to detox on your own -- If you die -- well, that's too bad. YOU are the one who decided to do heroin all your life instead of facing up to life's problems. Perhaps you should pay the price for this -- not me, not society, not the you.S. taxpaying, hardworking citizens. Perhaps if someone should hear of your plight, they would decide against doing heroin because perhaps they'd realize no one was going to bail them out of it.

It's people like you who will put me out of nursing. I can take the mean docs, the crappy co-workers, the hard work -- but I can't take you -- and I refuse to continue to be YOUR servant. If you were actually paying for your healthcare, it might be one thing -- but to lie there and demand that society does this for you because you have ***** up your life so badly, -- I can't even stand it.

If this is who Universal Health Care is going to take care of -- I'm leaving this country. Heck, it already IS UHC as we continue to take care of these losers, allowing them to work the system and suck it dry. It's not fair and we should be ashamed of ourselves and our government for allowing it.

Someone shoudl follow these people home and see to it that their stories are true or false, or whatever the case may be. Right now we have to take them for their word, and I have a feelilng their "word" is not worth much.

I understand this is a vent thread, so just let me say...

WOW!.

leslie

[AngelfireRN, MSN, RN, APRN]

Yep, Leslie, I think it safe to say someone had a REALLY bad day at work.

Seriously, though, I have really, truly wanted to say that so badly to a select few in my career that really steamed my clams. Especially when I knew that I'd run into them at Wally-World the next week, doing fine, cart full of junk food, walking upright, not grunting and moaning fit to make me hold my ears. It was truly a remarkable metamorphosis. I wish I could figure out how to bottle it. "The Wally-World Cure" I'd make a fortune. LOL

[SoundofMusic]

Let me clarify. And I did have a bad day with this woman. It was ridiculous -- and the worst was not being able to adequately take care of my other pts because this woman was so demanding every 5 minutes with her "pain relief." She'd turn on the tears at the flick of a switch. It was ridiculous.

If these folks were at least the slightest bit humble and GRATEFUL for their care, perhaps I could stand it. But here they are demanding, screaming, mad at you, the nurse, for every little last thing that goes wrong, for every 5minutes they have to WAIT for something so routine. They complain non-stop about everything -- I say let them go HOME.

I don't feel they should be allowed to demand their care. They are lucky to be receiving it -- lucky that anyone puts up with their nonsense, and pays for it to boot.

Is that tough to hear? Well, I'm sorry -- but it needs to be said. Our society just coddles these people, demands nothing from them. It's bringing us down as a nation and I think it needs to stop.

[leslie :-D]

trust me soundofmusic, i sooooo understand.

the only thing i was taken aback about was "if you die, oh well...or something to that effect.

and truthfully, my line of thinking was along the lines of angel...that you had an incredibly baaaaad day.

but yeah, i very much empathize w/you.

leslie:)

[shetazrn]

In so many ways I agree with soundofmusic. I cannot take care of patients that are in the ED with an MI or a GI bleed because I am taking care of "the squeaky wheel." It makes us cynical. We didn't get into nursing for the money, we would have gotten out by now. We wanted to care for patients. We try our best not to judge, but it surely is difficult when you pull a visit history and find out that the person in bed A that is screaming his/her head off has been here 50 times in the last 52 weeks for the same "pain" and the man/woman in bed B has a GI bleed and hasn't said a word for the 2 days that they have been here. UGGGGGGGHHHHHHHHHHH

[jessiern, BSN, RN]

How about this:

Suppose Patient X is in and out of facility often. Suppose this patient demands large doses of demerol. Don't order morphine, or dilaudid, nubain. Nope, demerol. 75mg every 2 hours for a 180 lb man. Who you have to wake up everytime you go in the room. Or, if they are awake is eating burgerking (dx: abd pain). Sometimes you can't find them...they are in the waiting room watching tv with friends.

Also, suppose patient X calls nurse's phone every 30-45 minutes to ask for pain meds. Dont' forget, nurse also has 5 other patients with REAL med needs.

Wouldn't it be nice to say "Patient X. DO NOT CALL MY PHONE AGAIN FOR PAIN MEDS. I have 5 other patients with needs, and I can't attend to those due to you pestering me. At 34 years old, you can look at the clock and see it is not time. When it is time, I will bring it. If I dont' come AT THAT MINUTE you can assume I am too busy at the moment, so dont' call me to remind me. Believe, you are not forgetable. You may call if you have any other needs. But DO NOT CALL ME FOR PAIN MEDS"

Oh yeah...I did tell that to Patient X

[BlueRidgeHomeRN]

angelfirern said:

especially when I knew that I'd run into them at wally-world the next week, doing fine, cart full of junk food, walking upright, not grunting and moaning fit to make me hold my ears. it was truly a remarkable metamorphosis. I wish I could figure out how to bottle it. "the wally-world cure" I'd make a fortune. LOL

LOL!

I've seen them look at me, blanche, and start in with a fake limp.

had a diabetic tell me the junk food in the basket was for her grandson, not her [sure, and I've got property in louisiana that's great at low tide!!] she came to me, btw...I don't even say hi to pts unless they speak first.

[imburnedout]

Not just patients, my own family members as well (in-laws), people never cease to amaze me:

1. Being a nurse does not qualify me to be the family doctor. If you are sick, call your doctor. I've just worked 12-16 hours on my feet, so no! I don't want to drive across town to look at your swollen ankles when I know dang well that you havent been compliant with your diet or diuretics because you wanted to go play bingo today and skipped your lasix.

2. Yes, I can understand why your joints hurt, they are carrying around an extra 200lbs. Yes, it does make sense that your knee wants to buckle after a while of standing.

3. Yes, you are going to keep chronic bronchitis when you continue to smoke 3 packs of the cheapest brand of cigarettes available; and no I can't fix it for you.

4. To the 19 year old patient with 3 babies at home: I don't care if you are mad that I won't go "swipe" you a bag of diapers to take home to your kids. Is it not enough that I have to come up here and put up with you, so they can take taxes out of my check to pay for the medical expense for you to keep spitting out babies, and to get treatment and pain relief for those "spider bites" that you only seem to get along the viens of your forearms, that you seem to get at least once a month?

5. No sir, my job duties do not include helping you out with that erection, or satisfying your need for a woman's touch.

6. No mam, I do not speak spanish. Would you go to a nudist colony and ask them to put their clothes on?

7. No mam, I can not tell you how much of your mother's B/P meds you should take.

8. No, I can not give you just a little extra pain meds and yes they will miss it.

9. No I really don't want to come wipe your butt just because you are too big to reach it.

10. No mam, we can not keep your momma an extra day or two because you want to go visit your cousin out of state.

11. Yes mam, your mother is very sick and we are doing everything we can to help her; though it seems she is sick because no one has checked on her in some time and she had to resort to eating cat food because no one saw to it that she had food.(this really happened)

12. No, we will not insert a foley because you don't want to get up to use the bedside commode RIGHT NEXT TO YOUR BED!! (actually had a pt. ask for this once)

13. I'm sorry, we are fresh out of the cure for stupid.

14. What?? Your ticked because you've brought the whole family to visit daddy in the nursing home and he's all dressed up in a hospital gown and someone else's socks?? Then bring him some clothes!!!

15. No I will not call the doctor out of surgery to come talk to your daughter since she had a hair appointment this morning and missed him.

16. No, I will not let you (patient) bum a cigarette.

17. No, we can not just call you in a prescription for oxycontin, as you are not a patient here, or no we can not refill your pain meds early because you accidentally flushed THE WHOLE BOTTLE down the toilet again.

We actually had to evict a patient out of the nursing home because his wife was getting his check every month but refused to pay his bill. I later learned that ours was the third facilty he had been evicted from for the same reason.

But my all time favorites are the ones who show up to the ER screaming chest pain, only to find out they've had a sore throat and didn't want to have to wait in line behind all those other people.

To the young, new, frat-boy doctors: NO, I will not just "fix it" and send you the order to sign. I would however like to find out where you went to med school, so I can sign up. **With this particular doc, we've actually had to send the police to his home to get him when he wont answer pages, calls or faxes when he is on call for ALL the docs in town**

Just my rant's but then.... I'm burned out.

[-MNC_RN-]

I'm going out on a real limb here, revealing more than I normally would. I do this becuase I think it illustrates a very real frustration that nurses can have and to show that we are all, in fact, human and can do stupid, stupid things.

Keep in mind that: I actually said this to a patient, and that I did not get away with it.

I said this when I was overworked, overtired, and dealing with some personal stress. This does not excuse my actions. Remember, though, that as a nurse, you may experience the combination of factors I did. Make a different choice.

Patient was admitted to my unit after his third, or fourth suicide attempt--overdose. Vented in the ED but waking very nicely, thank you. After confirming that he was, in fact awake and able to appropriately follow commands, we extubated him.

He immediately began a foul-mouthed tirade against my hospital, about how horrible the care was, about how he would rather have gone to such-and-such hospital, but they didn't give him a choice, etc. He started flaming me personally, and all of my fellow staff had the pleasure of his wrath as well.

I had had enough. So at one point I snapped and said...

[Wait for it.]

"Well, the next time you try to kill yourself, do a better job!"

It was like I was outside of my body. I could see the words in a balloon over my head as I desperately reached out to shove them back in my mouth.

Ooops.

The charge nurse was in the room with me at the time. His jaw hit the floor.

Fortunately, his family (sort of) supported me and informed him that he deserved what I said. (I don't agree with that, but at the time I took any support I could get.) My fellow staff did a fantastic job of calming him down and talking him out of a lawsuit. My manager just about burst into tears when I told her about it the next morning. (Imagine the first thing you hear at 0700 is one of your favorite staff greeting you with, "Say, we need to talk about something...")

I use this almost every time I teach a class to illustrate that even we nurses get burned out by things or do/say things we regret. There is no "super-nurse".

By all means, enjoy thinking the things in this thread as a form of therapy. But keep an eye on your emotions. If you're thinking these things too emphatically, you need to talk to someone for your own sake.

[SoundofMusic]

MNC, thanks so much for your candor and insight. We could all use a lot of that around here, as well as at work.

I think I'm at this point now, in a baby jr. nurse sort of way, and if I stay any longer, it will grow to be a really festering problem. I need to talk to someone about it.

I will admit, I have a hard time with these types of patients. I'm very impatient with it. I'm a person who had a very tough childhood, yet survived it and went on to build a beautiful life and family w/ my husband of 20 something years. I had choices and took the high road every time, even though it was tough and I was tempted not to. I wanted to give up at times, but didn't. I am all about hard work, being ethical, being honest, and doing the right thing. I have a lot of impatience with people who do not.

People who are truly SICK -- now for them I have all the compassion in the world. I'd almost trade places with them at times -- or at least want to be there for them in the most real way I can. I pray for them personally, at the end of my shifts and they are constantly on my mind when I go home.

I want to be dedicated to people who are sick - not people who are faking it to get drugs and feed their terrible habits.

I dont know where to get "help" for this feeling? Where can I go? Any books to read? Suggestions? If a hard lecture is what I need -- then by all means, someone step up and do it. I just don't know where else to turn with these feelings. I am a Christian person, but somehow, my faith isn't coming through for me here . . .