upset pt

1. When a previously pleasant patient's head suddenly spins around like the Exorcist ... make sure there's not a medical cause. Blood sugar dropping? Agitation brought on by hypoxia? Neuro event?

2. Barring any of that stuff ... you said she had just called a friend. You have no way of knowing what that conversation might have entailed. The patient could be angry about any one of 100 things unrelated to her hospital stay.

I have a lot of success redirecting the patient by calmly pointing out that they have been resting comfortably for the last x hours and, "If there is something else going on that is bothering you right now I'm sorry, and I understand that may not be my business, but there is no reason for you to speak to me like that. I'll be back shortly when you've had a few minutes to pull yourself together."

3. Continued intent to sign out AMA? No problem - paging the physician now ...

4. Take it personally? Why?

Patients don't lie, they have false believes.

I'm not trying to be smart, just looking at it a different way.

pts certainly do lie so do their families.

agree with sudden metabolic changes as a possibility. sometimes there's an underlying psych problem. i'm no psych expert but this sounds like our old friend borderline, on accelerants . maybe a psych pro can help me out on this. can this happen so fast and hard with borderlines, or is there something else that would?

Mean people just make real ugly sick people. No big surprise.

The OP simply misread her pt. It takes awhile, but eventually you can pick the hysterical ones as soon as they get off the elevator.

As far as not making it personal, that's tough. An assault is an assault. Physical? No. But verbal and psychological? Yes. I don't give anybody a pass for attacking me just because I'm a nurse. Or it's just a job.

I'm trying to work on that.

pts certainly do lie so do their families.

Yup they do lie. I had a LOL one day out of ICU, so she had some ICUitis. 5 minutes into shift change she's on her bell. At first I thought she was just a confused little lady ( but off going nurse said she was alert and oriented, just weak), but when I went in there to do my assessment, she was completely with it. Knew why she's here, date, time, ect (had been here a while in the ICU) So basically she was very needy, which was fine, I made sure I got her all situated in the am, made sure pain, and nausea was good. I was in there 2 hrs, thank god my other patients didn't need me. I really was in there from 0725-0930. So finally I am able to get out of there to see my other people, I ask if there is ANYTHING else I can get her. " No I'm fine". 5 minutes later, she on the bell again. I couldn't get it immediately, but eventually went in. I cant remember what she needed, but this went on for a few more hours. So around noon, I get a call from a concerned granddaughter. Basically grandma has called her twice already, crying and upset because I was neglecting her, ignored her call bell, covered in pee, ect. I was like bull S(#%!!! I explained to the daughter that I had been in there ALL morning. She had a head to toe scrub first thing because I fond her a mess from nights, all her needs were dealt with. Granddaughter was fine with my explanation. Well she calls 2 hrs later again with the same issue of grandma calling her in tears. Saying I had not been in there for 3 hours. BULL$%!!. Granddaughter understood.

I went and had a talk with the patient. I asked her straight out " did you call your granddaughter and say theses things?". She said yes I did. I said, "you know those things aren't true then, right?" The patient acknowledged that I was indeed in there all am and there was nothing she needed. She was pretty quiet about it though and wouldn't say why she said those things. We had a discussion about hourly rounding, PCU not being the same as ICU, and if she really needed something else, I would be there as soon as I could. Helped a little bit, I just think she was obnoxious.

So basically if there is nothing wrong with them, like hypoglycemia, hypoxia, hypotension ect, if they are being obnoxious, call them on it and have a discussion and chart chart chart. Sometimes you need to get risk management involved early on if they are making false accusations. They usually want to be aware of these types of situations so damage control can be done early on

It is usually a mental issue, which your coworkers and manager should have no problem understanding. If I took personally all the crazy stuff I have dealt with with pts I'd be a basket case myself .

I think it depends on the setting. If something is off and a patient is making accusations or insinuating that you are neglecting when in fact you are not, at my facility I would get the social worker so she could investigate. I would stay out of the room until the social worker got back to me. You can never be too careful. Of course we try to handle what we can and try to get as much of an assessment as possible in case it is an acute medical episode. But I would have a CNA with me and then get the social worker.

I could have sworn we worked on the same floor except this was male. He called someone in my presence saying this nurse wants me to do what ive been doing since morning and I will be in here a while (meaning in the hospital). What was i trying to get him to do (ambulate). what had he been doing since morning (going to Bathroom).

patients do lie and some of them have nothing wrong with them. Some like it when they are in the hospital as helpless babe and everyone gets to feel sorry for them and they can get out of a lot of stuff

Consider the source, if you've ever had someone complain before- if both point away from you, that's your "answer" :)

Delirium perhaps? Was it at night? Sundowner s yndrome perhaps?

I so don't miss working in a hospital. I either hated the patients or their families. Something about the hospital really makes otherwise sane people freaking whack jobs.