I mean the ones that make you want to implement a tourniquet around the neck, pillow therapy, and a Kerlix roll to the mouth. The ones that make you want to rip your hair out, jump up and down and scream in the middle of the hall, and then follow it up with a nice tensile-strength test of the Sheetrock...with your head. 6 years of bedside nursing and now as a new grad NP (boards-here I come) have given me ample fodder, and I bet others on here have some doozies as well.
1) LOM in with CHF, on dialysis, won't eat, on tele, and the doc has just ordered no more Boost, which he was swilling up to a 12 pack a day (you can just IMAGINE what his fluid levels were). He was allowed 2 per day, and had had his quota before I ever darkened the floor. After about 50 rings on the light (I kid you not) demanding a Boost, we start getting cals from the tele room saying that he is off the monitor. The techs would fix him, and 10 minutes later, we'd get another call that he was off again. After report, I went to assess him, replaced his monitor and explained to him why he was not allowed any more Boost that day. I didn't even make it back down the hall before the tele room called again. Back to the room I went, and there was his monitor, pads stuck to each other, on the meal tray. I put new stickers on, replaced it and told him in no uncertain terms that it was to be left in place, to which he responded with a volley of unrepeatables, followed by "Bring me a Boost! Please, please, PLEASE!" Only the way he said please, he was not being polite. We wound up having to put him in restraints, not only d/t the tele monitor, but because he took to throwing things at nurses and techs who whould not bring him his Boost at demand.
2)Guy with a trach stoma that he wanted dressed at a certain time BID, with Xeroform gauze, 4X4s, Kerlix, and tape, to his exacting specifications. Doc went along with this cockamamie mess to pacify this man, why remains a mystery (why do they EVER go along with some of the things they do?). You can guess when he wanted his change done, shift change. Every time, called q3 minutes on the nose. Just like Old Faithful, you could set your watch by him. And he'd call until someone came in there. Well, one night, he got me, and I wasn't having it, we had a true emergency, and that trumped his 24-step program, which involved a gown and mask, for HIS comfort. After I informed him that we had an emergency and he would have to wait (this was after he had gone to refusing to tell the ward clerk what he wanted and demanded HIS NURSE), he sulled up. And when I went in there IMMEDIATELY after we got the emergency settled, he COVERED UP THE TRACH STOMA, and refused to let me do the change. Said he wasn't ready now, and I'd have to wait. Like a little kid. I looked him dead in the eye and told him he could have it done now, or he could have it done by next shift, because I wasn't putting up with any b.s., and that he could report me if he wanted to, I didn't care. I was so mad at that point. He let me do the change, and after that, I was the ONLY one he let do it. Even if I did not have him as a patient, he would refuse to let his nurse change him, and make them get me. He even tried making them call me on my days off. I don't know what I did or said that prompted the turnaround. Maybe I reminded him of his Mama, LOL!
