I just had one of the worst nights ever. First off...I had a sweet lady die on me (it was expected)....I just feel so bad for her family....since it is right before x-mas and all. Anyways...two of my other patients were these little old ladies who are both the biggest pains in the butt I've ever seen, heard, or taken care of. They both complain constantly, the one lady swears at staff, yells help me, help me constantly....and then you would go in there to help her and she would want something trivial as she is still yelling "help me, help me"....I would politely reply " I am helping you" and then she would say "well help me faster damn it".....then she would start swearing and calling staff worthless. She is literally out of control!!!!! And when she's awake...she's on the call light constantly...errrrrrrrrr. I took over the other lady at three when the 3 to 3 nurse went home....(there was noone to replace her) Anyways...she put her light on and I went in there...she immediately started saying that noone had taken care of her all night, her water was old, her back hurt and noone would help move her(she COULD be totally indept.), "how can I ever get better if no one helps me or takes care of me". Now...we all know damn well that she is well taken care of....she's just a psycho who likes to *****. Errrrrrrrrrr. The funny and strange thing is that both of these ladies are old retired nurses....god help me if I act like that in my old age. The part that really pisses me off is that they aren't that sick anymore and really don't need to be there......instead..they stay and we become their handmaiden's....and the patients who are really sick and need attention , don't get as much attention because we are all tending to these crazy women. I just can't believe that anyone could be as mean as these ladies are...it just about floors me. Now.....I never ever would hurt a patients....but lastnight...I seriously felt like ringing their little necks. Am I a bad nurse or what...? Iv'e gotten a lot of complements on my care and kindness so....it's not me...it's them. I just got to my breaking point and almost broke down in tears.... I didn't become a nurse to be pushed around and treated like you know what by a 80 pound old lady!!! I even tried being stern with them...but made it worse. Ok...I need to get to bed...I just really, really needed to vent...I hope you guys understand...
I am a student nurse, you are scaring the ---- out of me. don't they medicate people like that to mellow out? My mom was a nurse and she is the same way!
I have had a few of those and they are exasperating to say the least. If they are "old nurses" they are expecting the same kind of care they gave. Which we all know isnt possible in this day and age. Our patients are sicker than many they took care of. I also found that a lot of these little old gals just need a ear to listen. The families probly spend no or little time with them. They come in 10 mintues and have done their duty to "grama".
If someone has a few minutes pull up a chair and let them vent. They need it too, and also gives a great opportunity to explain to them why you dont deserve the verbal abuse they are heaping on you and the other nurses. A lot of time if you explain that you arent verbally abusing them and dont expect to be verbally abused by them they seem to understand that. Good luck,, i know not all can be soothed easily.
But remember there but by the grace of god go I/you.
they're expecting the kind of care they were able to give. Interesting point. Things have changed drastically in our work the past 3 decades and elderly nurses may recall fondly a very different healthcare setting (if their memories are clear that is...LOL)
I've had some awesome conversations with retired nurses who become my patients...not all are mean tempered and manipulative. A fair percentage of elderly women who have become embittered by life DO become this way as they age. As do many COPD patients....for example.
I agree 'there but for the grace of God' go I. Sometimes understanding works..sometimes it doesn't and we do the best we can. I agree some dementia, depression or delirium may be an extra added bonus here..and sometimes drugs like Risperdal or others CAN be appropriate.
Hang in there gals and guys...and Merry Christmas!!
None of my 2-legged family members is up yet this Christmas morning, so let me take a few minutes to express how much I enjoyed your post and the replies to it.
OOCH-Canada told you what worked for her, and it works for me too. What I mean is that I feel that all of my patients deserve at least ONE reasonable explanation of my relationship with them. My first encounter with any patient frequently includes pulling up a chair and obtaining eye level contact. In the madhouse that ER usually is the first thing I do is apologise that it took so long for me to get to them, but now that they have me I am ALL theirs. For GSWs this might consist of hand-holding and explaining that a lot of people will be doing a lot of things, (needles, X-rays & many, many "stupid" questions). I never cease to be amazed at how many times I get the first reasonable response from patients who are angry, hostile, drunk, high and psychotic. It's always worth a try, but the hardest tricks are timing, and resisting the all-too human inclination to fight back/agrue ect.
Alzhiermers folks are a challenge to everyone. Before I got my nursing license I got a B.A. in Psych. I worked on locked wards all the way through nursing school. I worked with children and adolescents, though, so I learned almost nothing about Alzhiemers. I learned much more about it from my next door neigbors mom, a retired teacher who "lost it" along with her husband. Mary Ann (fake name) taught
me more about Alz. than any of my pts. My wife spent a few months as M.A.s day-sitter, we would take her with us to choir practice or social events at our church. She couldn't tell you what happened 5 minutes ago. She never called me by my real name. She called my wife by the name of her daughter (odd, since my wife is white.) She called me by her son-in-laws name. After comparing notes with Rod (fake name) he told me that she called him by MY name, so maybe either of our names just means, "White boy" to her!
Ruby (fake name) our close friend and retired nurse/geriatric SW, said that my efforts at reality orientation were futile with M.A. Ruby said, Dont waste your time trying to ration with her." After all Ruby, is older than M.A. and spent many years caring for seniors. At one of our day trips we ran into a friend who had worked at the same school as M.A. It was amazing at how many mutual collegues she could remember after he spent a few minutes reminiscing with her. It kinda reminded me of my first semester clincal where my patient told me about WWI, but was unable to tell me what happened 2 min ago.
Caring for retirees from the helping professions is a challenge also. An LPN told me about her experience at the Old Nun's Home. Mother Superior could deliver "RIGHT ON" obcenities that would put the saltiest sailor to shame!
Which part of the health care system is more neglected; mental health or elder care? I try to get help with either one whenever I see it. I believe all seniors and ALL of us need help. I lost my psychiatrist along with my insurance recently, but believe me as soon as I have "benefits" again this is the first thing I intend to rectify. My last insurance had a $2,000 lifetime cap. Would that get me more than a week under lock-and-key? Would it get me more than a few months of psychotherapy? I doubt it. Many years ago I learned that my practice would be severely restricted, if not precluded, if I ever get a psychotic diagnosis. My only option is mental health. After all, we've put all the mentally ill onto the street or prison. WE DO NOT NEED MENTAL HEALTH--THERE IS NO SUCH THING AS MENTAL ILLNESS! That's what the government-insurance industry tells us.
We gotta keep trying though. Follow nurse62's advice and do the best you can to have SW assistance for your patients and for you.
Age 34 before realizing that I was born a nurse. Rare day goes by that I don't say at least a small prayer before and after every shift. Thank for sharing your shift with us. I will remember you in my prayers, as long as you remember me in yours. I need all the help I can get. After 20 yrs in ER I was fired/crusified and am going back to Psych Nursing. I suspect that I may be jumping from the frying pan to the fire.
Keep up your posts. I have learned the therapy of hugs. If you don't need one, I do!
"SW, said that my efforts at reality orientation were futile with M.A. Ruby said, Dont waste your time trying to ration with her." After all Ruby, is older than M.A. and spent many years caring for seniors. At one of our day trips we ran into a friend who had worked at the same school as M.A. It was amazing at how many mutual collegues she could remember after he spent a few minutes reminiscing with her."
I agree, in al the time I worked with alzheimers, it always amazed me how every day was different, and one could never tell really how much they understood. I always think reorienting is worth it- always assume they know more then they seem to, they may just not be able to tell you how much tehy understand, even when they do.
Also, every time I've ever had a bad expereince with a confused person I thought back and saw how my frustration showed, how I wasn't patient, etc, although some little old ladies are just mean, tehy are so because they are confused, though, they dont have those social cues going, adn because tehy dont understand, they are scared.
Heres a tip I'm having luck with- try food as often as possible. "here, I made this cake for you" works often to sweeten someone up. not always though, there is never an always.
I don't think a patient like that can be medicated just for being loud and annoying!! As a student, that is my worst fear as well....
but good for the OP of this thread.... you put up with the CRAP to the best of your ability... and when you get home you VENT and let it all OUT!! That is healthy, and I think coming here to post is helping you "deal"..... hopefully you have a supporting family who will let you "get it out" when you get home, too!
I am a student nurse, you are scaring the ---- out of me. don't they medicate people like that to mellow out? My mom was a nurse and she is the same way!
Usually you save the PRN medication for the patients who are very- very combative and or hallucinating. It has been my observation that giving meds such as Haldol or Ativan may have adverse effects such as too much sedation or paradoxyl effects such as being more combative. Many times elderly patients respond to meds different than more youthful patients.
Good luck in school. Don't be too afraid. I am designing my own line of combat nursing gear to help save us all from these type of situations. Let you know when it is out.
Thanks all for your thoughtful responses to my major "vent". God must have been on my side the next night at work because I got to work in CCU (because they were full).....the ladies were still there....but I got a nice little break from them for a night.....so ...that was nice. Also..it seems as though the influenza A...hit all at once in our little town...so med/surg was full of them....also a blessing to not have to work out there right before x-mas. There's nothing worse than influenza A for the holidays. Thanks again everyone for all your support....I'm really not that intolerant of a person.....just had enough that night...as I'm sure everyone is familiar with one time or another.
Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.
A fair percentage of elderly women who have become embittered by life DO become this way as they age.
Interesting statement from another poster. My MIL is like this. Her next-to-last hospitalization, she actually bit a nurse. She's over 80 and in poor physical health and seems to be experiencing dementia ( we are 1200 miles away so haven't seen for ourselves). My dh talked with her yesterday and said her speech sounded slurred; I think she's "chemically restrained" to keep her calm (she's at home). As long as I've known her, she's had issues with depression, anxiety, etc. and I think now her real emotions are coming out. I also think she wants to die. She has to have someone with her 24/7 now, and they do keep someone with her while she's in the hospital.
Interestingly, she started nurses' training many many years ago but never finished.
Specializes in LTC,Hospice/palliative care,acute care.
Originally posted by meownsmile
I have had a few of those and they are exasperating to say the least. If they are "old nurses" they are expecting the same kind of care they gave. Which we all know isnt possible in this day and age. B]
Great point-one I had not considered.Someone else mentioned manipulation and anger...Years ago we were taught that reality orientation was the way to go with the demented and patients had less rights in those days....Those old nurses used to make their patients do what they wanted them to do.....They were all about control...We are taught now that reality orientation is futile and a patient has the right to refuse.I am still working with a few "old timers" The more control they loose over a resident the more short tempered and angrier they get.They also seem to take things personally-as if the demented residents are conspiring to make their shift miserable...I hope and pray that I am not a mean little old lady...
Sounds like a fun shift at my facility... I've actually been attacked, pushed, bitten, slapped, pinched and spat on by my residents (LTC).. I don't mind it as much if they have dementia, but its the demanding retired nurses and school teachers who are the worst. None of these people have any prn seditives (chemical restraint) or would refuse their psych meds. Sometimes "yelling" at them (esp the men) works.... using theraputic communication hardly ever works. Where do these little old ladies get their strength??
Mandylpn
543 Posts
I am a student nurse, you are scaring the ---- out of me. don't they medicate people like that to mellow out? My mom was a nurse and she is the same way!