I had a middle aged patient (neurologically intact), who rang the bell and said "Can I have my nurse in here?". I replied "What is it that you need?" (Because sometimes you walk in there and find it's something you could have brought for them!). He said "I really need to see her." So once I walk in, I find out that he had a bowel movement and needed to be "cleaned." This is a man capable of asking for the bedpan or getting up to the bathroom!
It truly bothered me that he had a bowel movement on himself. Long story short, I told him rather frankly that he needs to ask for the bedpan in the future. Next day, I hear from other nurses that he was really upset with me and said I was nasty and cruel towards him.
If your capable, do it yourself.
I worked yesterday and found out the behaviour continued, I guess some nurses didn't give the "ask for the bedpan or bathroom" speech. He even asked one nurse to move his left leg closer to his right leg in the bed (Are you kidding me???). He was admitted with heart failure and recovering well....
Specializes in Assisted Living nursing, LTC/SNF nursing.
With all this 'customer service' attitude these days at places, it's getting to be more the norm of if you don't do it for them, you will be reprimanded for not helping with every need (or non-need) and your job could be on the line for saying something as trivial as "who's going to do this for you at home?" In other words, been there and got it for denying services since 'the customer is always right.'
My take is -- if you can reach it, you can wipe it. If you're on a vent, sedated, immediate post surgery, have contractures, etc., that's one thing. I've also told people that if they don't start doing for themselves, the doc will look at a nursing home consult (this was for a 30 year old DKA who suddenly couldn't do anything for himself) or a psych consult. That usually motivates them to stop acting like a nut. I've also told people, "Ma'am, it's disrespectful for me to wipe you when you can wipe yourself, it's like I'm saying you're an invalid."
The ones I feel bad for are the ones who are usually continent but who aren't after surgery or because of meds who are just mortified and so embarrassed. I tell them it's not their fault, don't worry about it, but I know I would have wanted to crawl under the bed if I'd had a problem after surgery and wasn't continent.
Specializes in Trauma Surgery, Nursing Management.
When I run into the occasional pt like this, I am quick to set boundaries. If they complain about me, I really don't care. We have all dealt with the manipulative pt, and I will try to work with them-to a point. However, I know that the ridiculous requests will not stop unless I set very clear boundaries coupled with explanations of said boundaries.
Hospital does not = hotel. Nurses do not = waitresses.
I use reverse psychology on patients over a certain age. I say to them, "Who is going to do these things for you when you are discharged home?" When they can't answer the question, I say to them, "We better start practicing these things now because you don't want to be discharged to a nursing home; if the treatment team finds out that you are struggling with toileting yourself, they are going to start looking at alternative discharge plans." Every time I have had this talk with someone, the game changes. I believe the problem (most of the time) is that the patient is lonely and wants someone to spend time with them. I have seen patients in the hospital for up to a month with no visitors or phone calls and during their stay I find out they have 6 kids that haven't bothered checking on them. Sad. I say whatever works. The truth is, if they are capable, then they MUST do it themselves. The goal is to keep our patients as close to their normal level of autonomy as possible; we want to maintain their quality of life as much as we can.
Sometimes, this lil' frail old man (that is your patient) was a nasty and not so very nice father or family member and that is why no one cares if he's in a hospital. Not saying this is the case, but I have seen it plenty of times when this is the reason and well................such is life
I always give them the 'we need to keep your indepence speech, so you can go home.' Works like wonders... I'm not there to baby them, I'm there to help them with what they can't do. If they can press the call light they usually can feed themselves, turn, and grab things, change the channel... Quick my job to start grad school, and although I will miss somethings about bedside nursing, I sure won't miss the my 'nurse is my mother and I'm a 2 year old toddler attitute!'
I had a lady once with one deformed hand/fingers. Other hand/fingers perfectly normal. She would call for help to wipe her butt after a BM. THE PROBLEM: She was a VISITOR (daughter of one of my LTC residents). She would tell some of the staff that she would "hold it" til she came to see Mama so we could help her. Umm..no, you are a 60 year old lady with the same birth defect you have had from the day you were born. Surely you have adapted to being able to wipe you own orifice. I refused to do it!
Must have been rough, having to hold it in the all the time until her Mama finally got admitted. It's a wonder she survived that long.
I agree. Nothing irks me the most that very capable pts acting like they are at end of life.
Just two days ago I was working post partum and one of my pts was an intact spontaneous vag. G5P5 who called me into the room on her day of discharge to give her a bed bath.
I did a double take and pretty much blurted "Are you serious?" She was stunned and explained that all her other deliveries her mother would give her a bath for days post partum because of the "cuatentena". Her mother is no longer living.
I pointed her to her bathroom where the robe, towels, fancy shampoo and loofah were waiting for her. I told her I was very sorry but that she would have to do it herself as we don't bath perfectly capable pts on this floor and she needed to demonstrate she was well enough to do it herself prior to going home.
She was very upset. I went to take care of my team of 9 gyns and sections.
If management has a beef with that I am quite ready to hand over my badge, ugh!
I had a lady once with one deformed hand/fingers. Other hand/fingers perfectly normal. She would call for help to wipe her butt after a BM. THE PROBLEM: She was a VISITOR (daughter of one of my LTC residents). She would tell some of the staff that she would "hold it" til she came to see Mama so we could help her. Umm..no, you are a 60 year old lady with the same birth defect you have had from the day you were born. Surely you have adapted to being able to wipe you own orifice. I refused to do it!
What? Well I had a resident's family member who needed B12 shots and came in with the medication and asked if we would get her a needle and give the shot to her....yeah.
I work at a nursing home and rehab place and more than once I've had to casually say, "Are you sure you can't do that for yourself? Gee I hope you don't have to go from the rehab side of the facility to long term care because that happens sometimes." It's like a miracle occurs!!!! :lol2::lol2:
Who are these people who actually WANT the health staff to clean up their pee or poop?!?!? When that happened to me during labor and delivery (it doesn't just happen during the pushing stage) I was MORTIFIED! Everyone I have ever known who has had this to happen was MORTIFIED!
I love the patients who hoist themselves off of the toilet with exaggerated effort, and then grab ahold of the sink in front of them with their hind ends sticking out waiting for the staff to wipe it, as if no words are needed. "Short arm syndrome." It should be added to the admitting diagonsis of some patients.
I use reverse psychology on patients over a certain age. I say to them, "Who is going to do these things for you when you are discharged home?" When they can't answer the question, I say to them, "We better start practicing these things now because you don't want to be discharged to a nursing home; if the treatment team finds out that you are struggling with toileting yourself, they are going to start looking at alternative discharge plans."
Who are these people who actually WANT the health staff to clean up their pee or poop?!?!? When that happened to me during labor and delivery (it doesn't just happen during the pushing stage) I was MORTIFIED! Everyone I have ever known who has had this to happen was MORTIFIED!
IowaKaren
180 Posts
With all this 'customer service' attitude these days at places, it's getting to be more the norm of if you don't do it for them, you will be reprimanded for not helping with every need (or non-need) and your job could be on the line for saying something as trivial as "who's going to do this for you at home?" In other words, been there and got it for denying services since 'the customer is always right.'