Why is it always the patient with the worst situation? geez

[gloryfied]

Why is it always the patient with a chronic disease, stage 4 of some cancer, or some autoimmune, self deteriorating condition that passes judgement initially, or wants to be picky about their care?

For eg, a pt who was homeless, he passed out walking 30 miles in the heat to a shelter after his landlord kicked him out, stage 3 cancer, continues to smoke, he smelled really bad because he had been at the hospital with the same clothes he came in.

He refused EVERYTHING, his telemetry, assessments, vitals ... and the nerve to not want an African American nurse at some point during his care here. Goes out to smoke, against rules.

I just thought, dude, you are at your worst, and you have the nerve to be reckless to people and make our hob harder.

Pt I have tonight, has cancer, maybe it might be my fault at reading people, but I went in to say hello, you can sense his annoyance. His wife was pretty nice. I assessed him, said "call if you need anything". He goes "uh huh, yea, have a good day (although its the night shift).

Maybe he's passive in life in general, idk. but I will not be rude or reckless to the person who was taking care of me. Like how you shouldn't scream at the waiter serving your food - they'll spit in it sorta thing.

I hope to continue to look at these people as just overstressed with their condition, and that this might not be who they are on a daily basis. wow.

[tothepointeLVN, LVN]

Ever heard the words sick and miserable together?

[iluvivt, BSN, RN]

You would be surprised how much a patient may actually reach out to you with a few kind words . To the guy who walked 30 miles in the heat...I would have said "that sure must have been really exhausting to walk all that way" and just wait for his response. To the man with Ca..well I would have introduced myself..taken his hand and said..."I am here to try and make it a bit easier on you so please call me for any little thing and I will be here". Most people do respond well to just plain old caring about another human being that is suffering.

It was NEVER the high tech stuff that I remember while undergoing my many surgeries, but rather is that was the kind nurse who took my hand and said "you will get through this and it will be OK".

[jadelpn, LPN, EMT-B]

I don't expect very sick people to be happy go lucky at all. I may not be experiencing what they feel,but I can imagine how they feel.

And, I just wanted to know why in your sickest position, why be so miserable. I understand the issue of having cancer, or some sort of chronic condition, I just dont understand why the short temper or quick to get angry at people caring for you, but be so lovely to your aunt, or uncle who is in the room with you. I just wondered, what have we nurses done, that you act this way toward us. it's their family, so i get it, but we are here to help and care for you.

ANywho. I guess i was speaking from a sense that if I was in a vulnerable state, choosing certain people to be angry at would not solve my problem, it will only deteriorate my health.

Grief has a number of stages. Anger is one of them. And I am having a hard time understanding the validity of your claims. You can not even begin to understand how they feel unless you have been there. People who have chronic illness and terminal illness are SICK. EVERY. DAY. They hurt, they have undergone poking and prodding and treatments that leave them depressed and depleated and in some agony. Most may be pleasant to their familes because they do not want their family to keep on worrying about them. So they put on a front. And that front comes tumbling down as soon as the last family member leaves. And so it should. The most important thing you can learn as a nurse is to not take this personally (choosing certain people to be angry with???? REALLY????? It is not about you). And the only thing you need to imagine is that a patient can be sick and tired of being sick and tired. And as I said in my earlier post--it makes most people angry when they have a loss of control to the point of being hospitalized--a nurse is doing for them what they used to be able to do for themselves. Continuing distress would tell me that perhaps hopice should be consulted--only because it would be imperative that the patient be able to go through the stages of grief with as much or as little help as they need.

[gloryfied]

tothepointLVN nope!! never heard of it please elaborate for the rest of us please. educate us.

and iluvivt, I am a very compassionate nurse, and although it may not be so necessary to say on this forum, my patients, they appreciate the care i give them, they express that to me at the end, all the time. because they can see that I give them more of me, than just the title of being a nurse. I sit on their bedside, and chat with them about how they are feeling, hold their hand? of course. how else can i express to them i care about them because however i treat these people is the EXACT same way I want any family member of mine to be treated God forbid they were admitted to a hospital. so I give my all.

That homeless patient, although being homeless is a sad situation, his high crime, and drug activity landed him evicted. as humans we judge. Here you have this man, high intensity criminal history, and drug hx, prejudice, evicted, no job, chronic lung problems, still fighting the staff to go smoke and talk to everyone the way he wants and requesting the nurses line up so he can pick who he wants as a nurse? are you kidding.

Our job is to heal and care, but that does not mean to feed into someone's miserable persona.

my opinion. but thanks for your lovely responses. :)

[sauconyrunner]

Yes, not going to win me over on this one. So this homeless patient, because e has a history of criminal behavior, drug use, prejudice, no job, somehow should behave differently because of this? He should be grateful that someone is caring for him? Why?

No, he doesn't need to be requesting certain nurses, any more than anyone else does. Not at all, thats just tough for him.

But he really deserves compassion, his life sounds horrific, and I imagine that if you actually talked to him, he'd probably tell you this is not the life he imagined. It does not sound as if you treat all your patients exactly as your would a family member.

Having been really sick and Ill at one point in my life, I can say with experience, you have NO idea what some of your patients go through...it's impossible to imagine. I thought I knew, and then I had quite an experience. When I returned to work, I was much more astute and a lot readier to just hang tight and be nice to folks who were being irritating and annoying, because I;d kind of been there, even if only for a moment.

[Esme12, ASN, BSN, RN]

I don't expect very sick people to be happy go lucky at all. I may not be experiencing what they feel,but I can imagine how they feel.

And, I just wanted to know why in your sickest position, why be so miserable. I understand the issue of having cancer, or some sort of chronic condition, I just don't understand why the short temper or quick to get angry at people caring for you, but be so lovely to your aunt, or uncle who is in the room with you. I just wondered, what have we nurses done, that you act this way toward us. it's their family, so i get it, but we are here to help and care for you.

ANywho. I guess i was speaking from a sense that if I was in a vulnerable state, choosing certain people to be angry at would not solve my problem, it will only deteriorate my health.

First of all don't take it personal. They are angry, really angry...... but it has nothing what so ever to do with you. You aren't going to like what ai'm about to say.......but........

I know this may come as a shock........but.........It is NOT about you at all. It's a common misnomer that it is about the care that you give. Well....it isn't. It's about giving the care that those in your care need.....what THEY need, not what YOU need, or what you THINK they need.

As someone who suffers an auto-immune disorder there are days you are just downright P.O.d..........I am sick of being sick. I'm sick of hospitals and:madface: "medical people in general.

Then some perky, fresh, full of life new grad wants to come in and tell me they KNOW how I feel.......well, you don't. Telling me you understand is REALLY ANNOYING.

It's annoying to the patient in that bed......... for there is NO WAY you really understand what they are going through.....because unless you too are dying of cancer, can't walk, lost a child....what ever that patient is experiencing.... you have NO CLUE how that person feels. I think that is one of the most annoying things health care people do, is tell the ill you "know how they feel". Because you don't.

Unless you have experienced their situation you cannot imagine how they feel and you cannot predict how you would actually feel in that situation. You really have no way of knowing how that mother feels at the loss of her child....unless you have lost one yourself. I always told patients.....I have no idea what you are feeling but I can see how upset you are....I am so sorry you have to bear this burden....what can I do to help right now......because you can't change their diagnosis, their prognosis or that their child/teenager/loved one is dying or dead.

I have a family member dying of cancer...right now in the hospital. He is depressed. He is angry. He is P.O.d. He doesn't want to hear how sorry your are and there are times he can't respond to happy chatter for if he opens his mouth he will do nothing but scream in pain.

He won't be mean to my nieces or my sister or anyone in the family because he loves them and feels guilty for putting them through this and for hurting his children when they are so young. He wants to live to see his grandchildren and his children become parents.....to sit and hold their grand children. but he won't he is dying. So they won't be grouchy with family....you however are a complete stranger and they can be grouchy with you. But it isn't personal...you could be an orangutan....and they would take it out on the orangutan. They are angry........ it's apart of the grieving process that they have to go through....have you heard of the Kubler/Ross Death and dying? It pertains here. Elisabeth Kübler-Ross Foundation

I know I have sounded harsh.....and I don't mean to be. I had to make a point You need to realize that once you place that nurses cap(figuratively speaking) it is no longer about you and your feelings. It's about the patient and what they need. That homeless guy? Maybe he likes it that way. Maybe he made a decision YEARS ago that he doesn't like society and wants to do exactly what he wants....so he decided to live at the fringes. Again.....it's about him....not you.

This is from experience.......each person reacts differently to life's obstructions to their path. Some positive and some negatively. Some patients partners/husband/wives/SO will react and become pillars of strength....and others will decide this is not the path they want and leave. You never know how someone will react until they are there. I know that many promise to love honor in sickness and in health as well....that is just not always the case.

Just remember that it is about the patient and that it isn't personal. Also remember until you are in their shoes for real....you really have no idea how you would feel or how you would react. When greeted with hostility just acknowledge...."I see you are not in the best mood/place right now .....but I am here if you need anything is there anything I can do right now.....I'll check back in xyz amount of time....I'll leave you alone right now". Combine your compassion to this knowledge and you will be a greater nurse that you already are.

Remember...There but for the Grace of God go I.

[Been there,done that, ASN, RN]

tothepointLVN nope!! never heard of it please elaborate for the rest of us please. educate us.

and iluvivt, I am a very compassionate nurse, and although it may not be so necessary to say on this forum, my patients, they appreciate the care i give them, they express that to me at the end, all the time. because they can see that I give them more of me, than just the title of being a nurse. I sit on their bedside, and chat with them about how they are feeling, hold their hand? of course. how else can i express to them i care about them because however i treat these people is the EXACT same way I want any family member of mine to be treated God forbid they were admitted to a hospital. so I give my all.

That homeless patient, although being homeless is a sad situation, his high crime, and drug activity landed him evicted. as humans we judge. Here you have this man, high intensity criminal history, and drug hx, prejudice, evicted, no job, chronic lung problems, still fighting the staff to go smoke and talk to everyone the way he wants and requesting the nurses line up so he can pick who he wants as a nurse? are you kidding.

Our job is to heal and care, but that does not mean to feed into someone's miserable persona.

my opinion. but thanks for your lovely responses. :)

Do I smell sarcasm?

[gummi bear]

Erm....I think that I understand where op is coming from. I've just learned not to take it personal. I think that in these cases the patients may be having some sort of loss of control issues, or maybe even some sort of mental illness or personality disorder issues. If you're lashing out at people that have only tried to help you during your worst times, then there are some underlying issues going on that have nothing to do with the healthcare personnel.

For example, I had a patient that was a noncompliant DM type 2. Boy, he sure was mad at the world when he found out that his foot and lower leg had to be amputated due to self negligence and pure old hard headedness (he had been to our unit multiple times in the past, and I literally watched his foot deteriorate over time). Anywho, he was already mean and surly, but after he learned about his pending bka he made life hell for whoever was responsible for his cares. He threw food on the floor because "it tasted bad" or didn't get any salt or sugar. If he couldn't get peanut butter and jelly sandwiches at 2 in the morning (blood sugar was checked whenever he made these sorts of requests), he would throw a tantrum. He would **** or crap in the bed on purpose (he is not incontinent) if one of his many requests weren't promptly met (for example, freaking back massages during change of shift, and he KNOWS that he's making non emergent requests at awkward times). Things have to be his way or else you would be cleaning up ****, poop, or glucerna from the floors, bed, tables, etc. He is also very verbally abusive to female staff members.

Moral of the story? Suggest a psych consult in these situations. Anger is one of the stages of grief, but some people were like this well BEFORE they were diagnosed with the condition that they were admitted for. That's healthcare for you :)

[tothepointeLVN, LVN]

Our job is to heal and care, but that does not mean to feed into someone's miserable persona.

When you have that kind of attitude your shutting the door on them emotionally. But hey I only work with the terminally ill patients every shift so what do I know? Though most of them are pleasant to me and a delight to work with so maybe its my attitude they feed off. Its not about you. It's about them. Grow up and be a nurse.

[redhead_NURSE98!, ADN, BSN]

First of all don't take it personal. They are angry, really angry...... but it has nothing what so ever to do with you. You aren't going to like what ai'm about to say.......but........

I know this may come as a shock........but.........It is NOT about you at all. It's a common misnomer that it is about the care that you give. Well....it isn't. It's about giving the care that those in your care need.....what THEY need, not what YOU need, or what you THINK they need.

As someone who suffers an auto-immune disorder there are days you are just downright P.O.d..........I am sick of being sick. I'm sick of hospitals and:madface: "medical people in general.

Then some perky, fresh, full of life new grad wants to come in and tell me they KNOW how I feel.......well, you don't. Telling me you understand is REALLY ANNOYING.

It's annoying to the patient in that bed......... for there is NO WAY you really understand what they are going through.....because unless you too are dying of cancer, can't walk, lost a child....what ever that patient is experiencing.... you have NO CLUE how that person feels. I think that is one of the most annoying things health care people do, is tell the ill you "know how they feel". Because you don't.

Unless you have experienced their situation you cannot imagine how they feel and you cannot predict how you would actually feel in that situation. You really have no way of knowing how that mother feels at the loss of her child....unless you have lost one yourself. I always told patients.....I have no idea what you are feeling but I can see how upset you are....I am so sorry you have to bear this burden....what can I do to help right now......because you can't change their diagnosis, their prognosis or that their child/teenager/loved one is dying or dead.

I have a family member dying of cancer...right now in the hospital. He is depressed. He is angry. He is P.O.d. He doesn't want to hear how sorry your are and there are times he can't respond to happy chatter for if he opens his mouth he will do nothing but scream in pain.

He won't be mean to my nieces or my sister or anyone in the family because he loves them and feels guilty for putting them through this and for hurting his children when they are so young. He wants to live to see his grandchildren and his children become parents.....to sit and hold their grand children. but he won't he is dying. So they won't be grouchy with family....you however are a complete stranger and they can be grouchy with you. But it isn't personal...you could be an orangutan....and they would take it out on the orangutan. They are angry........ it's apart of the grieving process that they have to go through....have you heard of the Kubler/Ross Death and dying? It pertains here. Elisabeth Kübler-Ross Foundation

I know I have sounded harsh.....and I don't mean to be. I had to make a point You need to realize that once you place that nurses cap(figuratively speaking) it is no longer about you and your feelings. It's about the patient and what they need. That homeless guy? Maybe he likes it that way. Maybe he made a decision YEARS ago that he doesn't like society and wants to do exactly what he wants....so he decided to live at the fringes. Again.....it's about him....not you.

This is from experience.......each person reacts differently to life's obstructions to their path. Some positive and some negatively. Some patients partners/husband/wives/SO will react and become pillars of strength....and others will decide this is not the path they want and leave. You never know how someone will react until they are there. I know that many promise to love honor in sickness and in health as well....that is just not always the case.

Just remember that it is about the patient and that it isn't personal. Also remember until you are in their shoes for real....you really have no idea how you would feel or how you would react. When greeted with hostility just acknowledge...."I see you are not in the best mood/place right now .....but I am here if you need anything is there anything I can do right now.....I'll check back in xyz amount of time....I'll leave you alone right now". Combine your compassion to this knowledge and you will be a greater nurse that you already are.

Remember...There but for the Grace of God go I.

Thank you for offering your insight on this. I try really hard not to say "I understand" or anything of that sort, even as a former chronic pain type person I DON'T understand exactly how they feel.

The only place where I'm with the OP is the people who come in and refuse everything, or want to make up their own rules, etc. and tell me how many "rights" they've got. Dude, you also have the right to WALK OUT OF HERE. I didn't ask you to come here! I actually told one COPD lady, who was very angry on admission, telling me all the things she had the right to refuse, "Then maybe you need to have a talk with your family or write up some documents that tell them to stop picking you up off the floor and bringing you in here when they find you, because all we can do once you're here is our job, which is to make you feel better." That shut her up. I mean, sometimes they act like we went to their house and dragged them to the hospital ourselves to make money or something.

[PrettyLady87]

First of all don't take it personal. They are angry, really angry...... but it has nothing what so ever to do with you. You aren't going to like what ai'm about to say.......but........

I know this may come as a shock........but.........It is NOT about you at all. It's a common misnomer that it is about the care that you give. Well....it isn't. It's about giving the care that those in your care need.....what THEY need, not what YOU need, or what you THINK they need.

As someone who suffers an auto-immune disorder there are days you are just downright P.O.d..........I am sick of being sick. I'm sick of hospitals and:madface: "medical people in general.

Then some perky, fresh, full of life new grad wants to come in and tell me they KNOW how I feel.......well, you don't. Telling me you understand is REALLY ANNOYING.

It's annoying to the patient in that bed......... for there is NO WAY you really understand what they are going through.....because unless you too are dying of cancer, can't walk, lost a child....what ever that patient is experiencing.... you have NO CLUE how that person feels. I think that is one of the most annoying things health care people do, is tell the ill you "know how they feel". Because you don't.

Unless you have experienced their situation you cannot imagine how they feel and you cannot predict how you would actually feel in that situation. You really have no way of knowing how that mother feels at the loss of her child....unless you have lost one yourself. I always told patients.....I have no idea what you are feeling but I can see how upset you are....I am so sorry you have to bear this burden....what can I do to help right now......because you can't change their diagnosis, their prognosis or that their child/teenager/loved one is dying or dead.

I have a family member dying of cancer...right now in the hospital. He is depressed. He is angry. He is P.O.d. He doesn't want to hear how sorry your are and there are times he can't respond to happy chatter for if he opens his mouth he will do nothing but scream in pain.

He won't be mean to my nieces or my sister or anyone in the family because he loves them and feels guilty for putting them through this and for hurting his children when they are so young. He wants to live to see his grandchildren and his children become parents.....to sit and hold their grand children. but he won't he is dying. So they won't be grouchy with family....you however are a complete stranger and they can be grouchy with you. But it isn't personal...you could be an orangutan....and they would take it out on the orangutan. They are angry........ it's apart of the grieving process that they have to go through....have you heard of the Kubler/Ross Death and dying? It pertains here. Elisabeth Kübler-Ross Foundation

I know I have sounded harsh.....and I don't mean to be. I had to make a point You need to realize that once you place that nurses cap(figuratively speaking) it is no longer about you and your feelings. It's about the patient and what they need. That homeless guy? Maybe he likes it that way. Maybe he made a decision YEARS ago that he doesn't like society and wants to do exactly what he wants....so he decided to live at the fringes. Again.....it's about him....not you.

This is from experience.......each person reacts differently to life's obstructions to their path. Some positive and some negatively. Some patients partners/husband/wives/SO will react and become pillars of strength....and others will decide this is not the path they want and leave. You never know how someone will react until they are there. I know that many promise to love honor in sickness and in health as well....that is just not always the case.

Just remember that it is about the patient and that it isn't personal. Also remember until you are in their shoes for real....you really have no idea how you would feel or how you would react. When greeted with hostility just acknowledge...."I see you are not in the best mood/place right now .....but I am here if you need anything is there anything I can do right now.....I'll check back in xyz amount of time....I'll leave you alone right now". Combine your compassion to this knowledge and you will be a greater nurse that you already are.

Remember...There but for the Grace of God go I.

::Applaudes:: :yelclap::w00t::bowingpur:thankya:

I have an uncle with COPD, and the stories that he has about the hospitals, staff, near death operations, etc...I don't blame him for the criticism he gives them. It is what it is, and as medical staff we need to swallow with a smile, and ask if there's anything more we can do. Simple.

[rubato, ASN, RN]

Esme12,

Your post brought tears to my eyes. Thank you so much for reminding me why I want to be a nurse.