UGH! This is my first vent since I've become a Nurse Intern II while attending nursing school.
I worked over the w/e and had a pt who was extremely large (well over 300 lbs), came in with UTI and A-fib and was incontient. This woman literally drove me to nuts the entire 12 hours I worked her floor.
For starters, for some strange reason, she couldnt lift her index finger to push the call light that was LITERALLY an inch from her finger so she would yell to the top of her lungs, NURSE, NURSE whenever I walked by. I would go into her room and asked her why she felt the need to yell and not use her call light and she said she "couldnt raise her hand" to reach it, (although she could have pressed the call button on the side of the bed rail near her arm). So I ask her what I can help her with and she wanted me to (get this) close her miniblinds. I closed the miniblinds and she said, "the light is still in my eyes, can you move my bed to get the glare out of my eyes since the blinds won't close any further?" This woman is hooked up to 2 L of O2 so I told her there is no way to "move her bed" to the opposite side of the room because of the window, I told her I can turn out all the lights and close the door to see if that would help. She says, "can you put a cover over the window?" I told her no and told her if she needed anything else, to lift her finger and use the call light on the side of the bed. I even put the call light box right on her chest (within arms reach) to use it.
Why no more than 30 seconds later (literally), she is SCREAMING NURSE again? I run into her room and ask her what I can do for her, and she says (get this) Can you move my cup closer to the edge of the table so I can use the straw to drink it? She was USING her hands to eat breakfast, but couldnt use her index FINGER to press the call light.
Then the kicker, I leaves her room (after pulling her cup literally a half inch further than it was on the table) and she is SCREAMING nurse again and this time, she managed to pull out her IV and there was blood everywhere. So, I had to do a linen change (while she was in the bed, as well as clean her up and put on a new gown). The nurse had to start a new IV in which she CRIED, MOAN and complained the entire time. When I put on her grown, she couldnt lift her arms up to put them in the sleeves so I had to pull the gown over her arms, in which she complained I was "hurting" her and she needed a pain pill.
Fastfoward, to an hour later, she is constantly on her call light for little things, like "can you make me some ice tea? can you turn me to the right side? can you turn the channel on the TV?", etc. I ended up putting her on the bed pan and she would ring the light literally as soon as I walked out of the room and to say she "thinks" she is finished pooping and when I go to remove the bed pan, she "squirts" diarrehea all over the damn place, including on my sleeve. NOTHING is in the bed pan. It took 2 nurses and myself to clean her up, and this happened 4 times over the course of 12 hours. Due to her hemmroids, the nurse didnt think she would be benefit from a rectal tube.
Meanwhile, while I'm spending all this time in this pt's room, there is a little ole lady two doors down that is Influenza type A, incontient, and NEVER rings her call light for anything, and I feel bad because I know she's in need of a bath, change, and linen change and I'm wasting all my time in this pt's room who thinks she is in a Holiday Inn Express!
And her family members are just as bad! They literally hunted the nurse down to say that "my sister wants her food cut up because she can't cut it herself because her hands hurt", although her "sister" was eating just fine with BOTH her hands before she got there.
Sorry so long. I just don't get why people don't understand they are in a HOSPITAL and not a HOTEL! We are not room service there to serve your every demanding comand.
I remember when I was still fairly new and was working on the floor - I hadn't been there very long when a patient's light came on.
When I went in to answer, one of the family members tells me that they are leaving, and that I'd better take good care of 'mother' - that she was my most important patient. It kind of ticked me off, the way it was said, and I told them 'sorry, but ALL my patients are important to me'. As I recall, the patient herself was no problem.
Another time, I had family call me into a room before they left, and said, in a very snotty tone 'You make sure you give them a back rub'. I assured them, if time permitted, I would certainly try.
I'm like oramar - I'm done with it now - mine is due to a disability, but if some miracle occured, and my hands became perfect again - I'd not go back to nursing. I'm done with it, and would do anything else.
"I have the time" is a motto around my work place.
I had a patient who tried to give me her change purse. She wanted me to go down to the gift shop, return and tell her what was "cute" in the store and then purchase the items for her.
I told her I would try to get a volunteer to help her out, but I couldn't leave my other patients to be a personal shopper. She refused and stated, "But you're suppose to have the time to do this!"
She remained upset with me for the remainder of my shift.
I never answer to NUUURSE, NUURSE! When pts begin yelling, I close their door. I am not their beck and call b**tch! I also let them know that that is unacceptable behavior, let them complain I do not care. Ten to one they are the pts families that everyone including management know are PIA's and if they need nurse kiss a**, don't give them to me. As far as young patients....they definately can be whiney, I let them know that if they need to wine well they can call their mama. Sounds harsh but, I don't go to work to play control games. The hospital is where WE have the control, I will always do for my patients if needed, care for what needs done, intervene for emergencies. I will not be abused, and used by those who are manipulative, and badly in need of a b**tch slapping.
With some patients, it's easy to see how they ended up in this situation at this point in their lives. In the OP, this is a person who is used to expending very little physical energy to help herself, but rather, depends upon others to do things for her. And it appears that the family enables this type of behavior. This is not at all uncommon, and we are not going to change a lifetime of dysfunction in one short hospital stay. The only thing you can control is how you respond to a patient with these types of demands.
Specializes in ICU, CCU, Trauma, neuro, Geriatrics.
document, document, document... I know this is an old speech. Document patient request, nurse response and after a number of Q10 min or less requests for personal needs. Have a chat with patient about their frequent needs and is there something that isnt being addressed? Document this also. Then I document, due to frequent requests, it is impossible to meet this patients numerous needs in a timely fashion. This also needs a social services consult and possibly will also trigger a psych consult by the physician.
I have asked other nurses to cover one or two of my other patients for a period of time so that I can answer the call lights of the needy one and document things appropriately so that social services and psych have something to work with. Yes it is time consuming for an hour or so but so worth it. The patient has their needs addressed and we don't have to be used as personal slaves to someone out of control.
The Question: Why do people think the hospital is like the Holiday Inn Express?
My Answer: Probably, in part, because of an billboard ad I have seen recently in my area that reads, "Private Rooms. Personalized Care." It wasn't referring to a new hotel, but to a new emergency center at a local hospital. And I thought that hospital ERs were about treating people, I mean "customers," with serious health issues, and were not concerned about whether they have private rooms. I guess that next some hospitals will be bragging about their conceirge services and/or their haute cuisine for patients.
The Question: Why do people think the hospital is like the Holiday Inn Express?
My Answer: Probably, in part, because of an billboard ad I have seen recently in my area that reads, "Private Rooms. Personalized Care." It wasn't referring to a new hotel, but to a new emergency center at a local hospital. And I thought that hospital ERs were about treating people, I mean "customers," with serious health issues, and were not concerned about whether they have private rooms. I guess that next some hospitals will be bragging about their conceirge services and/or their haute cuisine for patients.
I work in the unit and we have this new thing called "dining on call" patients actually get a menu, and we the nurses have to call the food orders in to dietary! We don't have phones in the room, so yes we have to call them in! Thank god not everyone eats...most are vented, but for those that do what a pia. yes hospitals are the new holiday inn!
We are just the big mean nurses who won't feed our patients. Ya I became a nurse so I could torture my patients by not feeding them. If you're that sick then you should not be asking me for food, a smoke, or caffine! Drives me crazy!!! I explain to them that if surgery were to be an option the patient can not have any food or drink because their is a risk of aspiration which could lead to being dead! Oh so he can't even have a soda cracker? What? Did you hear a word that just came out of my mouth? It's soooooooo frustrating.
Soooooo true...they really don't get it...sooo frustrating!!!!!
Holiday Inn Express?!?! I wish... people in these parts think I'm the concierge at the Ritz-Carlton!!
My favorite question to some of these types of patients is: "How do you do this at home?"
And if you can reach your privates to scratch 'em, you can wipe 'em off too!!
I've taken to documenting conversations verbatim, as they occur, so that when the negative Press Gainey's come in, my manager has written documentation explaining my actions.
"Patient hit RN with open hand on RN's left forearm while discussing patient's need for IV insertion and NPO status. Patient replied that she was "only joking". RN replied that hitting was unacceptable. Patient replied that she was only joking and hit RN in arm again. RN informed patient that assault on a healthcare worker was a crime in this state and security would be called and charges would be pressed. Patient stuck out tongue. RN asked if there was anything else the patient needed, because she "had the time'."
Yes, it's frustrating for sure! I recently had a pt. w/ a low BP who was mad that I told her I would be glad to get her a lemon mouth swab after I retook her BP. This woman was so rude and nasty to me. She said she wanted in "Now"....Pure frustration made me say...."Listen, I am more concerned that your BP is 84/60 than I am about your dry lips!" I mean, what the heck, ya know....some patients...grrrr
We had 300 patients come through our ED the other day, and more than half of them shouldn't have stepped through the doors. Each and everyone of them though was yelling about the wait....
The problem is...the average grade level understanding of the patients and their families that come to the ER is roughly 5th gade. Seriously, our discharge instructions are for a 5th grader.....
banditrn
1,249 Posts
I remember when I was still fairly new and was working on the floor - I hadn't been there very long when a patient's light came on.
When I went in to answer, one of the family members tells me that they are leaving, and that I'd better take good care of 'mother' - that she was my most important patient. It kind of ticked me off, the way it was said, and I told them 'sorry, but ALL my patients are important to me'. As I recall, the patient herself was no problem.
Another time, I had family call me into a room before they left, and said, in a very snotty tone 'You make sure you give them a back rub'. I assured them, if time permitted, I would certainly try.
I'm like oramar - I'm done with it now - mine is due to a disability, but if some miracle occured, and my hands became perfect again - I'd not go back to nursing. I'm done with it, and would do anything else.