Your most difficult patient and how you turned it around

Nurses General Nursing

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This is a question for those experienced nurses. We would all like to be empathetic to our patients. Many are scared, besides being sick and they and/or their families may want us more running out of the room than to help, which is not an option.

Give us a time when you were able to take that most difficult patient:angryfire and tell us how you were able to turn that around:) .

Thanks in advance.

Specializes in Medical.

If I've ben busy and can't get to the patient soon after they buzz, I apologise for keeping them waiting as I enter the room. Almost without exception they say they understand that we're busy.

Of course, half the time this is a lie, as proved by the fact that they then want a hundred things done, and tell tedious, long, pointless stories, but at least they're not angry :)

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Specializes in Medical.

If I've ben busy and can't get to the patient soon after they buzz, I apologise for keeping them waiting as I enter the room. Almost without exception they say they understand that we're busy.

Of course, half the time this is a lie, as proved by the fact that they then want a hundred things done, and tell tedious, long, pointless stories, but at least they're not angry :)

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This is why I like ventilated pts!

But seriously, If sitting and talking doesn't make things better, I "kill'em with kindness" (not literally). It's hard for most people to be mean or angry with someone who's being nice. And besides, being nice will keep you in a good mood, not angry or frustrated. It's hard enough dealing with difficult pts. :)

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This is why I like ventilated pts!

But seriously, If sitting and talking doesn't make things better, I "kill'em with kindness" (not literally). It's hard for most people to be mean or angry with someone who's being nice. And besides, being nice will keep you in a good mood, not angry or frustrated. It's hard enough dealing with difficult pts. :)

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Give us a time when you were able to take that most difficult patient:angryfire and tell us how you were able to turn that around:) .

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Had a patient, who was admitted for back surgery, developed several post op complications, and had been hospitalized for 4 months. Pt. was very angry and verbally abusive.

The first evening I took care of her, I notice that her care plan included several dressing changes/ meds/ IV tubing changes in the middle of the night. I asked her if she was getting any rest at due to the frequent wakenings. She said she wasn't getting much sleep at night. I asked her what I could do to make the nights easier on her. We came up with a plan that I would only wake her once during the shift to d0 all of her needed care, instead of coming in every hr or so. We also agreed that I would not wake her up to give her pain meds, unless she specifically used the call bell and asked for them. She told me she had no problem with me charting that she had refused her evenng pain meds unless she did actually ask for them.

I found that after a few days of this routine, she became cooperative and a lot nicer person. I even enjoyed taking care of her.

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Give us a time when you were able to take that most difficult patient:angryfire and tell us how you were able to turn that around:) .

------------------

Had a patient, who was admitted for back surgery, developed several post op complications, and had been hospitalized for 4 months. Pt. was very angry and verbally abusive.

The first evening I took care of her, I notice that her care plan included several dressing changes/ meds/ IV tubing changes in the middle of the night. I asked her if she was getting any rest at due to the frequent wakenings. She said she wasn't getting much sleep at night. I asked her what I could do to make the nights easier on her. We came up with a plan that I would only wake her once during the shift to d0 all of her needed care, instead of coming in every hr or so. We also agreed that I would not wake her up to give her pain meds, unless she specifically used the call bell and asked for them. She told me she had no problem with me charting that she had refused her evenng pain meds unless she did actually ask for them.

I found that after a few days of this routine, she became cooperative and a lot nicer person. I even enjoyed taking care of her.

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Specializes in Medical.

Sleep really isn't valued enough - the hospital environment isn't conducive to rest as it is, and then we wake patients for meds, IVs, obs, catheter and drain measurements, pressure care...

Of course some of this is more important than their getting sleep, but I don't think we look at grouping activities enough, or doing as hipa did and asking the patient what they'd prefer.

Most of our patients are in two bed rooms - I try to group overnight activities for both patients if possible, and stagger drug or ob times so they coincide, but it's not easy.

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Specializes in Medical.

Sleep really isn't valued enough - the hospital environment isn't conducive to rest as it is, and then we wake patients for meds, IVs, obs, catheter and drain measurements, pressure care...

Of course some of this is more important than their getting sleep, but I don't think we look at grouping activities enough, or doing as hipa did and asking the patient what they'd prefer.

Most of our patients are in two bed rooms - I try to group overnight activities for both patients if possible, and stagger drug or ob times so they coincide, but it's not easy.

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i agree that validation and empathy go a long way in softening most situations.

but one must acknowledge those patients that are not a&o x3, and just are incapable of understanding any sort of reasoning.

one time i had a male dementia pt. (his dx stated dementia/with agitation which was an understatement). he was pretty young and also did not speak/understand english.

every time i did a fingerstick on him, his whole hand would totally crush mine as if he were trying to break it. (did i tell you he was extremely muscular and brawny?)

and he wasn't even being combative when he did that.

we seemingly established a mutually trusting relationship where he would let me do what i needed to do with him.

when i had to pack his ulcers, i would show him the supplies, letting him know what i was about to do.

one day as i packed one of his openings, he managed to grab the top of my head then get me in a head lock!

this was 2 minutes after he had smiled in love at me.

thank goodness i leave call lights at the bedside, which i frantically pushed that red button 1000 x's.

it took 4 people to unlock his arm around my neck.

and when i was finally released and other nurses came to finish the dsgs,

he actually blew me a kiss goodbye and waved. (something i had taught him :rolleyes: )

in summary, there are some you just cannot turn around. :chuckle

leslie

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i agree that validation and empathy go a long way in softening most situations.

but one must acknowledge those patients that are not a&o x3, and just are incapable of understanding any sort of reasoning.

one time i had a male dementia pt. (his dx stated dementia/with agitation which was an understatement). he was pretty young and also did not speak/understand english.

every time i did a fingerstick on him, his whole hand would totally crush mine as if he were trying to break it. (did i tell you he was extremely muscular and brawny?)

and he wasn't even being combative when he did that.

we seemingly established a mutually trusting relationship where he would let me do what i needed to do with him.

when i had to pack his ulcers, i would show him the supplies, letting him know what i was about to do.

one day as i packed one of his openings, he managed to grab the top of my head then get me in a head lock!

this was 2 minutes after he had smiled in love at me.

thank goodness i leave call lights at the bedside, which i frantically pushed that red button 1000 x's.

it took 4 people to unlock his arm around my neck.

and when i was finally released and other nurses came to finish the dsgs,

he actually blew me a kiss goodbye and waved. (something i had taught him :rolleyes: )

in summary, there are some you just cannot turn around. :chuckle

leslie

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