Your Most Maddening Patient/Patient's Family Situation

TheCommuter, BSN, RN · Jun 4, 2012

A badly overweight female patient was admitted after a major CVA. She was flaccid on both sides, dead weight, very heavy, totally incontinent, and required anywhere from three to four people for transfers from the bed to the wheelchair or toilet. Her daughter spent the night, rode the call bell, and demanded that staff get her up to the toilet hourly. She didn't urinate or defecate at the toilet during the vast majority of these hourly 'get-ups,' but it caused undue physical and mental strain on our already short-handed staff.

I also had the demented elderly gentleman who pressed his call light every 15 minutes for various requests: "Fluff my pillow!" "Rub my feet!" "Gimme a sip of water!" "Turn me!" "Change my channel!"

I cannot forget to mention the family members who were threatening staff because they know we do not have security: "You haven't seen crazy yet!" "Don't mess with me!" "I will blow this place up!"

dudette10, MSN, RN · Jun 4, 2012

There is one type of patient that really gets under my skin, and it isn't the type that everyone would say, "Yeah, that gets me, too."

It's the LOL dementia patient, alert and oriented x 1 that will fall flat on her butt if she tries to walk around (which she always wants to) because she's lost every bit of awareness of her own limitations. I took care of a family member with dementia for a number of years, and the personal experience is what makes me loathe--yes, loathe--those assignments. I became sick and tired of having to enter a fantasy world where folding towels and other banal busy-ness became the most important job in the world just to keep someone safe! Unfortunately, my personal experience has made me the go-to girl for those exact types of patients. (Or maybe because no one in acute care wants them, either.) I should be an Oscar-winning actress with how much I can put on a good face for situations that I just want to run away--screaming--from!

While the alert and oriented x 4 that demand everything under the sun can get on my nerves mightily, at least there is a pattern to their needs, I can anticipate them, and it's not some far-flung imaginary world where home is just down the hallway and someone long-dead is waiting to be seen.

Ok, that was a rant. I feel better.

dirtyhippiegirl, BSN, RN · Jun 4, 2012

This is going to sound really weird and specific but I hate, hate, hate those post-extubation patients who complain about how much their throat hurts and NOTHING helps. Ice water doesn't help. Throat spray/lozenges don't help. 2 mg of IV dilaudid doesn't help!

Nothing helps. You had a tube down your throat for hours/days/weeks. It's going to hurt for a while. Yet the patient is still calling me in to complain at least once an hour, and looking at me like I can pull some magic pill out of my butt that will make their throat pain go away.

Same goes for patients who are NPO and complain constantly about how thirsty they are. I know you're thirsty. It sucks. Get over it. Complaining to me about it every time I walk into the room isn't going to change anything. You're still NPO.

allnurses Guide · Jun 6, 2012

Oh, you should have seen the two dear daughters I dealt with Sunday.

As soon as I got home, I cracked a beer.

I was gracious the whole time and gladly called the doc on his cell and hooked them right up!

Hey, if they want to complain about what Dr. So and So is or isn't doing, then they can talk to the doc directly.

I get tired of taking the hit for the doctors all the time!

JZ_RN · Jun 7, 2012

Had a middle aged guy dying from AIDS one time who refused to tell his family the dx, including his wife and kids. I called the ethics committee at the hospital but left before any outcome was reached so I dunno what happened. And they were so upset that we were just "letting him die" and were mad that we wore full face shields, gloves, and gowns.... we did it 'cause he'd spit at us. No thanks. Infuriating.

redhead_NURSE98!, ADN, BSN · Jun 8, 2012

OMG, I think this thread should get as big as the "things you'd like to tell patients but can't" thread.

1. It chaps my butt when a family member strolls in midday and is like "DON'T YOU ALL CHANGE THE SHEETS AROUND HERE?"

"Well ma'am, we've asked your ambulatory, alert and oriented husband if he wants to get cleaned up, or even just get out of the bed for five minutes so we can change his sheets, and he refused, twice."

"WELL BOB YOU DIDN'T TELL ME THAT WHEN I ASKED YOU!" No, you just asked, "didn't they change the sheets" and your hubby played ignorant and neglected. Wahhh.

2. The family member who "is a nurse" (i.e. works on a cleaning crew at another local hospital, and yes I've taken to looking people up on the board of health website by name when they say they're a nurse, 3/4 of the time they're not listed), comes in mid-morning sticking their thumb in everything for 25 minutes complaining, asking questions and making ridiculous demands, and then promptly disappears for the day;

3. The family member who knows full well we change shifts at 7/7, but calls at 7:10am/pm to quiz the new nurse on shift, who has few answers for generic questions like "how'd she do last night?" Well ma'am, I was in bed last night so as far as specifics are concerned I have no idea how they did. They're still alive, is that the answer you're wanting?

4. Family members who act like their relative is dying when they come in for a lap appy or a ureteral stent...then wanting to know "success rates" uh, define success please. I mean, you don't have an appendix anymore, I'd call that successful.

Finally, I had a wife last week that, on my first entrance into the room, said "He better be going home today. I'm supposed to be home recuperating from surgery, not here sleeping on an uncomfortable bed." I literally had been in the room two minutes. I did tell her she was welcome to go home and sleep wherever she wished, since her husband (again, stable, ambulatory, alert and oriented) was the patient.

Mia_2011 · Jun 8, 2012

I had a patient one day who was waiting to be cleared and scheduled to have hip replacement surgery. Daughter at bedside from shift change, making sure to ask for the patient's pain medications round the clock. I even tried telling the daughter that their loved one was fully alert and capable of reporting pain and that THE PATIENT needed to request her medications.

I would ask the patient how their pain level was and they would respond "I'm fine no pain, just uncomfortable" (we had them in bucks traction), so I told patient that when they needed pain medication to call. Ended up administering pain medication 3 times during the course of shift before patient was even scheduled to go to surgery.

The daughter had not left beside at ALL through the day and I walked in to her on the phone complaining to someone that I was ignoring their loved one's pain and I had not administered ANY medication at all. All be it I am walking in to administer the third dose of IV pain medication. Anyway, as I finish up administering, I wash my hands, and literally as I am walking out of the room my phone rings...The woman on the other end of the line goes "Are you so and so's nurse?" I said yes, and she immediately started cursing me out telling me that I was a horrible nurse for completely ignoring their loved ones pain and that she was going to report me for negligence". I ended up cutting the woman off mid sentence and said " I just gave your loved one pain medication, I have given them now three doses of it throughout the day, and I will not tolerate being spoken to like that" and the woman on the other end of the line goes "that's not what my sister told me. She told me you haven't given her anything!"

I was so annoyed with this entire family by the end of my shift that I ended up requesting to not be assigned the next morning.

redhead_NURSE98!, ADN, BSN · Jun 8, 2012

I do SO enjoy when the patients and family members lie to other family members like that. "Ah been here FIVE DAYS and haven't had mah sheets changed!" (they've been here 3 days, and I've just changed their sheets personally 2 hours ago). I can't imagine their motivations, other than they enjoy drama in their lives. I call them out, every single time, and ask them if they are confused as to what has gone on today.

Beach23 · Jun 9, 2012

I love these posts. The joys of working on the floors. I personally just love when the repeat ETOH patient comes in eats three meals a day, (your lucky i get one meal in in 12 hours) and still doesn't get cleaned up. Gets IVF, benzos and then leaves AMA No problem. I'm glad we made you comfortable and we will see you back in the ED for c/o chest pain and do it all over again..

Catch22Personified · Jun 9, 2012

I already gave report and clocked out ready to leave but then I hear an overhead page; I responded to a Stat/Unresponsive patient that was near my permanent assigned unit. While I was pumping the ambu bag, some crazed family member waving her camera phone was yelling about her husband not being changed or something and threatening to report us for neglect.

Honestly there is a patient with no pulse right now and you are bothering us over something this trivial? What scares me most was, it was discovered that this family member was actually abusing the patient, so I guess she was putting this facade that she cares.

I've noticed the families that care most for their loved ones are very involved in their care, do not harass staff members every waking moment, and DO NOT interrupt people during life threatening situations.

PeepnBiscuitsRN · Jun 10, 2012

I have a new one now, the family member or nursing home that dumps the totally disoriented, end stage Alzheimer's patient off in the ER. On arrival to our floor we don't know jack squat about him, he's not only ES Alzheimer's, but he's aphasic, a shouter, a feeder/turner- but strong enough to try to get out of bed repeatedly....and the family didn't have time to discuss their father's condition or medical history...or code status, ergo he's full code.

Or the family who's loved one is just like the above mentioned patient...and the family pulls out all the stops- keep her full code! Oh heck yes go ahead with the feeding tube! Intubation? Please, yes!