Let’s face it: Even though we got into the profession because we want to help people, there are times when you just don’t like a certain patient.
The one who smells bad; the one who has an irritating spouse; the one who drones on about how nurses don’t treat her well; the one who constantly buzzes you; the one who complains and complains and complains about the pain no matter how much pain medication you administer; or, the one whose situation is so sad you feel morbid about life, too.
It can be a chore to go back to those patients—especially on units where patients are there for more than a couple days. Knowing what you’re in for, how can you not dread it? Day after day, you secretly hope that they might not be there at your next shift.
But they are, and somehow, you have to get over it. Or how will you survive nursing?
How do you do it? What do you do when you simply can’t stand a patient?
 |
|
|||||||||||
 |
||
search realityrn
sign up for weekly cartoons, tips, and blog posts
Register to win a pair of RX Medical Silver Fox Crocs
|
|
|
 |
October 23rd, 2007 at 10:47 am
before you approach that patient say a prayer and always smile–I am a retired nurse ,and belive me I have encontered a lot of agressiveness in my 50yrs in the profession. Take a deep breath and be pleasant –it works
October 26th, 2007 at 11:22 pm
Fortunately, I work in the OR and it will not be long before that patient is off to sleep!
Which is MY reason for working in the OR!
I do my best work when the patient is asleep…naked…totally vulnerable, and strapped to a table!
Ummm, there could be a problem here. 🙂
Adrienne Zurub,RN,CNOR
‘cardiacbitch’…so what!
Author,’Notes From the Mothership The Naked Invisibles’
http://adriennezurub.typepad.com
October 30th, 2007 at 3:04 pm
I work in long term care so those guys are there everyday and they aren’t going anywhere. I have found that if I treat them like I would have wanted my mother treated (and she WAS one of those that you described above) then it is easier. And if you KILL them with kindness it’s easier on both of you…..
November 3rd, 2007 at 12:37 pm
It is ok to request a change of patient. Some personalities don’t go well together. Sure, some nurses will say we are professionals and should be able to deal with difficult patients, or patients that we just can’t warm to. This is true, but its also true that there is no harm in some cases, changing patients either. What happens when that isn’t an option?
Like a couple of people have mentioned before, being kind is the best way to deal with most things, and giving a thought to how things may look from another perspective.
nursingaround.blogspot.com
November 3rd, 2007 at 8:59 pm
Thanks grannyb, I became a LPN to work with the elderly. I was a hairstylist and loved my elderly patrons and they loved me. I had never been a CNA, and didn’t know the reality of LTC. I am working on my RN and still would like to work LTC, but like every nurse, but especially in LTC, having a mentor sure makes a difference. Thanks
December 3rd, 2007 at 3:46 am
I find the best thing to do is keep a smile on your face. I know it’s hard, but it really made a difference for me. I’m a CNA on a pediatric unit and there is a girl who has been on the floor more often than her home her entire life. Whenever a new person came on she would treat them horribly. She even cussed me out. She did this to me for six months. Then one night she told me I must really love my job because I just keep smiling, despite the fact that she’s treating me like crap. After that she was very kind to me.
It’s not just her either. I find that smiling goes such a long way, especially for the confused patients because they still know what a smile means.
December 3rd, 2007 at 10:23 am
The Unliking Staff?
There’s no such thing as an unlikeable patient. For me, the cause of an ‘unlikeable’ patient, are usually staff who cannot see beyond their chores or daily grind.
Every patient I have privelige to come into contact with brings a story of a life journey in which I get to play but a small part.
I ‘cope’ by maintaining my humility.
As a student I was fortunate to be shown this poem by “Kate”. I shall rant no more and leave the poem to speak it’s own story…
http://www.southerneditorial.co.uk/bulletin/nov05/poem.htm
December 3rd, 2007 at 11:32 am
that is a really awesome poem. I think it would be a good thing for everyone to read, especially those who work in nursing homes.
I’m a nursing student, and last week in clinical I had an elderly woman who had many medical diagnoses, complications, etc. I had to stay up all night the night before just to write down all her information on my student sheets, care plan, and her 31 drug cards. The next morning I get to the hospital and she is screaming in pain (her nurse had just given her Dilaudid), and she doesn’t want “that student nurse to be in here.” She was on contact precautions, which, being a nursing student, means I must be in full ‘garb’ whenever I entered the room. She was full assist EVERYTHING and even set up an elaborate escape attempt (had a family member call her room and talk to me pretending to be physical therapy so I would send her downstairs in a wheelchair and she could make her great escape). When I gave her pills, she chewed instead of swallowed and then looked at me with contempt and said, “now get out.”
There definitely are difficult patients out there, and you DO have a moment or two of dislike for them. I’ve always told people that you may be nice on the inside (“heart of gold” and all that), but how you present yourself on the outside matters too. People can’t help but respond to what they see.
December 3rd, 2007 at 2:30 pm
Ian, in all due respect, are you being completely honest? Surely there is at least one patient you didn’t like. Maybe it was just a clash of personalities, it does happen. It doesn’t mean you are a bad nurse/person. Recognizing that you don’t someone is part of the job, and dealing with it is the other part. You sound too perfect.
nursingaround
December 4th, 2007 at 6:06 am
ok, my friend, let me see…
I work primarily with mentally disordered offenders in a secure environment. This tends to include; violent and aggressive people, a few murderers; occasional rapists; every other one is a ‘Personality Disorder’ or ‘Psychopath’; paedophiles; stalkers; dangerous drivers and people who vote Liberal. (I made one of those up).
I have never met one that did not have a redeeeming feature about them. Putting aside their criminal activity it is all too common to find a real person underneath who, through some misfortune or bad timing, has come unstuck.
Violent and aggressive patients: 9/10 were physically abused by parents. The others were neglected.
Murderers: Generally the victim is a close family member or partner but they were completely insane at the time, often a history of childhood abuse also – and they have to live with that guilt all their natural life.
Rapists: Often victims of abuse themselves or were raised in a household where Dad was law and strict with it to the point of physical violence to the child, Mum was the person who did the cooking, cleaning, washing, etc
PD or psychopath: refer all the examples above plus a little bit of genetics, throw in some disadvantageness like low socioeconomic group, ethnic minority, educational difficulties, etc. and a touch of maltreatment by the psych services who don’t really care that much.
Paedophiles: rarely meet one that wasn’t sexually abused already as a kid – tho some with intellectual impairment cannot form ‘adult’ reltionships or are mentally ill and deusionally thinking at the time of offence.
Stalkers: Often deluded or have trauma related disorders (see above). Several don’t actually wish harm to their ‘victim’ they just invoke fear by their obsessive actions.
Dangerous drivers: Often crisis related incidents or chronic alcoholism if not totally psychotic where judgment is impaired.
Liberal voters: Deluded.
I was never abused as a child, in any form. i know many were and ‘survived’ without becoming criminals or even just ‘obnoxious’ people. However, I cannot set one persons story against the next and judge them for it.
If I couldn’t validate the experiences leading to the crimes for my patients – I’d probably hate every last one of them – but then we wouldn’t need hospitals; we’d lock them up in prison and happily forget about them. But then, I can probably provide the same defense for every person in prison too. We just choose to lock them away because, as a society, we don’t want to take that risk or carry that burden. And why not? We can’t afford it any other way (financially, spiritually or morally).
As a person, I do not condone or agree with their behaviours. I certainly do not like what they have done. However, as a nurse, I am there to treat them to eradicate that risk to them and society and I can’t very well do that if I go around showing them my contempt.
So, if I can understand and validate reasons for these most heinous of crimes, why would I worry about dear old Mrs Jones who just doesn’t like the look of my face when I bring her breakfast?
The issues with many nurses with the ‘unlikable’ patient is that they fail to see how their attitude and approach to the patient makes a difference. Find out why they’re like they are; and I guarantee you’ll find a “Kate” behind every one of them.
No one is born wanting to be grumpy and miserable or a paedophile or a murderer; life experience (and the occasional predisposing pathological or genetic factor) makes them that way and people respond better to you through kindness than they do through resentment or confrontation.
Perhaps this little Aesop fable may enlighten? 🙂
http://tomsdomain.com/aesop/t3n10.htm
December 4th, 2007 at 1:38 pm
You still miss my point. I’m not talking about the criminally insane, I’m talking about regular Mr/Mrs Blogs, who you just don’t connect with. There doesn’t even need to be a reason. It’s only a matter of time before you come across someone you don’t like. It’s part of being human.
All I’m saying is that it is ok not to like a patient, just as long as you do your job effectively. Sure, it does help when there is a good rapport with a patient, and yes, I should be holistic and think of the emotional well-being etc, and I do that, but you must have the occasional patients you don’t like.
On the opposite side, I remember looking after one patient for a whole month, and actually got on well with the guy, but I was never told that he was a child molester until after all that time. It was a strange emotion that passed through me that day when I saw the guy. I wondered how it was possible to get on with the a guy who could do such horrific things. Appearances can be deceiving.
Anyway, I find you just a little to faultless. Go on, I dare you to admit to not liking a patient.
Regards
Bryn
December 4th, 2007 at 3:41 pm
I am a nurse extern while I am finishing my last year of school. I specifically want to work nights because people are sleeping most of the time! I really think what bugs me the most are demanding families. You may have 5 patients but in each room you have 3 or 4 people, you end up having 20 people you are trying to look after! If people have a genuine complaint about something, then I’d like to hear it, but I really have a hard time dealing with these difficult patients. I know that people are often not themselves in the hospital (at least I hope they aren’t like that all the time!), but I definitely can agree that personality clashes will happen.
With patients like that, I try to cluster my care so I can be in there for a few minutes and they can complain and gripe away and then when I’m done in 10 minutes, it’s over!
December 12th, 2007 at 12:20 pm
As a nursing student, I realize that I have much to learn about dealing with difficult patients. This last semester I was assigned a patient on a med-surge floor who was known to be “contrary”. The staff nurse taking care of her was relatively fresh out of school too (just over a year), and the two of us were trying to take care of this woman without much success.
When the lunch tray arrived we had just finished giving the patient her insulin coverage and were trying to convince her to take her other PO medications when she threatened to hit the staff nurse with a green bean. We both had to excuse ourselves to giggle outside the room before going back and finally convincing the woman to take her medications and eat her lunch.
I mentioned this to my clinical instructor (who had been a CNA for 10 years before her 10 years as an RN) and sarcastically thanked her for giving me such a difficult patient. The next time I had to go into her room that day, my clinical instructor went in with me. I was amazed at the change in attitude the patient had with my instructor! She was nice, willing to communicate, and cooperative – all because my instructor held her hand for a little bit while talking to her!
With all the stresses of school work and the preparation required of me for each clinical day, I had been feeling sort of disconnected with why I had chosen to go into such a difficult profession; I had lost the reason and was just focusing on the “gotta get through it”. In those few minutes I watched my instructor interact with my patient, I remembered why I was doing what I was doing, and actually got to witness what the nursing profession really is. Taking the time to connect to that “difficult” patient and make them feel better, make them feel valued, make them feel that you really care.
Since then, whenever I find I’m having a problem connecting with a patient or come to the conclusion that I just don’t like them, I think of that day and try to bring the spirit of my clinical instructor to my interactions with the current patient (and then I thank my lucky stars that I only have to deal with them once!!).
December 22nd, 2007 at 10:19 pm
“Difficult patients” do not exist. Difficult needs do.
If patients are requiring extra input or support and you find that it is above the norm; maybe they’re scared to death that they’re about to get an anaesthetic and might not live? Maybe they’re worried who’s looking after the dog at home? Maybe they’re just not used to being in hospital and live at home with a very supportive partner who does everything for them? Maybe, even, they’re petrified of the ‘difficult staff’ who worked the shift before you and need some TLC to perk them up again? Even if you think they’re doing it just to be deliberately annoying – why would they do that? There must be a reason – perhaps the ‘difficulty’ started because you were the nurse on shift before who just ‘skimmed over’ their care to prevent spending any more than barely necessary. This is merely prolonging and exacerbating the problem.
However, reading admoore14’s post kinda puts my point across succinctly – 2 minutes spared in kindness or understanding prevents 20 minutes wasted in conflict. The more ‘difficult’ the patient; the more kindness I feel is required. It’s like we do to maintain homeostasis when we inject insulin, apply a respirator or administer pain relief – but providing a balance of the psychological/emotional kind where indicated.
It’s called holistic care.
..and dear Bryn,
It comes down to this; I’m paid to like patients. As a nurse I do that because I am in my nursing persona.
Yes, as a human there are people I do not like. Mostly these are politicians, misogynists and people who blame others for their faulty behaviour.
No, as a nurse there are no patients I do not like. It says so in my code of ethics. 🙂
February 27th, 2008 at 2:42 am
I just wanted to share the nurses response to the Crabbit Old Woman.
A Nurse’s reply
“To the ‘Crabbit Old Woman”
What do we see, you ask, what do we see?
Yes, we are thinking when looking at thee!
We may seem to be hard when we hurry and fuss,
But there’s many of you, and too few of us.
We would like far more time to sit by you and talk,
To bath you and feed you and help you to walk.
To hear of your lives and the things you have done;
Your childhood, your husband, your daughter, your son.
But time is against us, there’s too much to do Patients too many, and nurses too few.
We grieve when we see you so sad and alone,
With nobody near you, no friends of your own.
We feel all your pain, and know of your fear
That nobody cares now your end is so near.
But nurses are people with feelings as well,
And when we’re together you’ll often hear tell
Of the dearest old Gran in the very end bed,
And the lovely old Dad, and the things that he said,
We speak with compassion and love, and feel sad
When we think of your lives and the joy that you’ve had,
When the time has arrived for you to depart,
You leave us behind with an ache in our heart.
When you sleep the long sleep, no more worry or care,
There are other old people, and we must be there.
So please understand if we hurry and fuss
There are many of you, And so few of us.
February 27th, 2008 at 2:44 am
I forgot to note –
The author of the Nurses Reply was written by Phyllis McCormack
February 27th, 2008 at 2:48 am
Whoops actually the Author of the reply is Liz Hogben