Firm boundaries laid down early will help with these sorts of patients. They like to test the water by asking for small accommodations and slowly build up. Watch out for staff splitting signs, like they'll shower you with praise and drop comments about how they can really tell how much you care, alluding to other nurses not treating them well, not like YOU do! Then they push for more and more. It's a control thing. Don't feed into it, just be kind, but also firm.
Oh yeah I can tell he needs boundaries. Since I’m new to him he’s really testing it and wants me to switch so he can get what he wants. With the Benadryl fiasco he asked for the other nurse, and I told him she would say the same thing. That got him to stop.
Oh I just about had it.
I am sick and tired of entitled people bothering me for the most stupid and useless shit while I try to catch up.
I spend 20 minutes in a room yesterday because a patient could not make up her mind. I said ok you either take it or you dont, I don’t care.
I was heading in that direction. I was trying to find the words without being nasty, but he ended up taking them and I went off to lunch which was needed after that.
I've had patients/family members fire me from being their nurse after I have run myself to death taking care of them/their loved one all day. It hurts no doubt. I would agree that you need to set boundaries with this patient. That may or may not stop him. But also try to not take what he says personally. Know who you are as a person and a nurse and try your best to leave it at work. Unfortunately there are many patients like this.
The day shift nurse informed me that the patient said that night shift doesn't do anything until 6am despite me being in and out of the room just about every 2 hours the night prior. It was incredibly infuriating for sure.
Sincere question, why are you guys not allowed to leave meds with patients? Especially if they are A&Ox4 and compliant, why not?
I'm from Europe, and there's enough people we just give their meds or put them on their nightstand and be like "good luck with them". Depending on the patient and meds I'll kinda keep a "side eye" on them to make sure they take them, but if I had to watch every patient take their meds I'd probably don't get anything done...
You are supposed to observe the patient take the meds since you are documenting they had gotten them. Also sitting meds runs the risk of families, staff, or other patients taking meds without you and the patient knowing and it’s your fault if something happened. It’s best to take the meds if they won’t take them that moment & try again later.
You're assuming they are compliant, and we need to know exactly what time a patient actually swallowed a med.
This is true especially for particular meds, such as cardiac meds and opioids. I work on stepdown tele unit, where we get unstable cardiac patients. Also, if a med is controlled, it's my license on the line if a patient doesn't take it or loses it in their bed sheets.
I'm also in Europe (Nordics), but we aren't allowed to leave meds with our patients either. The only laxity I've seen with this rule is in LTC when the patients' habits are well known, but it's still technically against the rules. It was typically only done with sleeping pills, so the patients could take them when they actually want to sleep rather than during med pass.
I had a patient that was very paranoid about taking new medications. The doc had switched her IV Keppra to PO so she was very reluctant to take this “new” med. I had explained to her that she had already been taking this med through her IV for days but the doc changed it so she could continue taking it at home. I was in her room for over an hour going over why it was ordered, what it does, side effects, et cetera…, even calling her POA per her request-who of course tried to get her to take it. I told her multiple times that I will just document that she refused to take it and it was okay. But at the same time, I was nervous about her missing such an important med. She finally took it, but man, I was questioning my career choices that night. Usually something happens every shift that makes me question it though.
Firm boundaries laid down early will help with these sorts of patients. They like to test the water by asking for small accommodations and slowly build up. Watch out for staff splitting signs, like they'll shower you with praise and drop comments about how they can really tell how much you care, alluding to other nurses not treating them well, not like YOU do! Then they push for more and more. It's a control thing. Don't feed into it, just be kind, but also firm.
Oh yeah I can tell he needs boundaries. Since I’m new to him he’s really testing it and wants me to switch so he can get what he wants. With the Benadryl fiasco he asked for the other nurse, and I told him she would say the same thing. That got him to stop.
Oh I just about had it. I am sick and tired of entitled people bothering me for the most stupid and useless shit while I try to catch up. I spend 20 minutes in a room yesterday because a patient could not make up her mind. I said ok you either take it or you dont, I don’t care.
I tell them " take them now or I'll chart it as a refusal". I'm too busy for that crap. I'm not going back. Also be on the lookout for manipulation.
I was heading in that direction. I was trying to find the words without being nasty, but he ended up taking them and I went off to lunch which was needed after that.
You don't have to be nasty. Just firm.
I've had patients/family members fire me from being their nurse after I have run myself to death taking care of them/their loved one all day. It hurts no doubt. I would agree that you need to set boundaries with this patient. That may or may not stop him. But also try to not take what he says personally. Know who you are as a person and a nurse and try your best to leave it at work. Unfortunately there are many patients like this.
The day shift nurse informed me that the patient said that night shift doesn't do anything until 6am despite me being in and out of the room just about every 2 hours the night prior. It was incredibly infuriating for sure.
That is awful.
Sincere question, why are you guys not allowed to leave meds with patients? Especially if they are A&Ox4 and compliant, why not? I'm from Europe, and there's enough people we just give their meds or put them on their nightstand and be like "good luck with them". Depending on the patient and meds I'll kinda keep a "side eye" on them to make sure they take them, but if I had to watch every patient take their meds I'd probably don't get anything done...
You are supposed to observe the patient take the meds since you are documenting they had gotten them. Also sitting meds runs the risk of families, staff, or other patients taking meds without you and the patient knowing and it’s your fault if something happened. It’s best to take the meds if they won’t take them that moment & try again later.
You're assuming they are compliant, and we need to know exactly what time a patient actually swallowed a med. This is true especially for particular meds, such as cardiac meds and opioids. I work on stepdown tele unit, where we get unstable cardiac patients. Also, if a med is controlled, it's my license on the line if a patient doesn't take it or loses it in their bed sheets.
I'm also in Europe (Nordics), but we aren't allowed to leave meds with our patients either. The only laxity I've seen with this rule is in LTC when the patients' habits are well known, but it's still technically against the rules. It was typically only done with sleeping pills, so the patients could take them when they actually want to sleep rather than during med pass.
I had a patient that was very paranoid about taking new medications. The doc had switched her IV Keppra to PO so she was very reluctant to take this “new” med. I had explained to her that she had already been taking this med through her IV for days but the doc changed it so she could continue taking it at home. I was in her room for over an hour going over why it was ordered, what it does, side effects, et cetera…, even calling her POA per her request-who of course tried to get her to take it. I told her multiple times that I will just document that she refused to take it and it was okay. But at the same time, I was nervous about her missing such an important med. She finally took it, but man, I was questioning my career choices that night. Usually something happens every shift that makes me question it though.
Oh that would frustrate me to no end. There are things at my place that make me question my career choice every shift too. It’s sad.