Difficult Patients

There are so many types of patients in the world. They can be pleasant and cooperative, demanding and manipulative, rude and aggressive, confused, psychotic, etc...

Patients that I have found particularly difficult to deal with are those who are demanding and manipulative, and those who are rude and aggressive. I mean, look, you are in the hospital because you're not feeling well, so just blooming do as you're told.

My recent weekend on -call was probably one of the least busy ones. However, the amount of difficult patients I have to deal with was really pushing me to my limits, and I could feel myself losing my patience. One of the example was this:

I was paged multiple times by fellow nurses in a particular ward about this gentleman, who claimed that he was not seen by a doctor for 4 days. He has threatened to take an irregular discharge, and he was being really rude to the nurses. He has also been self-medicating in the ward (which is not allowed in the hospital environment). I was told that he was seen by the junior house officer the day before, who tried to reassure him, but he has refused to listen to him. He had insisted of seeing a senior medical doctor. Therefore, I was called along.

When I arrived, he had all his bags packed (but was still in his sleeping robe!). I looked through the notes, and I found 2 entries (one by the consultant looking after him on Thursday and another by a senior doctor in the same team). The last entry was on Friday. Remember that it was the weekend...and in this hospital, no formal ward rounds take place...and only patients who are acutely unwell, would be reviewed. So, the whole crisis about he "was not seen" was a total farce.

I introduced myself and apologised for taking such a long time before I had the time to see him. He accepted my apology. BUT, then came verbal diarrhoea of what he was not happy about. He was unhappy about this medications. He demanded to have a few of his medications that were stopped because of his worsening kidney function. He was unhappy about the way the nurses are treating him. He was unhappy about the fact that he is a medical patient in a surgical ward. He was unhappy about why his consultant has not been to see him over the weekend...etc...the list went on and on. He said I should have got the consultant to review him.

I got pretty fed up, to be honest. Who are you to tell me what to do? You are a patient, and you should do as you're told. If your allegations were true, then I'm happy to accept your complaints...but the fact was, none of them were!

Anywho, I could only apologised, and explained why his medications were not given, and stressed to him that it is the weekend, and only very limited medical team are on site.... gosh...it took me like an hour just to keep him happy! I could have used my time to review other sicker patients.

I suspect what might happen at the end of day is, he may well file a complaint. I remembered reading through one of the complaint letters addressed to a particular consultant.

"I am happy and satisfied with my medical care. But I am outraged that I was given a soup spoon to eat my porridge, and the trousers that the nursing staff provided me with (as I did not have any of my own) did not fit. It was too big!"

I laughed when I read that....what kind of complaint is that?? What is the problem between using a normal spoon and a soup spoon to eat your porridge...it is just the same. And, I think he was lucky enough to be provided trousers to put on before discharge.

Patients....what can I say? I guess it makes my job colourful.

*my apologies in advance to any patients who got offended by reading this post.