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10 Terrible Patients You’ll Find In Every Hospital …And How To Deal With Them
Topic: Health Care

Ever wondered what made Nurse Ratched so mean in One Flew Over the Cuckoo’s Nest? It could have been the terrible patients she was forced to deal with on a daily basis at her mental health hospital. While it’s probably true that most people you’ll encounter in your facility will be normal, you’re bound to encounter some bad eggs from time to time. A bit of humor can help get you deal with these hospital hell-raisers.

1. The Paranoid
Similar to the Hypochondriac, the Paranoid thinks that you, not an intestine eating super-virus, are trying to kill him. He’ll hide under the covers every time you enter the room — even if you’re not carrying a foot-long needle. Since the Paranoid patient will be scared of you no matter what, try saying a line from a different horror movie each time you enter the room. Some suggestions: “They’re coming to get you Barbara,” (from Night of the Living Dead) while holding out you arms and rolling your eyes back like a zombie; or “One, two, Freddie’s coming for you,” (from Nightmare on Elm Street) while toting a small chalkboard and some fake nails.

2. The Penny Pincher
Every time you go to give the Penny Pincher a procedure, they pull out their bank book and ask how much it’s going to cost. It’s a legitimate concern if this person doesn’t have health insurance or if he or she is on Medicaid, but otherwise, what’s the issue? The next time you’re wheeling the Penny Pincher out for their spinal tap and he or she mutters about the money, launch into the story about the woman in Poughkeepsie who paid for her leg amputation with a year’s supply of her famous chocolate-chip peanut-butter cookies to her surgeons.

3. The Hypochondriac
The doctor diagnoses them with pneumonia, but they swear it’s cancer. You tell them to expect pain after the surgery, but they attribute it to a fatal blood clot. There’s no talking a Hypochondriac out of his or her death wish, but have some fun with them by pretending to have a serious talk about their “condition.” Sit down on the patient’s bed and say, “I’m sorry to tell you this Chuck, but you have Hypochondria.” See how long it takes to register.

4. The Complainer
Whether it’s about their care or their chicken pot pie dinner, this type of patient plans to run you up the wall with their whining. You’ll never be able to address all of this person’s grievances, so don’t waste your time consoling them. Instead, add a bit of sunshine to a Complainer’s day by listing all of the other things that could be wrong with his or her health and their situation. For instance, if the patient laments not having their IV tube cleaned, say, “It could be worse – it could be your soiled bedpan.”

5. The Talker
Five minutes into a conversation with Talkers, you’ll know their vital statistics, mother’s maiden name and the time they almost got run over by a car — when they were five years old. The Talker’s verbal vacuum will suck anyone in and render them helpless. Fend off the chatty cyclone by feigning deafness/an ear infection/ laryngitis or any other ailment that will hinder or at least lessen the painful impact of their self-centered conversation.

6. The Flirt
The Flirt cares not that you’re in scrubs, not a short skirt and stilettos — he will still find ways to talk about your anatomy to get a date. Short of saying you’re not interested, married, gay or a heartbeat away from filing a sexual harassment charge, remind him that the last patient that made a pass at you now lives at the county mental hospital.

7. The Know-it-All
“Geez, Nurse Mark, I really think that I could do a much better job inserting that catheter,” says Omnipotent Oliver. You’ll never do right by Know-it-Alls, so take it lying down — literally. When you get patients like this, coax them out of bed, lie down in their place and tell them to administer treatment to you. Then make a bet with yourself on how many seconds it’ll take before they throw up their hands and start crying.

8. The Mind Changer
One minute she’s hot, the next she’s cold. First, she wants brown slop for dinner, now she wants green. In addition to being Al Gore’s best friend, Mind-Changers send you scurrying in several different directions throughout the duration of their stay. Put a stop to the indecisive insanity by not giving them any options — whatsoever. They’ll get the hint when they’re getting wheeled in to their leg amputation surgery even though they checked in for appendicitis.

9. The Needer
The Needer constantly wants another cup of water, extra blanket, lower heat, but, most importantly, your presence every minute of his or her stay. This person is probably in several
co-dependent relationships in his or her normal life and is used to getting constant attention. You can use a dual-nurse approach for this patient. Saunter into the Needer’s room with a coworker and upon hearing his or her first request, say to the other nurse, “Did you hear something?”

10. The Deal-Maker
“If I keep this IV in, can I leave a day earlier?” would be an inquiry uttered by this type of patient. They’ll wheel and deal for just about anything, whether it’s extra butter on their mashed potatoes or after-hours visitors. The simple way to deal with the deal-maker
is by using uncomfortable/embarrassing procedures as a bargaining chip. Tell them if they can keep a lid on it for a day, you’ll ask the doctor to put the needle in the arm, not the “other area.”

Though their conditions may be serious, laughter may be the ticket to tackling terrible patients. These personalities are no match for an experienced nurse who can move past their pestering ways. Greet each one of these patients with a needle and a nice smile.

A firefighter, Tim from Norfolk, Virginia wrote to me a few days ago. He read Rescuing Providence and wanted to say hello. Our departments are similar, Norfolk and Providence both respond to about 40,000 calls per year with similar populations. One difference we noticed, Norfolk runs with eleven rescues, Providence, six. Both departments have the same amount of fire apparatus, Norfolk about fifty more firefighters.

Tim tells me they need more ambulances, the amount of calls overburdening their resources nearly every day. Same here, only worse. Every day we go through the same drill, non-stop calls, not enough resources. All we hear is how the city and state need to cut back, there is no money to support our fire department. Make do with less, we’re told.

I wonder when or if we’ll figure out a way to make this system work.

I had always thought that if people had a better understanding of just what it is that firefighters and EMT’s actually do for a living some of the resentment about our pay and benefits could be lessened. The book, Rescuing Providence describes a few days in my life. People who read it take with them a feeling that their tax dollars delegated for public safety is money well spent.

While listening to the open forum segment of the Matt Allen Nation, www.630wpro.com
I heard what used to be a typical caller complaining about all the firetrucks and rescues shopping for food at the supermarket. The caller didn’t think it fair his tax dollars were being wasted so a bunch of firefighters could do their shopping on his dime. Matt handled the caller respectfully, suggesting that if he had a problem he should call City Hall, but also telling the caller that the guys in the trucks are still on call and will drop everything if their radio goes off.

Years ago this talk show host had a terrible experience at a Pro Labor rally. Talk shows are traditionally right leaning, in this area anyway, and the reception given to Matt and Dan Yorke, who was the on air personality at the time was less than respectful. A bunch of firefighters gathered around the broadcast booth and banged one of the bagpipe bands drums and shouted so loudly it interrupted the broadcast. As Matt was to say later, “I have seen pure evil,” when talking about the rally and the participants. Things do get ugly at some of those rallys. I grew up in a union household and firmly believe in them. Sometimes our methods convey the wrong message.

I was glad to hear Matt tell a later caller that anybody who read the book, Rescuing Providence wouldn’t complain about a rescue at a supermarket.

Thanks, Matt, for not holding a grudge.

The steps were wide, perhaps six feet across. An inch of snow covered the treads, I saw foot prints lead to our patient, a forty-five year old female.

“I’ve got two witnesses,” was the first thing she said, followed by,

“I told the landlord to take care of these steps. He don’t do nothin but take money.”

“Can you move?” I asked.

“No.”

“Can you wiggle your toes?”

“No.”

“Can you feel your legs?”

“No.”

Great.

Ladder five’s crew managed to get her onto the longboard and stretcher. I asked one of the “witness’s” what happened.

“She fell down the stairs.”

I looked at the six steps. The footprints went directly to the indentation in the snow where we found the patient. The snow on the steps was uninterrupted other than the footprints.

I grabbed the bottom of the stretcher and lifted my end. The three-hundred pound woman felt like six as the stretcher, and my back groaned under her weight. Her cell phone rang, she answered, told the person on the other end to “talk to the paramedic, I’m being rushed to the hospital,” and handed it to me.

“I thought you couldn’t move,” I said.

The folks at Rhode Island Hospital knew her name before I said it. She’s a weekly visitor. Nothing like sacrificing the body to keep our citizens safe. Or, in her case, to make a little money.

The Comfort One protocol spares terminal patients the indignity, pain and discomfort of life saving efforts by EMS personnel. Patients can opt for comfort measures only during their last days or hours. No CPR, no intubation, no IV’s for cardiac drugs, basically we provide oxygen and comfort. Our patient wore such a bracelet. His two-year battle with cancer appeared to be nearing an end. He started having trouble breathing yesterday, followed by muscle cramping. I have taken him to the hospital numerous times in the past and was inspired by his and his families courage. It was sad to see it come to this. Henry carried him , down the snow covered stairs of the second floor apartment which will be his final home and into the rescue. He never complained.

We gave him supplemental oxygen and brought him to the hospital. Hasbro Children’s Hospital. He’s eight years old.

He usually called from a pay phone on Broad Street. It seemed strange seeing him in his home. The front steps looked weak, I tested them with my foot before putting my full weight on each tread. The “Beware of Dog” sign was a nice shot of self esteem for the fifty year old mutt who lay chained to the inside stairs. He put a half-hearted growl out there for anybody interested. For his sake I stepped to the other side of the entryway as we walked past.

Too bad It never rains inside, I thought as we walked through a few rooms into a rear bedroom. This place could have used a rinse. It hadn’t seen the business end of a vacuum or broom in decades. Filth festers when it has nowhere to go.

Our patient lay on a couch, seizing. His vacant stare looked past us at something only he could see, his body shaking and rigid. It was a mild seizure and only lasted a few seconds. The shaking managed to loosen an empty pint of vodka from the filthy cushions.

“He didn’t take his meds,” said a dark lady who suddenly popped out of a doorway. “Said he’d drink a corner and be all right.”

We loaded him onto the stair chair and into the bright sunshine, careful not to fall through the porch steps. He seized again when we got him into the truck. When he came out of it I asked him how much he had to drink.

“A corner.”

I thought back to the empty vodka bottle and envisioned an inch of booze at the bottom, when tipped to drink filling the “corner” of the bottle.

We took him around the corner to Rhode Island Hospital.

“What’s the matter,” I asked John, who stood outside of a Dunkin Donuts sipping a coffee.

“My lips are bleeding.”

“No they’re not.”

He bit his bottom lip hard enough to produce a few droplets.

“I have AIDS.”

“Really.”

“Full blown.”

“Get in the truck.”

I took him to the ER. He had just left. I was there last night at midnight when another Providence Rescue brought him in, reason unknown.

All of the phych beds in the state are full, the Chest Pain Unit at Rhode Island Hospital now being used as a holding area. I have no idea where to bring the next one.

“Why did you call 911?”
“I’m dehydrated.”
“You don’t look dehydrated.”
“What do dehydrated people look like?”
“Get in the truck.”

He stood outside the Providence Rescue Mission, smoking a cigarette. He wore his forty years badly, I would have sworn he was sixty. He stepped into the rescue and made himself comfortable on the bench seat as I started my report.

“How long have you been dehydrated?”
“Since last night.”
“Really.”
“Yup. A water line broke and I don’t have running water.”
“When did the line break?”
“Last night.”

I closed my eyes and started counting.

“One-thousand one, one-thousand two, one-thousand three…”

We were out of resources, mutual aid necessary. Cranston to Providence for an elderly lady who fell, Warwick for chest pains, Smithfield to Providence for an allergic reaction. On and on the calls kept coming. And on. And on.

I had the pleasure of visiting my cousin, Madison’s third grade classroom recently. She wanted me to talk about my experience as an author but her classmates seemed more interested in my experience as a firefighter. I only put a few of the kids to sleep, the rest tolerated my story and treated me well.

Thank you Madison, Mrs. Raver and the rest of the class for the opportunity to speak to you and answer your questions. (even the one about stealing the man in the wheelchair’s boots!) I had a lot of fun.

I’ve had a few days off since the New Year’s Eve Massacre, (stabbings, assaults, pedestrian struck, man out a window, head lacerations, concussions, and a nineteen year old who eventually delivered the state’s first baby of the new year.)

Add another stabbing to a recent rash of stabbings here in the capitol city. A delivery man was attacked by four men as he sat outside Stop and Shop in the Manton neighborhood. They beat and robbed him, eventually stabbing him in the stomach. Last week three young men were stabbed during an incident near Broad Street. My patient was a nineteen year old with three wounds to his upper torso. Whoever did the stabbing was not kidding around, he was going for a kill. The last call of the night on New Years Eve was for a man with stab wounds sitting on a porch near Thurbers Avenue. I found five stab wounds on this guy, one of which punctured a lung. As I walked out of the trauma room at Rhode Island Hospital another man walked into the ER holding his intestines in his hands. He was attacked on the same block as my patient.

I wonder if all of this is coincidence or is there a slasher in our midst?

January 1st, 0200 hrs. We turned the corner into mayhem. A car sped toward a group of people, striking one, throwing him onto the hood then onto the street. Others first ran toward the victim, then saw the car do a 180degree turn and fishtail back toward the victim. People scattered every which way, the enraged driver went for the guy laying in the street. He miraculously avoided being hit a second time. Veakro stopped the rescue in front of the victim, put on the lights and stepped out while I radioed for police. Unbelievably, the car did another 180 and buzzed the rescue. The guy on the street managed to stand and walk toward the sidewalk, right before the car made another pass.

Somehow, nobody was killed. As the maniac sped toward the city we treated the victim and tried to calm the crowd. They had been out for the evening, rented a limousine which overheated on the highway. The stopped at an adult entertainment nightclub on Allen’s Avenue because one of the passengers knew a bouncer there and they wanted to use the restroom. The limo driver told me later that this was her first nigh time job. She heard the money was terrific.

“I’m going back to taking people to the airport,” she said, still shaking from witnessing the madness.

The cops came a few minutes later and took a report.

New Years Eve, 2007 was over. A New Year had begun.

Providence City Hall, New Years Eve

Photo Credit: Peter Goldberg