A patient being treated for an MI has been transferred to a step-down unit from the intensive care unit. She uses the call bell as often as every 15 minutes
Each time a staff member responds, the patient complains about her care or makes a seemingly small request. Several staff tell the primary nurse that the patient is "obnoxious" and that they feel inadequate because they can never seem to satisfy her needs. The primary nurse can be most helpful by: a. explaining that the demanding behavior is due to the patient's increasing anxiety.
b. "laying down the law" to the patient, limiting use of the call light to once per hour.
c. rotating caregivers to give each person a much-needed respite from her complaints.
d. asking the patient's family to sit with her and help meet her need for attention.
A
Teaching staff the probable basis for the behavior will change their perspective. They will realize the problem is anxiety that is increasing her neediness and that the patient is hurting emotionally and not simply a difficult person. If staff reduce the anxiety, the patient's insecurity will decrease, and she will not summon staff so frequently. Setting limits on calling for staff does not help the cause of the behavior and will only increase the patient's distress and desperation. Rotating caregivers and asking the family to help provide care benefits the staff but not the patient.
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