I have a long-term care patient with ALS who is paralyzed from the neck down and on a vent. He is very particular about his positioning and has a lot of requests. He does not have a speaking valve, so to understand him you have to read his lips or use a speaking board. When I first started working with him I felt frustrated at times, but I remained patient and helped him until he was satisfied. Now I know him pretty well and I can usually understand him and anticipate his needs. I do spend a lot of time with him, but he is always grateful when I help. He is very needy, but he is also very pleasant in my opinion.
What is making me sad is that the CNAs and some of the other nurses complain about him a lot saying that he is too picky and impossible to please. He expresses that they are too rough with him and that they don't take enough time to make sure he is comfortable after care. The CNA who attends to him most often told me that she wishes he could be transferred from her assignment because she is tired of all of his "ridiculous requests." I think I'm doing an ok job of communicating with the CNAs to get his needs met, but I am starting to feel upset that they aren't showing any regard for him.
He and his brother explained to me that he started getting sick about 6 years ago when he began to drop items or have trouble turning keys. The disease progressed and he started to lose the use of each limb. Two months ago he lost control of his trunk and was placed on the ventilator with a trach. This guy is A&Ox3, and he is trapped in the prison of his body! He can't even swallow his own secretions, he relies on me to come in regularly to suction his mouth. Plus, since he is newly vented he is still acclimating to his current level of function. Sure, I might end up taking my break a few minutes late some days because a speaking board takes more time than talking... but I didn't go into this field for the breaks, I became a nurse so that I could help people. Anyway, now that he and I have a good rapport, if I occasionally tell him I am very busy he is understanding and does not take too much of my time.
I understand that this type of thing happens all the time in nursing, and I do think I am handling both my relationship with the patient and with my colleagues well, but I just feel sad about the whole situation. I felt the need to express myself about this in the hopes that some of you might understand.