I will try to keep this short, but so much info and feeling it will get lengthy...
So I got a patient a few days ago. Thirty something female with altered LOC on admission, newly Dx Graves disease and uncontrolled diabetes. Found out that she lived at home and wasn't taking her meds, so her family stepped in. Sadly they knew nothing about diabetes and when she was acting oddly in the home, they would just give her lots of sugars. She was admitted with big time DKA!!!!!!! I got her three days after ICU, and she still was quite out of it and not talking.
I walked in...cracked a joke about myself in my intro and she laughed so hard! It was set...she and I were going to get along big time! And we did! Something about her just took a piece of my heart and kept it...something I have really never experience just meeting a patient, and certainly not as strongly as this one!
I went home and did a ton of research on Graves Disease, and really got a feel from actual websites from people suffering from it! That was quite helpful.
She and I got along so well, but sadly yesterday after I left...she tried to leave the hospital and almost made it (found two streets away). The MD d/c'd her one on one in her room, and I said ONLY if she was by the RN desk (she was out of site of the RN desk till we moved her). Crud!
So today it was like starting all over. She wasn't speaking...not even to me. She was angry and doped up and sedated. I felt my heart fall out! I spent all day just giving her choices and letting her have her space, and I told the MD's to trust me and I would have her speaking again an in better spirits by EOS.
After I talked with her, with her not responding...I let her know she was going to have her space to figure things out, but I would not stop caring for her and making sure she was safe! About an hour later she was talking to me again and in tears telling me I was the only person that listened to her, and she really trusted me out of everyone! I let her tell me her story and we both cried and talked about life... It seems she was always being TOLD what was going on, and had no choices or info really! I promised I would change that post haste after our cry and hug...and I DID!
I talked to all her MD's and told them what was up, they understood and really involved her in her plan of care (and not her family...she is beyond of age to make choices for herself!). She really didn't get along with her mother who was caring for her so I contacted discharge to see if she had other options...and I asked but one favor of her...
"Talk to the MD's so that they know what is going on and involve you...if you stay silent they have nothing to go on like I do since we talked! Please just go through the motions if you have to...but answer their questions...be honest for your own well being...and if there is any problems let the nurses I will have caring for you (which I scheduled personally) know...they will contact me!".
She felt so much better, and all three MD's were stunned at the sudden change in 8 hours! I simply told them...she may have a medical problem...but the HUMAN problem was a bigger wall...I started tending to that...now lets work with both and keep this going!
I got her diabetic lessons for her and she agreed for her mother too. I got her counseling outside of hospital when she is out. And the MD's listened to her! And for the first time in my career...I gave a heart felt hug to a honest and true PATIENT that trusted me with her life!
Sometimes we forget what it is like to be the pt. The 'you will do this and you will do that' with little regard to 'what works for you, is this okay or shall we look at other options?"...That maybe when someone lashes out it is something more basic than medical...and needs tending to as much if not more for the patients total well being!
Just thought I would share this story...it sure reminded me again...and my heart is so filled with joy and hope for this wonderful person that I tear up just thinking of her and my professional yet very human relationship!
