Patients We All Know and Love
- 28 As I've grown older (and hopefully wiser), I've become more and more appreciative of the human animal. Each and every one of us is different from everyone else, yet somehow, people under duress tend to behave in certain ways that have a consistency that never ceases to amaze me. And in my estimation, nothing causes duress like being a patient in a healthcare setting. Even people who are ordinarily sane, decent human beings tend to wig out a little during a hospital stay. And for those of us who are charged with their care, one thing is for sure---no matter where we go, no matter where we nurse, we will encounter one or all of the following:
The Drama Queen: This patient is usually, but not always, a middle-aged female with "intractable" nausea and vomiting accompanied by abdominal pain that can be relieved only by massive doses of Dilaudid. She has been scoped seven ways from sundown, CT'd, ultrasounded, exploratoried, yet no cause has ever been found. She will lie in the bed, sighing audibly as you attempt to assess her roommate. She has developed carpal tunnel syndrome from over-use of the call light button during her many hospitalizations. She complains incessantly about her clear liquid diet and sneaks candy bars from the ER vending machine when she goes outside to smoke; yet when she is finally upgraded to full liquids (meaning she's close to discharge) she'll manage to have another episode of N/V which guarantees another round of tests, as well as another day or two of "fluff my pillow, bend my straw".
The Stoic: By contrast, this one never complains about ANYTHING........often, to his/her own detriment. The Stoic is the first to get up and ambulate after surgery, won't take anything stronger than Tylenol, and doesn't report increased pain or other alarming symptoms until it's almost too late, like the post-MI patient I cared for some years ago who "didn't want to bother the nurse" when he suddenly became short of breath. I walked into the room on my rounds to find him grey-faced and diaphoretic, his 02 sats in the 70s, B/P in the dumper. I couldn't get him back to the ICU fast enough. He coded on the way down the hall, then again in ICU. He had to be flown to the regional medical center for a four-vessel CABG that same night; I never found out if he made it or not.
The Party Dude: Never lets anything so petty as hospital rules and NPO status deprive him of a good time. He always seems to be surrounded by a crowd of big, burly college guys who sprawl out on the empty bed, leave Taco Bell wrappers and potato chip bags all over the room, and make enough noise to wake the recently deceased patient down the hall. I've seen drunken poker games that left a place in better condition. And when you try to evict said 'visitors' from the patient's room, they all look at you innocently and say, "Hey, there's only a coupla minutes left in this football game, we'll leave when it's over, 'K?" Two hours later, you call Security because the patient himself is asleep, his buddies are all passed out under his bed, and you just KNOW that's marijuana you smell in the bathroom.
The Pampered Princess: Must never be seen with 'bed head' and wouldn't dream of going into surgery without full makeup and all of her diamond rings taped to her fingers. This is typically an older woman whose sense of refinement prompts her to eschew hospital gowns in favor of a satin peignoir. Her bed is covered with stuffed animals and her own comforter from home. What separates her from the Drama Queen is her dignity; she will complain about the "service", but she doesn't abuse the call light and will not allow herself to become a burden on the nursing staff. Unfortunately, her independent streak is sometimes her undoing; she will get OOB to use the bathroom in the middle of the night, put on those ridiculous high-heeled slippers instead of grippy socks, and fall hard on the linoleum floor.....with predictable results.
The Know-It-All: Is almost always related to a medical professional, and her knowledge of health matters is just enough to make her dangerous. She will regale you with tales of "my son, the doctor" and claim that no one else on the planet is as qualified. She also reads numerous "health" publications, which may be of questionable veracity, and travels with a suitcase full of vitamins and potions which you, her nurse, either have to confiscate---with the resulting howls of protest and threats to sic Dr. Wonderful on you---or begin the laborious process of getting them ordered by the admitting doctor and written into the MAR.
The Class Clown: Regards even the most serious condition as if it were the world's biggest gag. Trying to teach this newly-diagnosed diabetic how to prepare and inject insulin is an exercise in patience, as he will sit there and play with the syringes, crack lame amputation jokes, and otherwise act like an overgrown eight-year-old. While the professional in you knows, down deep, that his demeanor is more than likely a cover for his fears, the un-professional in you wants to slap him upside the head and scream "PAY ATTENTION, DIPSTICK! THIS DISEASE IS GONNA KILL YOU!!"
These are but a few of the patients we all know and love. Who are yours?
About VivaLasViejas, ASN, RN
VivaLasViejas has '17' year(s) of experience and specializes in 'LTC, assisted living, geriatrics, psych'. From 'The Great Northwest'; 55 Years Old; Joined Sep '02; Posts: 25,271; Likes: 36,804.1Sep 28, '09 by lamazeteacherMine is the home health patient I had, who swore she self cath'd every 5 minutes. She had enough UTIs to substantiate that, too. She'd conned a doctor at a midwest prestigious medical institute, to give her a colostomy for her constipation!
Whenever she tired of self cathing, she'd call the agency for her favorite nurse - me, to put in a Foley. I'd get there, and she'd say she changed her mind and didn't want it. 2 hours later, I got the phone call for the Foley - again! Needless to say her insurance wouldn't pay for all the visits and somehow I got wound around her little finger and accompanied her and her husband to the big city, to care for her postop following a vulvectomy - don't ask!
After 2 more days recovery in a luxury hotel room 26 floors up, her husband became competative for attention and threatened suicide by opening the stupid French doors leading to a fake balcony. I called 911, and we all got thrown out...
I'm happy to report, post script, that she eventually became sane enough to have the colostomy reversed, and caths only every half hour following intensive bladder training. Her vulvectomy healed without incident (a miracle, given her spare hygiene).4Sep 28, '09 by HalinjaSomewhere in there between Pampered Princess and Drama Queen...Somebody's Baby. She's young, has several tattoos, a nose ring and a belly ring. She cries when the blood pressure cuff inflates, and jerks her arm away with a scream when you try to start an IV, thereby insuring that you have to poke her AGAIN. She has a needle phobia and can't handle pain. I'm really puzzled how the Tats and the body piercings got there...
And she calls for her Mamma, squirms and screams that she's going to die as the anesthesiologists tries to start an epidural.5Sep 29, '09 by nerdtonurse?The Dysfunctional Matriarch -- this is the grandma/greatgrandma to an improbably large brood of individuals who all insist on staying with their venerated progenitor around the clock, sleeping in shifts, keep a book listing everyone who's come in the room, what they did, what they said, and then quizing you on "Well, Sissy Sue said X 3 days ago, and now you're saying Y...." Change in condition, ever heard of it?
They will also blatantly ignore fluid restrictions, diet orders, activity orders, and refuse to allow you to turn the Matriarch because she's comfortable....and then go ballistic when things go wrong because of what they wouldn't allow you to do....document, document, DOCUMENT.
Man, I'm just tired thinking about those....2Sep 29, '09 by liebling5Let's not forget Susie Sundowner. She's as cool as a cucumber all day long. Let 1430 come around, she's popping up from her w/c like popcorn, challenging your facility's no-restraint policy.
And, her son, who loudly denies that anything is wrong with mom. He challenges your every move to properly medicate her and keep her from falling for the nth time this month. Oh yes, then months later, Denying Son calls up and asks you to "do something for her!"1Sep 30, '09 by VivaLasViejas, ASN, RN GuideQuote from liebling5I've got two of them on my unit, complete with families in total denial. They're perfectly behaved for the day and noc shifts, then come unspooled the instant the door closes behind all the 'carpet people' at 1700 and raise hell all evening. And everybody thinks we 3-11 shifters are "just picking on them". Oy.Let's not forget Susie Sundowner. She's as cool as a cucumber all day long. Let 1430 come around, she's popping up from her w/c like popcorn, challenging your facility's no-restraint policy.
And, her son, who loudly denies that anything is wrong with mom. He challenges your every move to properly medicate her and keep her from falling for the nth time this month. Oh yes, then months later, Denying Son calls up and asks you to "do something for her!"