Son of a bad patient

[nursemike]

My father, whom I dearly love, is in the hospital tonight, should come home this morning. Had a femoral artery stent, which I'm hoping will relieve some of his ischemic leg pain, improve his quality of life, and help him keep his leg. He had the other side done a month ago, and is showing significant improvement. Not miraculous, but significant.

Of course I'm profoundly grateful to God, the doctors, and the nursing and support staff who've cared for them. I've made a point of thanking everyone I've seen, although it occurs to me I need to take a moment to add a thank you to the Almighty, although presumably he knows I'm grateful.

Anyway, the one discouraging aspect of this whole business has been Dad. I'm sorry to say, he's acting a lot like one of those patients. Rude, uncooperative, demanding, and impatient. Frankly, I've been embarrassed for him a number of times in the past day or so. And it doesn't help a bit that he's in the hospital where I work--except that I know my colleagues are used to it, just as I am. Like everyone here, we understand that pain, discomfort, and probably some anxiety, don't tend to always bring out the best in people. But, still...

I'm thinking I am going to send a note to the director of the cath lab to praise the nurses and others who treated him so well, and to express my regret at some of his behavior, and a similar one to the cardiology unit where he is recovering.

Okay, enough venting. We've all seen the receiving end of this enough to know the score, and I do take a little comfort in my own experience that it's hardly ever the sickest patients who give me a hard time. The 80 y.o on her third hip replacement is a trouper while the 19 y.o. with a broken wrist screams all night. I'm glad Dad's well enough to be a nuisance. But I do think I need to discuss this with him, because I don't think he has any idea how out of line he has been. Like calling the NP who put some towels under his heels an idiot because she didn't get them just where he wanted them.

Yes, I believe it did hurt worse where she put them, but she's a capable intelligent woman who was just trying to help, and all he had to do was say where he needed them put. Eh--I'm starting to vent, again.

Anyway, I clearly need to take some time to get some perspective, first, but I do want to make the points that need to be made, not least of which is that acting like a jerk doesn't always get you the best care. But if there are any cooler heads out there--especially if you've been through a similar situation--I wouldn't mind some advice. I don't suppose this will be his last trip to the hospital, and I would hate to see him get pillow therapy.

[nursemike, ASN, RN]

Thanks for all the advice and support. Dad's home and fine and in a much better mood, and a little sleep did help my outlook, too. He wasn't demented--just very grumpy.

I guess there's a good reason we don't treat our families. I can have a lot of empathy for strangers, but it's tough to see my lifelong hero vulnerable and not at his best.

Dad has chronic pain, especially in his feet and legs. Peripheral neuropathy, ischemia, and arthritis. On a prior stay, for CHF, the only bed he could get was on an oncology unit, where pain control is a high priority, and he had a much better stay. Unfortunately, a fair amount of discomfort is hard to avoid with catheterization--flat bed rest, tethered to a monitor, frequent labs and assessments.

On the ride home, Dad did voice his view that patient comfort ought to be the top priority, and I countered with my perspective, that it's a high priority, but not the top. Told him about a patient I recently had on a PCA with dilaudid for severe pain who stopped breathing. Stopped the PCA, got her back without narcan, and called the doctor. We reduced the PCA, which increased her pain, and worked on titrating through the rest of the shift. Not a direct analogy with his situation, but I'm trying to show him that the things we do aren't arbitrary.

Predictably, the staff who were taking care of my father weren't nearly as bothered as I was. Still, I do think a thank you card and some doughnuts may be in order.