First time a patient didn't like me

[Clovery]

I got stuck with an elderly pt who was having an episode of delirium and was combative. She wasn't "my patient" I just happened to be there and the nurses needed help getting her in a (posey?) restraint to keep her in the bed. Once they restrained her the floor nurses left and I felt obligated to stay in the room since I remembered in our training video that patients in restraints needed to be on 1:1 and no one else was there.

I put on Wheel of Fortune and was trying to distract her with that. She kept asking me to go to the desk and ask for scissors so she could cut the restraints off. Eventually she said "I don't want to be your friend anymore because you won't get me scissors." It was a long time I was in there with her, and she managed to get the telephone and tried to make a call. I had no idea if she actually succeeded in dialing a number, but she started talking "hello operator? they have me tied to the bed and won't let me leave, please send the police." I had no idea what I was supposed to be doing - I didn't want to infringe upon her pt rights to use the phone. Worried that she might have actually dialed 911, I convinced her to give me the phone, saying that I'd tell them where we were and give directions. But as I took the phone, she grabbed the cord and wrapped it around her neck. I got it away from her, wrapped it up and stuffed it in the bottom drawer of a nightstand. Finally a classmate walked by and I told her to get our clinical instructor.

I told her what happened and she got the nurse and they came back with the boxing glove mittens. I had to help hold her arms so they could get them on. After that the patient told me she hated me, never wanted to see me, and that I hurt her. I just kept trying to tell her that she was in the hospital, we were her nurses, we were trying to help her get better, and that she just needed to relax and get some sleep.

I really felt woefully unprepared for this situation and was so hurt to have the patient hate me. Anyone else ever deal with something like this? It's especially disturbing because I feel like my calling is to work with a geriatric population and I know these situations must arise pretty often.

[Toni82]

I am now a BSN student but I have worked as a cna for three years. Some of the people you come across will be down right nasty. They will threaten you, call you names, and even try to hurt you. I have been called the "n" word and spit on, slapped in the face by a 90 year old lady, had my lady parts grabbed by and old man while he made kissy noises at me, and been assaulted in the parking lot by the daughter of a patient because i bruised her mother while restraining her after she tried to stab me with a fork. I wasn't deterred because the good times have far outweighed the bad. I have had patients bring me flowers, bake me cakes, and invite me on vacation with them (of course I didn't go). The majority of patients and families will appreciate what you do. You are getting into a profession that is more than respected, it is trusted beyond all others. Most of your patients will adore you and if you continue to have that compassion, rightfully so.

[nurse1952fun]

When I was a student my first pt. was Ethel. I had heard about her from other students and I was petrified. She called me every foul word she could think of, some I had never heard of. The first time I had to take her in the shower room she pushed me under the water. This went on for 6 weeks of clinical. I thought I was not cut out for nursing. After my 6 weeks were up we had a going away party on the unit. I told Ethel we would not be coming back. She cried and begged me to stay. I was the only "visitor" she had since admission months before.

[sunnyskies9]

Confused and delirious patients are completely irrational. They do require a lot of patience to work with. You just have to keep orienting them and be completely honest and state only facts with them. It is nothing personal against you. I had a confused patient once tell me to go to hell, and I should be ashamed of how my parents raised me.

[tuhcoolyuh]

As a student, I had an elderly confused patient during my rotation in the ICU. He was put on restraints, and every time I was near or in his room, he started screaming at me, "HEY FATA**, get me out of here!" or "Fatso! Help me!" It was hurtful and humiliating, but I think good practice for growing a thick skin. I know he was confused and upset, and he was lashing out and trying to find some control where he didn't have any. It was pretty terrible, but now that I know I can handle that, I can handle anything.

[Twiggi]

I haven't had that yet, other than the helpful bit about it being unhelpful to reorient alzheimers patients, I thought that you did a good job and was in awe of your composure in a difficult case. I totally understand that you would take it personally, I think that you are able to rationalize it was the dementia talking, but it still hurts. I totally get it.

My heart broke a little about nurse1952fun's patient. Its important to remember that "Ethel's" can be just hurt and lonely individuals. Perhaps that is how they have learned to get attention and cope with isolation.

With some of the assault cases, if it was an alert and oriented client, or a visitor, I would be charging them. Behaviour like that is unacceptable, and hard to tolerate from the clients who have an excuse for it ( dementia, brain injury, tumour etc)