First time a patient didn't like me - page 2

by Clovery 3,263 Views | 16 Comments

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. ... Read More


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    Quote from Clovery
    Esme12 - thanks so much for your sweet and thoughtful reply. It really means a lot to me
    ...
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    I just wanted to add some sympathy. It's hard when your patients get confused and agitated. I work post op and you'd be surprised how many older adults get confused and combative after anesthesia. Once that's out of their system, they're back to normal and alert and oriented. I've been threatened with the police, been yelled at, had people try to bite, scratch, and kick. It's tough, especially because dealing with this is something that can't be fully taught before the situation arises. It's one thing to know in theory that these things happen. It's another to see that sweet little old lady turn into an angry biter.

    It sounds like you did good. Next time you'll be better at handling the situation. These things only come with time and experience.
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    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 vagina 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.
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    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.
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    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.
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    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.
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    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)


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