Patients We All Know and Love

**VivaLasViejas**, ASN, RN

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?

Patients We All Know and Love

About VivaLasViejas, ASN, RN

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