Clinical Woes

  1. I'm about halfway through my first semester of clinical, and up until now it has been fairly smooth sailing. Yesterday, though, I had my first experience where I felt like i just couldn't communicate or connect with a patient at all, and it was a difficult experience.

    One of the worst parts was towards the end of the day while I was administering oral meds, the patient told me to just leave the meds on his bedside table and leave, and he would take them when he felt like it -- but we're definitely not allowed to do that, because the MAR on the computer would read it as administered even if the pt didn't take it, the patient could spit it out, etc., and if there were complications, it would be hard to trace what was going on. Anyway, I tried to gently let him know that I had to be there to see him take his pills to be sure. The charge nurse had realized he had missed a dose of something earlier in the day and it was showing it his labs. He kept insisting to just leave them on the table, and he would take them "if he felt like it, later". I asked if I should come back later with the meds, if now was a bad time, and he refused that.

    The patient was just so mad, and he snatched the meds out of my hands. He took them, but obviously felt some hostility towards me now, no matter how much I tried to explain that it was just for his safety.

    Anyway, I just feel like my little bubble has been burst. It was my first bad experience with something like that -- the first month or so, I had always had patients who were fairly "easy" and personable. I knew it wouldn't always be that way, but I just feel thrown off now that I have my first patient who actually didn't like me.
  2. Visit vickymarie profile page

    About vickymarie, BSN, MSN, RN

    Joined: Feb '12; Posts: 49; Likes: 44
    Public Health Nurse
    Specialty: Public Health


  3. by   ckh23
    Live and learn, not everyone is nice. You will come across this time and time again in your career. Some people are just unappreciative and nasty no matter how nice you are to them.
  4. by   brillohead
    It was HIS problem, not yours..... ((((HUGS))))

    The fact that you care about it shows that you have the compassion a nurse needs, IMO!
  5. by   Annachu512
    Unfortunately, this is going to be a normal occurrence. You're going to have those difficult patients that make you want to just curl up and cry. Hard as it is, you have to shrug it off and keep going. I saw a LPN today try to give a resident their meds and they screamed and cried about it. When they finally got her to put them in her mouth by way of pudding, she just spit them back out in her face. At least you didn't have that happen.
  6. by   vickymarie
    I totally get that this is something I'll need to get used to - I guess I just needed to unload, because it was my first experience like this. I know that patients are going through some of their hardest times once we actually see them, and the last thing they need is to have to worry about being nice to me.

    Once I got home, I moped for a while, studied a little bit, and got some rest to clear my head. I guess it's all just part of the adjustment process, but... definitely one of the harder parts!
  7. by   mindlor
    If a patient does not want to take their meds, chart them as refused and move along. In the real world there is no time to convince people to take their meds. Be sure to notify the provider. This is why it is wise to never take the meds out of their packages until you are clear the patient will take the med. I had a patient with several PO meds that did not want to take is metoprolol because it made him feel funky.

    Charted it it not given, reason, patient declined, states it makes him feel "funky", then I put the med back in his drawer......

    We do this so that meds are not wasted.....
  8. by   vickymarie
    Well, I had gone in to confirm identity and everything and he watched me prepare them and everything and he said he felt fine. It was just, all of a sudden, once they were out of the packages, he decided that he just wanted them left on the table. I think that was what threw me, was that he seemed perfectly fine with taking his meds as I prepared them and opened them, but changed gears when I held them out to him. There was another med he refused to take, and he brought it up when I held up the package to tell him what it was, so I thought that he would do the same for any other meds.
  9. by   mindlor
    Bah, like everyone else said, you are going to have oddball patients.

    Just remember you cant make them take their meds, they have the right to refuse.

    You were spot on not to leave them at the bedside!! Great job!!
  10. by   Skips
    Don't let it get to you. He might have been stressed to be in the hospital, not feeling well, etc. It really had not a whole lot to do with you. Try not to take it personally. (:
  11. by   crazytonurse
    Quote from ckh23
    Live and learn, not everyone is nice. You will come across this time and time again in your career. Some people are just unappreciative and nasty no matter how nice you are to them.
    I second this! Reading this I was reminded of my first angry patient. 30 something year old man with full ROM, up walking the room and halls and was very "nice" until I refused to give him a bed bath, then he turned into a mean grumpy pain. Did I forget to mention that for the 2 days prior to my clinical day he was showering himself? Yea so he said some nasty mean things to me and to be honest it stung, but it also was a learning experience for all the students at post conference. Regardless of the situation experience is gained in every interaction with a patient.
    Last edit by crazytonurse on Mar 14, '12 : Reason: fixing qoute
  12. by   EllieBean13
    As a fellow student, I am sorry you had this kind of situation happen to you. I've had it happen before too, and I was able to take a step back and think about how he may be feeling (NANDA time!) powerlessness related to his hospital stay and working on the hospitals schedule instead of his own. As much as it stinks, patients throw fits and cause a stink to try to gain some control of the situation. This has nothing to to with you, in fact you handled the situation well. You sound like a great nurse, vickymarie. Don't let it get you down too much
  13. by   WildOne
    Aww yeah some patients are definitley not nice people. Sometimes I feel like I'm talking to a child and not an adult

    Some examples:

    the female patient who was NPO and kept sneaking M&M's then lying to me
    the male patients whose wife was super rude and possessive
    the 50 year old man who had just had an MI and was VERY controlling...lets just say I never said goodbye to that patient when I was a student I just left! ahahaha!

    Don;t worry about those people. Think of every experience as one you can grow from and for every rude patient I've met, there are 10 very appreciative awesome ones
  14. by   Galaxy1
    Not everyone will like you. Chart patient refused meds in 3 or 4 different places. Write a note that the patient refused after charting it in 3 or 4 other places. Inform the MD and chart that also (time, who MD is, throw in some VS, patient mental status), let your supervisor know, let the next shift know, let the family know (if authorized). CYOA cuz no one else will.