need help~please~

communication. . .i got floated to icu one night shift and got an admission who was a 19-year old girl who had tried to kill herself after her boyfriend had broken up with her by taking a whole bunch of her mother's valium tablets. after having her stomach pumped in the er she was sent to the icu for overnight observation. she was very distraught. physically, she was pretty stable, but kind of talkative and weepy. i spent a lot of time letting her talk and telling her that in time she would see things differently and that she would change her mind about her desire to die. mind you, i said this to her, because it was what i felt was the right thing to say. personally, i thought it was stupid to try to kill yourself. i went home at the end of my shift tired of babysitting her (this was my bad attitude over it) and probably thought about her for a few days and then forget about her. a few years later i was shopping in a local store and a young lady came up to me all smiles. "you don't remember me, do you?" she was all happy and cheerful. she proceeded to tell me that she was this young lady i had taken care of in icu that night. i remembered her right away because what i didn't tell you was that i was ticked off that i had been sent to the icu in the first place and i wasn't particularly happy about working with a suicide patient. this young lady kept thanking me over and over and telling me how she always remembered me telling her that she needed to give herself time and that she would interpret the things that had happened with her boyfriend differently in time. "you were so right", she kept telling me. she told me she was so grateful to have noticed me in the store and had the opportunity to thank me. and, she told me about how her life had changed and what she was doing then. she wanted me to know that i had made a big difference in her life that night. well, didn't i feel like the biggest hypocrite in the world, but really good that i had make a big positive impact on someone's life. i really needed that affirmation at that time.

what i learned from this was that (1) be very careful of what you say and how you say it to patients because you never know how they are receiving or interpreting it. we have a much greater influence on people that what we might think. (2) we have as much to learn as the patients do. in my case, i needed an attitude adjustment and to realize how much patients look up to us nurses when they are in a crisis situation. (3) no matter how much we are judging the patients we are nursing (and i admit that i can be pretty judgmental) you cannot let it show when you are at work. you have to leave your rotten attitudes at the door when you walk into work.

assessment/communication/problem solving. . .i was assigned to a little elderly lady who i was told was constantly talking so be prepared for her to take up a lot of my time. in addition, she had been complaining for two days of pain in her upper torso. i learned long ago after working on an alcohol detox unit that when people are talkative to listen patiently because sometimes they are trying in their own way to get around to getting something important out. so, when i had this lady as a patient i made time to listen to her. toward the end of my shift, i was doing something with her that involved her moving around in the bed, her complaining and moaning with pain in her ribs and out of her mouth flies something about her falling off the x-ray table two days ago. what? i immediately asked her to tell me what happened and she told me the entire story. then, she tells me she didn't want to get anyone in trouble! she had held this information in for 2 days because she didn't want to get anyone in trouble! within a couple of hours she was x-ray'd and found to have 2 broken ribs! all from a careless radiology technician who had not been paying attention and had allowed her to fall off the x-ray table two days before!

the lesson: always take time to listen to patients. make your own judgment of a patient's behavior and don't totally depend on what others report to you. developing a relationship and trust with people is important. learning to ask the kind of questions that will get you detailed information is crucial to assessing.