Particular Patient Populations - Do You Struggle?

[Nurse SMS, MSN, RN]

Do you have a least favorite diagnosis in terms of giving nursing care? I am a newer nurse, so that probably plays into this, but I am rapidly finding I really struggle when caring for patients with devastating neurological injuries. Fresh strokes and fresh spinal cord injuries in particular. I get very intimidated by the patient's (often) inability to communicate, particularly with fresh trachs. I am good about offering up pen/paper, but recently I have one who doesn't speak fluent English and who has been left without fine motor in their hands and cannot write.

I find also the families to be devastating to me emotionally in their understandable inability to grasp what has happened. Their questions of "How much better will he/she get? When do you think we can return to normal?" leave me like a deer in headlights, because it is so obvious this has been a traumatic event and a devastating one to their loved one...that nothing is going to be the same again....and that they just can't wrap their head around it.

I find myself dreading going into work when I have one of these types of patients. Trust me, I provide excellent care. I just get depressed by it.

Do you have a certain population that is that way for you?

[sapphire18]

GI bleeders...I don't mind giving blood, but I find it REALLY hard to deal with that tell-tale smell without making a face...pwew!!!

[msjellybean]

Drug seekers.

[RNperdiem, RN]

A day with a person withdrawing from alcohol or drugs without a patient sitter leaves me worn out by the end of the day.

I struggle with patients that have uncontrolled pain.

I once took care of a young man who had a big cancer surgery. Despite going up all day on the epidural, increasing the basal and demand rate on the PCA, I couldn't get his pain less than a 9. No, he wasn't faking anything, and anesthesia was called so much, they started hanging around the unit. Usually with enough meds and good positioning, I can get people comfortable enough, so it is frustrating to end the day with a patient still in uncontrolled pain.

[TheCommuter, BSN, RN]

I don't have a least-favorite diagnosis.

However, my least favorite patients are the ones who come from upper-middle class and wealthy society. The sense of entitlement grates on my nerves. Also, these people and their families sometimes treat nursing staff like chattels.

[OnlybyHisgraceRN, ASN, RN]

My least favorite is dealing with mech. vents. I'm very competent with vents but I just rather for my patient to be able to breathe on their own instead of a machine doing it for them. Vents can cause more harm than good at times

[MauraRN]

Drug seekers.

DITTO

[imintrouble, BSN, RN]

All of the above, except the vents.

No kids. No way.

[WillowNMe]

Drug seekers or unpleasantly confused dementia pts that I can't get a sitter for.

[Penelope_Pitstop, BSN, RN]

Ugh, gastroparesis. There are probably several perfectly lovely individuals who suffer from this, but we see the same patients again and again and it's the same rigamarole. Some of them make themselves throw up or claim they've been vomiting but they haven't (or do it because they've been sneaking food). Oh, and if they're diabetic, their sugars are terrible. Plus their blood pressures are usually ridiculous.

As far as patient populations...my paternal grandmother passed after a long battle with Alzheimer's and it is very difficult for me to care for these patients. I just visualize my loved ones, and myself, in their shoes and it is heartbreaking. These patients sometimes have amazing wisdom and stories to pass on to everyone, but I can't imagine how frightened they must be...or if they are too confused to be frightened, I wonder what they truly are thinking.

I used to have a huge problem with alcohol withdrawal patients, but I find that if everyone has been properly utilizing the benzo protocol we have, everything is fine.

[wooh, BSN, RN]

Undiagnosed abdominal pain.

[whichone'spink, BSN, RN]

Patients admitted post-suicide attempt. I am scared to say the wrong thing to rile them up in some way, because many of those patients are still particularly vulnerable and volatile.