Particular Patient Populations - Do You Struggle?

[Nurse SMS]

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?

[Hygiene Queen]

Pts with severe depression... the type of depression that renders thems so negative and Eeyore-like.

They are so far down in the pit of hell, you wonder if they are ever going to be able to swing their leg over and pull themselves out.

Then they refuse their meds or ECT, because "it won't help"... everything is negative.

Grrrrrrrr!!!!

I know they can't help it, but it is draining and frustrating.

[Kiwi82, BSN, RN]

Smart asses!!!! Mr's and Mrs' know-it-all!

"I have some K+ for you here because your K+ is low" (Btw, the pt stopped taking her K+ at home...a loonggg time ago)

Pt responds "K+ low??? I eat 2 bananas a day, that's impossible, I don't want K+, I don't need it. I eat my bananas"

Reallyyyyyyyyyyyy???!!!!!! OMG.

Or, how about the male patients that call you "babe" or "sassy"...or some other stupid crap??!! Drives me nuts!!!!!!!!!!

[Ruby Vee, BSN]

I hate dealing with the self-identified VIPs. None of the rules could possibly apply to THEM. They can pick and choose what meds they'll take, what treatments they'll allow and what activities they'll participate in.

[Aeterna, BSN, RN]

I will admit, I hate getting fresh stroke patients. I work med/onco and in our hospital, we have a "stroke unit", so pretty much all fresh strokes get admitted there. As a result, I don't have the proper knowledge base to really and truly care for them. I am not certified to do the TOR-BSST assessments (and none of us on our unit are). I don't know the stroke-specific assessments and am not certified to do them, so the best I can do is a neuro assessment. I'm not familiar with the stroke protocols. However, once in a blue moon, if the stroke unit is at full capacity with no discharges, yet we have an empty bed, occasionally we will get fresh stroke patients because our ER is constantly over-capacity.

I also dislike getting psych patients. Same as above, if our psych floor is at full capacity but we aren't, on the rare occasion, we will get a psych patient. I just don't have the personality to deal with them; I'm not suited for psych nursing. On top of that, we once had a suicidal woman on our floor, and she actually tried to hang herself in one of our shower rooms. I wasn't the nurse who found her, but it has scared me ever since.