rrehak

I was recently hired (not a new nurse, just a new job) and am the fourth of four nurses. The management is buying lunch today for us. But I'm off today because it's the start of my pre-planned and agreed to upon hire vacation. And not a real vacation - I'm taking my dying father on what will probably be his last trip, which my boss knows. I wasn't offered lunch on a different day. And when I get back, I'm scheduled for technician work for three days instead of continuing my orientation training. I probably won't be working here long.

I appreciate both the nurses who discussed physical causes and those who said there are limits to the nasty behavior we have to take. You're all right in your own ways and those are both parts of nursing, along with therapeutic communication. However, I'd like to offer my perspective. My mother was a malignant narcissist. Getting sick at the end of her life only made it so much worse. Because of the verbal abuse she heaped on me, I finally had to chose to be her daughter or be her caregiver. The doctors and nurses loved her. She was sweet, articulate, adoringly vulnerable, and very kind to them. Most of the time. But her true nature would show itself when one of them didn't do what she wanted. Her face would change, she would give a death stare, and raise her voice. She alternately got very quiet and moody or flustered and yelling. And the things she said behind their backs to me often left me wondering if I'd be able to retain them as her health care providers. Not every crabby patient has an underlying mental disorder. But many do. Very few staff ever believed me about her true behavior. They didn't want to look past the possible physical causes or their belief that she was just reacting to her physical illness. Please tuck this in the back of your mind. Someday you may care for a patient like this. There can be more going on than what you see or what basic assessment finds.