trouble patients?

[voskamp]

In my function I see patients severall weeks before surgery, and I prepare them for there upcomming operation. This week I met I patient that has me puzzled. She told me her story of 22 years hospital in and out and was very sad and distrusting of the medical profession. As she left my office she handed me a 200 pages story of her life, she wrote about all her encounters with docters.

Now this was something else! The story was a continuing saga about medical misstakes and misunderstanding. She ends the story with the following words; Emotions that I can't cope with, rot on my soul. I am a human beiing, I am a woman. I want to live. This is my story, the true as I see it.

After reading this my first emotion is that I realy want to help her, get some trust back in the medical profession.

But in those 200 pages i read that she had had fights with 8 docters, 2 fysiotherapists, 1 nurse and 2 HMO inspectors. That is a lot of people to have a fight with. (mind jou, I can name 8 docters where I could argue with)

She sued 3 docters in 1 trial with her pro bono lawyer (needles to say she lost) But this is written in her medical file, and she believes that ever since that trial docters stopped talking to her.

So maybe this patient is trouble?

I also realized from her story that she has no clou what her medical condition is. She knows something is wrong, causing her pain and discomfort, but she doesn't understand what it is. Dit nobody explain this? Right now she needs new surgery but she is afraid for the docters.

So my question is; How do I approach her; As patient trouble? or as a misunderstoot patient. If a patient has been difficult in the past, does that meen she isn't allowed a new chance? But how can I avoid being the next person on her list to argue with? I would really like to hear your views on this situation,thanks

[4XNURSE]

voskamp,

As I see it, you should treat this patient with the same courtesy and respect you would treat any other with. Be honest, and kind. Do your best, just like you did for the patient before her, and just like you will do for the patient after her.

You can't take the responsibility for what someone else did. You can't protect her from something someone might do in the future. You can show her your professionalism and integrety. What she takes home from that is up to her.

just my $ .02

ken

[Furball]

In this day and age when pts have the wrong kidney or extremity removed, I truly wonder what exactly happened to this woman?

I tell all my family members when they go into surgery for a knee or whatever to write on the other extremity "not this one" in red magic marker. I'm also amazed at what little information SOME docs provide for their pts so maybe she was clueless because her situation wasn't explained properly. On the other hand, she could be like many pts who hear only what they want to hear. Interesting post. I also agree with above poster re: treating her like any other pt.

[aimeee, BSN, RN]

I agree with 4XNurse, but I would add....document, document, document. Make sure your backside is well covered. A 22 year history of battles with the medical establishment and a 200 page life story set off lots of warning bells for me. I would wonder if she is a "career" patient.

[Zhakrin]

Once physical causation is rule out...

Think borderline personality, with some somtoform disorder (I thik this is the term?)

Very disfunctional relationship and often iniate hospitalizations but refuse to follow medical regimes. They frequently sue because of "misunderstanding" and bad nurse/doctor relationships.

If depression is the common cold of mental health...

and schizophrenia its equivalent of cancer then...

Borderline personality disoder is the 3 am drunk in emerge c/o of a explosive diarrhea...expect to be $hit on big time.

[semstr]

Hi Voskamp,

you work and live in the town I was born and grew up in!!

But back to your patient.

I am not a psych. nurse, but look at Zhakrins post, sounds "good" in this case, doesn't it?

Take care and hoi, Renee

[aimeee, BSN, RN]

Bingo, Zahkrin. Exactly what I had in mind.