Unresponsive patients--avoiding working with them

[DarcyInSATX]

I noticed that in home health care, HHC, where I work, most of the patients I've been trained on are unable to communicate except in grunts when they are uncomfortable. I also worked Sat Sun Mon and often missed church. I could live with this better before the pandemic when I had more in-person contact with friends. Also a Younger Family Member (YFM) lived nearby to help me every day with Elderly Family Member (EFM) with dementia that I lived with. 

In 2020 , I was going to change and work weekdays. Well, no, with the pandemic, I stayed away from in-person contact with friends. Then YFM was offered a job out of town in April 2021 and left. EFM's dementia got worse, s/he moved out to small assisted living and died a few months later. I fostered a pregnant stray cat in her/his room, and that lasted 10 weeks. (During the pandemic, no one would take a pregnant cat who got fed near my work place, I'd already seen her get "fat" and "skinny" once that kitten season, and I could not get her fostered or spayed. There she was, pregnant AGAIN, and I suddenly had a spare room. Soon I had four kitties not on the lease to foster.) 

I finally requested and received training with a weekday patient. That's when I realized that HHC has a lot of unresponsive patients, and I spent all my working hours with people who can't respond. I’m an extrovert, I get some of my energy from other people. But I was now alone at home. I had trouble meeting friends in person because I worked weekends and wanted to see friends who were vaccinated, masked, and physically distanced. I need more connection to friends. Zooms are OK but not enough.

The weekend pt is the most responsive pt I’ve had in a while, perhaps because s/he was normal until an accident that caused brain damage. Weekend pt’s family had a change in schedule and suggested that I work Sun afternoons instead of mornings. This Sunday, I will attend church and have lunch with friends before working with that pt. I hope that helps me feel more sane and connected to friends.

While texting back and forth to agency scheduler and agency case manager, I admitted that I didn’t want to work with the unresponsive weekday pt that I trained on, that they wanted to schedule me with. She reminded me of EFM’s unresponsiveness as s/he died a month ago. (During texting that day, I also packed up the kitties and did “owner surrender” to city Animal Care Services, then went home and packed up left-over bags of kibble and litter in EFM’s room to take to a cat-owning friend. I felt grief over giving up the kitties, and grief over EFM’s death. I didn’t tell that to agency, too much information.)

Questions: 

Has anyone else noticed that a lot of HHC pts are not very responsive? Has anyone else had trouble with that?

Has anyone else confused agency’s HR by asking for something and then refusing it? I feel bad about that but feel glad that I will not spend 12 hours one day a week with that unresponsive pt right now.

I thought that I was weathering this pandemic in much better shape than people I was reading about. Now I feel like I may be more fragile than I thought. Has anyone else felt that way? 

[LeChien, BSN, RN]

I work in private duty pediatric home care and it's mostly the opposite. Many of the patients I work with are responsive, if not verbally then in other ways. While the agency needs nurses to fill positions, you also need to be happy with your job. Like you said, you're there with them for 12 hours a day. Even with my unresponsive patients, that always gave me time to get homework done! Maybe look into a different agency? What part of the country are you located in?

[amoLucia]

You need to take care of you!  You've had a major family loss and a loss of those kitties was also a loss. In school, it's called grief & grieving that you're experiencing and it sounds like you're moving along in the stages.

And covid certainly hasn't made things easy for anyone. You're not fragile, just realistically sensitive, like everybody else has been feeling it too.

Not sure if dealing with responsive vs unresponsive pts is the real remedy here, but if it allows you some new control and improved psychic energy in the job, then GO FOR IT! Good for change!

Don't sweat it re your HHC agency. They'll survive, just be prof dealing with them. And if you find you need to, you can join another agency & start anew with a clean slate re your preferences.

Good luck.

[guest1143647]

Those were my favorite patients. 
I would rather work with them than the loud responsive active ones!

 

I am an introvert if that matters