Why is it always the patient with the worst situation? geez

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Why is it always the patient with a chronic disease, stage 4 of some cancer, or some autoimmune, self deteriorating condition that passes judgement initially, or wants to be picky about their care?

For eg, a pt who was homeless, he passed out walking 30 miles in the heat to a shelter after his landlord kicked him out, stage 3 cancer, continues to smoke, he smelled really bad because he had been at the hospital with the same clothes he came in.

He refused EVERYTHING, his telemetry, assessments, vitals ... and the nerve to not want an African American nurse at some point during his care here. Goes out to smoke, against rules.

I just thought, dude, you are at your worst, and you have the nerve to be reckless to people and make our hob harder.

Pt I have tonight, has cancer, maybe it might be my fault at reading people, but I went in to say hello, you can sense his annoyance. His wife was pretty nice. I assessed him, said "call if you need anything". He goes "uh huh, yea, have a good day (although its the night shift).

Maybe he's passive in life in general, idk. but I will not be rude or reckless to the person who was taking care of me. Like how you shouldn't scream at the waiter serving your food - they'll spit in it sorta thing.

I hope to continue to look at these people as just overstressed with their condition, and that this might not be who they are on a daily basis. wow.

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People who are at the brink of death's door, or even dealing with a chronic health situation are never at their best, because life as they know it will never be the same. There's so much that a patient who has dealt with diagnosis, chemo, chronic pain, depression goes through both physically and emotionally, that you will never see them at "their best" unless they make a full recovery. Even then, they can be jaded.

People are not usually intentionally homeless. (most people, there are some who choose to be, but that's a story for another thread) There's a great deal that happens in someone's life that they end up in a situation that due to whatever co-morbitities, is really complicated and to them can be hopeless, they get helpless, and usually want to retain as much control as they can. And honestly, if the newly homeless man who has a deadly disease has to walk 30 miles to the nearest shelter in the heat--a well person walking in the heat for 30 miles would smell--Perhaps he is mentally ill. Perhaps he is resigned to the fact that he is dying. Perhaps he needs to be in a hospice. There's lots of perhaps in this.....

And scared. There is so much uncertainty. So it is not being picky as much as it is an attempt at being in control of a really uncontrollable situation and illness. And yes, there are some passive patients--but mostly those who have resigned themselves to the end of treatment, their impending death, their complete loss of control, and the end of life as they knew it.

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Specializes in Oncology/hematology.

I am not a nurse yet, but it would seem to me that someone who is dying or has a chronic disease has lost control of their body. They feel as if they have lost control of everything. So, they take control in the only way they have left. For some, this may come out as mean. As far as the homeless man, mental illness is undiagnosed and rampant in the homeless population.

I know it's hard to continue to want to help people who are biased against you or intentionally go out of their way to hurt your feelings, but it's our job to care for them.

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Specializes in Med Surg.

I've had the opposite experience. The people with stage 4 cancer or other incredibly difficult diagnoses have been some of my best patients. It's the people with the easiest cases that have been my troublesome patients.

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It's undoubtedly because he has lost control in all other aspects of his life & although it appears unkind, anger is definitely a stage in the dying process. He needs unrelenting compassion.

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We all have our own ways of dealing with unpleasant issues. Don't judge them or get upset with them. Just take care of them as if they were your own family.

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Specializes in Hospice / Ambulatory Clinic.

Um hellow CANCER. You seem to be more concerned about how they treat you as to how they feel. Think about it this way they are just coming to the conclusion that life is supremely unfair. Wouldn't you be picky or neurotic too? Maybe I've been working hospice too long but I find it easy enough to take a mental step back and realize. This is not happening to me it's happening to them. It's pretty easy to be kind and empathetic then.

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Specializes in Home Care.

You don't have to take people's attitudes and words personally. People are the way they are, for me it easier to accept that.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
Maybe he's passive in life in general, idk. but I will not be rude or reckless to the person who was taking care of me. Like how you shouldn't scream at the waiter serving your food - they'll spit in it sorta thing.

I wouldn't even joke about that.

Guy with stage 4 cancer I give a lifetime pass to give me as many annoyed looks as he wants to. Hell, he can even stick his tongue out at me, put his thumbs in his ears and go "blalalalalala" if it would alleviate one iota of the pain (of all types) the person is in at that point.

I think it's really sad the homeless guy suffered heatstroke attempting to walk 30 miles to a shelter.

I can be crusty and cynical, but these two really don't evoke anything other than my sympathy.

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Specializes in nursing education.

I am not really understanding what you are trying to convey. "I just thought, dude, you are at your worst, and you have the nerve to be reckless to people and make our hob harder."

What does that even mean? Reckless to people? What? People don't choose to have stage 4 cancer or an autoimmune disease. Yes, patients come to us in rough shape, expecting things we can't provide, and are sometimes rude or not very appreciative of us. Keep your compassion, and if you lose that, find a new place that will hire you, I guess.

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It's not about you.. it's about THEM.

They are facing serious illness and... most likely death.

"I just thought, dude, you are at your worst"... yes ....he is and he deserves YOUR best. Not your judgement.

You have much to learn .. would you be "overstressed" if YOU were actively dying?

P.S. This made my heart hurt.

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I don't expect very sick people to be happy go lucky at all. I may not be experiencing what they feel,but I can imagine how they feel.

And, I just wanted to know why in your sickest position, why be so miserable. I understand the issue of having cancer, or some sort of chronic condition, I just dont understand why the short temper or quick to get angry at people caring for you, but be so lovely to your aunt, or uncle who is in the room with you. I just wondered, what have we nurses done, that you act this way toward us. it's their family, so i get it, but we are here to help and care for you.

ANywho. I guess i was speaking from a sense that if I was in a vulnerable state, choosing certain people to be angry at would not solve my problem, it will only deteriorate my health.

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