As a nurse, sometimes you have to be very firm with your patients or they will pretty much make your life a living hell. For example, I was caring for this one patient who decided that he was going to be very difficult.
In report, I learned that he was in pain, and his pain meds may not have been exactly adequate to control the pain, but because of a history of abuse, the doctors were being cautious and did not really want to order any other meds.
Before I could even get out of my chair to begin my rounds, this patient was on the call bell. The tech came and told me that the patient was very upset and wanted to see me right now about his pain meds. I quickly checked when his pain medication was due…of course it wasn’t due for another 3 hours. Hmm this was going to get interesting very quickly.
I introduced myself and asked him what I could do for him…He started right in. “I want to see your supervisor” Ummm…does he really think my supervisor is here this late at night!!!! “She’s not here right now, but I will pass on that you want to speak with her”
“I want to talk to my doctor right now” I of course told him I would call the doctor and let her know…of course that didn’t stop his rant and rave…
“I want to take a shower and I’m gonna do it right now” “Well that’s fine, I really don’t care, let me check to make sure the shower is clean, and we can do that for ya”.
“Well this is stupid…I know how this is gonna go…you are gonna come back in here and tell me I missed taking a shower by like a minute because it took forever!!!” I quickly explained to him that I really didn’t care if he took a shower but I did care if he took a shower in a dirty shower.
I told him I would call the doctor and have her come up to see him right now…so I went and paged the doctor and she came right up…but of course sometime in between my leaving the room and the doctor coming up, the patient had gotten in the shower. Of course the doctor didn’t stick around to talk to the patient so I had to put that fire out.
When his shower was finished, he started right back in on the pain medication issue “I never got any pain meds all day and I want them now…I’m dying…you can’t understand how much pain I am in.” Of course the pain meds still were not due for another 2.5 hrs. I quickly decided that I was not going to deal with this all night…I very firmly explained to him that I would bring in the medicine as soon as I could, but he could not keep bothering me all night with this…I told him I would re-page the doctor.
He stood up and got right in my face…he took his finger and started poking my chest…going off on a tyrant…now of course he was much taller than me which made it a little intimidating…but I just stood there until he stopped talking…and then said
“Sit down!!!” He just looked at me. “Sit Down!!!” He quickly sat down. “You need to stop talking!!! And listen to what I have to say!” From that moment on the dynamics had changed and we were able to have a real conversation about what he wanted and what his expectations were….which changed the tide of the rest of the evening.
However as I was leaving in the morning and walking by his door, I saw him standing over one of the techs doing the same thing he had tried on me…Hmm…guess being firm only makes a difference while you are in the room ;)
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