Come Here...!!!!

*****Disclaimer!!!! may contain some swear words******
One of my favorite parts of my job is getting to interact with patients.  This is a very good thing, since that is the majority of my job ;)  Anyway it never ceases to amaze me the things my patients do or say to make my night.  Many times, I deal with difficult patients.  However, it is much easier to deal with difficult patients when I know that they can’t really help it because it is related to the disease process.  Some example of this would include: older patients suffering from dementia, patients who are in genuine pain and patients who may have just heard bad news about their health and the rest of their life.  For these patients it is a lot easier to have understanding, compassion and sensitivity when they are being difficult.
One patient in particular made my night. He was an older gentleman and was suffering not only from dementia but a form called sundowners.  Now sundowner means that the patient is more confused and out of touch with reality after the sun goes down (night time).  He had no family with him and he was very confused.
He arrived on the floor, and I oriented him to his room as best as I could.  I gave him the call bell and yet knew that he probably would not be able to use it correctly since he was blind in both eyes.  I decided to leave his door open so we could keep a close eye on him.  This was a big mistake!!!!!!!  One that I was going to regret!!!!
As the night progressed, the patient became even more confused.  He started to panic and began to call out.  The tech went into take his vital signs and didn’t take the precaution of announcing herself before grabbing his arm.  He freaked out and threw up a punch with his right fist that caught the tech in the chest, knocking the wind out of her.  And that was only the beginning.
We managed to calm the patient down and went on with our tasks.  I thought the patient would get some sleep, but I am beginning to learn that patients never sleep at night, unless they are the patients that are pretty much self-sufficient (which doesn’t really make an easy night for the nurses and techs).
Every time someone would walk past the patient’s door, he would holler out for them to come in.  After the first few times, we realized the patient didn’t really need anything other than some good old fashioned attention.
As I was walking past the door at one point, I heard the patient yell something that I hadn’t heard him say yet.  He was very upset and was starting to freak out again.  “Come here b****s and whores!!!  I say come here.”  I was shocked to hear him say that.  I went in the room and began to talk to the patient.  He calmed down and I left the room.  But I obviously had set a precedent for the rest of the night because any time someone walked past the room we heard “Hey, come here b****s and whores!!! B****s and whores come here right now!!!!!”  While I’m not usually one that tolerates that language from my patients, like i said earlier sometimes patients with dementia may be allowed to say some things that normal patients would not be able to and it was kind of funny in an ironic way to hear this patient yelling it out.  Made for a very interesting night.