Tuesday, June 24, 2008

The patient I did not like

Surprisingly, despite my glowing personality and ability to get along with almost everyone (insert sarcastic tone here), sometimes there are patients I just don't like.

Yesterday was no exception. I was looking after a 65 yo COPD'er who was in for aspiration pneumonia. He was on 50% oxygen and his SpO2 was only 92%. He was fairly frail, I've seen 90 year old ladies look sturdier than him. By the time I arrived for the night shift, he was admitted and awaiting a bed on the floor. He had a reclining chair in his room, and except for breathing treatments, we had nothing to do for him until midnight.

But he made himself known. "nuuuurse. Put the bed... up?" he would ask. Then "nurse.. I cant sit... in the bed... I neeed to go... to the chair" so we put him in the chair. "put... the pillow... behind my back... and I want... a warm blanket.. around it. And a table... and a pillow to lean on".

Later when doing routine vital signs:
missE- "do you have any pain?"
him- "all over my body"
missE-" there is pain medication available to you, do you want it?"
him" what is it?"
missE- "dilauded, 1mg"
him" that won't touch me. I need 10... and I want some... morphine 100mg as well... that's what I normally take... If you can't... get that for me... than I don't want anything"
missE (getting annoyed). " did you want to try the 1mg Dilauded and see if it works? If it doesn't, than I can see about getting something more."
him "no... it won't work"
missE: "so you dont want any pain medicine?"
him "go away"

Later, when taking his bloodwork....
MissE- "hello Mr X, I'm here to get some bloodwork"
Him "you always take blood. I can't get comfortable.... how come other people have gone upstairs.. and I haven't... I can't sleep down here... "
MissE- "I know this can be frustrating, but they are working on getting you a bed upstairs. Sometimes there are certain beds for certain illnesses, and the people going upstairs qualify for those beds. I can try to make this area more comfortable for you as best I can, but its more likely that you will be spending the night in the emergency department"
Him "you always poke me... and the bed is uncomfortable... and you said... that they are getting something.. upstairs for me... I just want to sleep... I hate it here"
MissE- "Mr. X, we're doing the best we can. Are you comfortable enough where you are? Is it ok if I draw your blood now?"
him- "you ... keep on.. giving me needles.... I hate them.. and I'm uncomfortable.... and I need my table closer... watch my feet... fix my pillow... I need more blankets"

This went on and on all night. Did I mention his family was just as crusty and needy? We finally had to limit visitors to one at a time so that we could appropriately give time to our other patients.

Needless to say I was glad to leave work that day.


The Dating Guru said...

>Needless to say I was glad to leave work that day.

Ha! I don't blame you. Just found your blog through an article on NYTimes.com, and am happy I did! My mom was a nurse, and oh, the stories she could tell. I look forward to reading more of your blog.

miss-elaine-ious said...

Wow the NY Times? I had no idea! I'm just a lowly new nurse from Ontario, Canada.

Wow. Thanks for visiting!