Sunday, July 29, 2007

Dr. Jekyll vs Mrs. Hyde

My first assignment on my first day of clinical orientation was a combative patient. My preceptor gave her to me saying that, "she kicks, she cusses, but I think you should know how to handle a difficult patient."

Sure thing. I'm flexible. I got report from the night shift nurse and expected to meet frankly, the Mr. Hyde of all patients. When I went into the room for my first assessment, she was in bed sleeping. I decided to let her rest and returned about 30 minutes later. She was awake then, and we talked some about the plan for the day and what tests she had scheduled. With me, she was an absolute gem. We understood each other---she didn't want to be bothered, and I didn't want to bother her..we both just had to work together to get her taken care of.

Her son was at the bedside, and the other 2 patients in the room told me later that I'm the only one she didn't kick and fuss at. When I gave report to the next nurse, I told her specifically, that Ms. Hyde was fine unless she felt like she had no control in the clinical process. I returned the next day to find her on 4 point restriants (apparently she and the evening & night nurse) hadn't gotten along, she pulled out her IV and cursed them out big time.

I assessed her, talked to her and took the restraints off. She had to drink 2 Liters of Golytely for a procedure at noon, and contrary to popular opinion she downed it like she was a champ (actually drinking 1.5 liters of it!) Everyone on the unit, the techs, the nurses, even my preceptor are surprised at the fact that with everyone else, Ms. Hyde is a grade A B...but with me, she's like a lamb. She even let me put a foley & IV in her.

I'm not surprised. I think that patients sense the kind of energy that we present when we come to their bedside. If my energy is good and positive, she feels that and responds to that. Having sickle cell, I know what the other side of the fence feels like and perhaps that's why I'm able to relate.


Anonymous said...

You are right, pt's do sence your enrgy when you enter their room. Iv'e worked with psych pt's no one else could communicate with but I could get through to them. They senced felt for them like I did my other pt's and not with fear and disgust as some of the other nurses did. Your attitude when you walk into a pt's room makes a big difference.

Vixen said...

Hey Ms. Anonymous...I feel you. I agree it's all about attitude. It's a shame that so many people in the medical field don't have the right attitude anymore.