During morning huddle at the nurses station, a nurses mind can quickly take over and form opinions of how his/her day will go, and images of how the patient’s will “be”. When the Baker Act patient in 221, the “jumper” in 213, the suicide attempter in 205, the “over involved” family member in 230, the TB patient who’s in isolation in 227, the VIP patient in 238, and the “demanding” patient in 204 are revealed during this huddle, it’s easy to make assumptions about the day. Then if that’s not enough, during the morning report in which the night nurse reports important information about each of your patient’s, including her own opinions of the patient’s, the mind continues to take over..and it’s hard not to feel one of two things, “Oh crap, I’m screwed”, or “This sounds like a good day ahead “. But, you just never know!
She’s a tough one, always demanding attention.
He’s so particular and wants everything his way.
Her daughter calls all the time, and is very controlling and sometimes rude.
She says she’s in pain, but I wonder if she really has pain, or just wants Dilaudid every 4 hours…she has a history of drug abuse too.
He’s a regular, and is withdrawing from alcohol ….again. It’s his 5th time in the hospital this year.
He’s really confused.
This ones a drug seeker. That one’s an attention hoarder.
As as a new nurse, you’ll be overloaded with opinions from the very start of your day, but it’s important to try and clear the judgmental chatter from your mind, and form your own opinion of each of the patient’s in your care. Even if certain things appear to be true, perhaps you’ll have better chemistry with the patient then the nurse prior. Perhaps with time and trust, you’ll unlock the secrets behind the anger your patient carries. Maybe there’s a reason he drinks all the time! Maybe get to know the “why” behind the ETOH abuse.
Recently I was told that my patient was confused, by the night nurse during morning report, and by the physical therapist that worked with him later that day. He was slow to speak due to the progression of Parkinson’s, that caught his body. It took him time to get the words out and he had a soft voice, so some had no patience for this, and tagged him as alert but confused. While performing my morning physical assessment, when I got to the “neuro” portion of my exam, in which I ask for the patient to reveal the current month and year, the current president, and the location of existence, my patient was able to answer all three. “It’s August 2016…Obama..and I’m at Mease Dunedin Hospital”. There were also solid opinions of this man’s girlfriend, that many had formed during his stay. She’s rude, was one nurse’s opinion.
During my first encounter with her she was pissed off, stating the the physical therapist dragged her man through therapy, as opposed to providing patience and allowing the patient to work for it. “How will he ever recover, if he doesn’t do the work? He’s very upset, because they dragged him and rushed him through therapy, but he won’t say anything, so I will. His Parkinson’s has made him slower to move, but he’s very aware of his body and his mind is intact, and he wants to make the decisions.” I listened to what she said, and profusely apologized for the behavior of the PT, and assured her that I would be speaking to therapy about it for next time. She also shared another frustration, “people don’t take time to listen to him. He’s the one who makes decisions for himself. Listen to him. Take the time”, she demanded. Clearly she was frustrated, and I don’t blame her. I assured her that I did and will continue to listen and make time for him. She mentioned that one of the night nurse forced a cup of meds in his face, and said, “Here! Take your meds”, never allowing time for the patient’s shaky hand to grab the cup and take the pills by himself. This frustrated the patient and the family. Talk about stripping away one’s dignity. If it’s not enough that this man, who once was young, healthy and successful has to deal with his disease process, now he has to deal with feeling like a helpless bother.
This patient…we’ll call him Mr. J, and his girlfriend became some of my favorites. Despite the things that were said about Mr. J prior to my own assessment, I decided to form my own opinion’s of the man. He was my patient for 4 shifts. We joked and laughed together. I made time for him. I listened to his words patiently, and I was truly interested in what he had to say. I know he felt that. I got to know his really cool friend, who’s deaf and also famously known as, The Deaf Tom Cooney. You can read his stories here and here. I made sure Mr. Cooney was stocked with cranberry juice whenever he’d come by for a visit with Mr. J. That was his favorite beverage. Mr. Cooney and I became best buddies; hugging, laughing and talking about life together. He’d blow me kisses and throw me the hand gesture for “I love you”, whenever it was time for him to depart. You know the gesture, it looks like this:
Mr. J’s girlfriend and I embraced like old time friends when she’d come by for a visit, and I’d update her on Mr. J’s progress and the plan. She’d call me when she wasn’t able to make it in, and we talked like we’d known each other for years. I particularly loved when Mr. J’s slow to arrive smile would finally appear on his face, whenever I’d give him a hard time about something. We had fun together and joked, like any two adult friends do. I learned that at one time in his life he was a very skilled photographer and carpenter. His work was featured in magazines, and he had great success with his photography, particularly the works of the human body. Mr. J and his long time girlfriend enjoyed life together. When he was stronger he cooked, was extremely organized and ironed his girls clothes. He was very creative and enjoyed life. The way she spoke of him, reminded me of the way I speak of Doug. Mr. J reminded me of an older version of Doug. We also discovered similarities in taste for food, as we talked about some of our favorite places to eat. At one point we talked about the best sushi spots in town, and I mentioned that I love gyoza, a Chinese potsticker.
When it was time for him to leave the hospital, I was sad to say goodbye. He was one of my favorites and I loved the people who came to visit him. Before he left that day, his girlfriend called me in and they presented me with a gift they put together. “We did’t have wrapping paper, but we wanted to give you a gift before we leave”.
I was handed the most creative and thoughtful gift, that left me feeling so thankful. Between the two taped together paper plates, was a container of gyoza from the hospital cafeteria. I especially loved the “I love you” blue glove that was attached to the plates, and the sweet sharpie note written on the top of the plate, below the honey packet. It meant so much to me, and as I walked out of the room and down the hall, everyone stopped me to admire the creative gift.
His girlfriend asked to take a picture of the two of us together, right before he was wheeled off the floor in a wheelchair. Then we hugged and said our sentimental goodbyes. As I watched him leave, I was reminded once again to form my own opinion of others, and to enter each patient’s room with an open mind, free from the thoughts and opinions others try and insert there.