Patience with Patients

I'm finding it a little difficulty to blog without making my post sound like a nursing note, but here we go

I had this 45 year old woman with cervical cancer, currently receiving chemotherapy, chief complaint of altered mental status. She was a hot mess. She wouldn't sit still, was writhing around in her stretcher, non verbal and not following commands. I could tell she was uncomfortable, and was understanding what I was saying, but was just in so much pain she couldn't listen. My patience was waning as i struggled to complete the simplest of tasks to figure what was going on with her. I had a tech hold her down while I accessed her port to draw labs. I hung fluids but she kept getting tangled up in the line. I couldn't get an accurate blood pressure because she wouldn't leave her arms still long enough for the cuff to inflate. She needed CT scans but there was no way she could lay still enough for her to do the imaging. She kept getting out of bed, and 3 family members and I had a struggle to coax her back in. I cringed every time they came to the desk, because I knew it was going to be another ordeal.

I had already had a really shitty and busy day. I had her, two new patients that I had just thrown IVs in, and one ICU step-down patient that was finally getting settled. Welcome to the ER. I needed coffee. Badly. I was the floor for 8 minutes, tops.

When I get back to the desk, her family member is waiting for me, "We tried to grab you! Her colostomy bag exploded!" I rush into the room and she is now kneeling on the stretcher, elbows on the bed and refusing to budge. Theres stool covering her and the bed, and all she is doing is rocking back and forth on her knees and elbows. At this point I'm about to cry. I can feel my self getting testy while I'm begging her to roll over so I can clean her up.

I had asked the previous resident for some pain medication to calm her down, but because of her altered mental status he didn't want to go that route. Since then, the residents had switched off, so I went to the doc with eyes brimming, BEGGING for medication to calm her down. After 50 mcg of fetanyl and 1mg ativan she was finally FINALLY starting to relax. 

Her family came out to the desk, and stopped to see me before leaving. "Thank you so much for your patience with her. She's not like this. She's a CNA, she keeps herself clean, she drove herself to her chemotherapy appointment yesterday! We don't know what's going on but you've been wonderful and we really and truly appreciate the way you handled her."

And that made it all worth it.


TL;DR: Some patients need our patience

-K