this is not going to be pretty, but if you are still interested, go ahead, bore yourself and read my two previous posts, if you haven’t yet. just so you get to know the background.

yeah, i’m still talking about P.

she is like a headache that grows larger than life, like fever, that refuses to subside. yes, she is still in our unit.

yesterday, she finally got a hold of our nurse manager (NM). the AM nurse told me that our NM talked to her for two hours! yes, two hours!

after two hours of what i assume was a two way communication (read: P talked, NM listened), NM came up with a full page, single spaced guidelines on caring for P. there was a strict instruction, that at the beginning of the shift, that the nurse assigned to P, needs to read the whole page, very carefully. it was placed in front of P’s chart. why i have the feeling i will end up memorizing the guidelines, is not really clear to me.

let me share with you some of the guidelines, just in case someone out there ends up to be a nurse manager, and you encounter patients like P.

1. make sure you check P regularly to find out if she needs anything. (i say: by regularly, you mean more frequent than every 5-10 minutes?)

2. make sure that when you shampoo P’s hair, air dry it. ( i say: why stop there, can’t the unit afford a blow dryer? or a hairstylist at least? geez.)

3. P wants chocolate ice cream to take with her medicine, so make sure to order it before the nutritional services close. (i say: why not get a personal refrigerator from central service and fill it up with ice cream of different flavors? are we that insensitive to just assume she will like chocolate for the rest of her stay?)

4. when P’s phone rings, let her know that you can only hold the phone for 10 minutes at a time, but that you will be happy to do it again when you are not busy with your other patients. ( i say: how inhuman is that? don’t we know it is therapeutic for her to talk to her family for hours? after all, 10 minutes is such a short time for them to come up with ideas on how to sue the hospital)

5. etc etc etc etc.

i am appalled at the obvious “heartlessness” of our NM. i mean i expect her to be caring, compassionate, and understanding. i am shocked at her utter “lack” of concern.

not that i ever had a dream to be a nurse manager, but if i were one, i will do everything within my power to make P’s stay in our unit, one that she will always remember.

for starters, i will not give her a roomate, i care about her privacy. i understand it is important that other patients hear her when she tortures the nurses, but i believe her privacy gives her the chance to do whatever she wants, anytime.

i will assign two nurses to care for her. yeah, two every shift. i am a great believer in anticipating patient’s needs. i want to make sure a nurse is always there. and by always, i mean 24/7. by her bedside.

i will contact a chef to make sure P gets to eat anything she feels delicious at any time, any day.

a harstylist is out of the question. i will never let P’s self esteem suffer if she has a bad hair day. that would be unthinkable. she will definitely get her own stylist.

and in my break, i will arrange a vacation to europe, ready for the time when P is discharged. i am well aware of the importance of relaxation, and i will not deprive any of my patients the benefits of an expensive european tour. of course, she can take her sisters.

to remind P that she is THE most important person in our unit, i will hang a poster in her room that says:

“rules of patient care:

rule #1: the patient is ALWAYS right.

rule #2: if the patient is wrong, refer to rule #1″

NM’s guidelines depressed me. i felt sick thinking about it. at the end of the shift, i felt used and drained, and i can’t even blame my hormones. what makes me sicker is the fact that i don’t have the heart to refuse taking care of P, because i honestly or stupidly feel she deserves to be treated with kindness, just like every patient.

i go back to work on friday, and i’m sure, P is going to be my patient. it feels weird to be patronized by other nurses, to be asked if i’m okay every time i leave P’s room. they think giving me a little pat on the back frees them from their guilt of refusing to take care of her.

on the other hand, i think i will never be free from the guilt. because sometimes, if not most of the times, i lie to P when i show her i am happy she banged her call light. i am a liar and i’m tired and sick of myself.