measured and found lacking
i took a test of patience and i failed it. again.
you probably remember her. L, the patient we had to restrain because she was consciously trying to pull out tubes so she can “rest”.
she wasn’t wearing her speaking valve but i have taken care of her a few times that i got pretty good at reading her lips. anyway, she had been off restraint for two days but the whole day, the day nurse told me she was so agitated and was constantly asking for pain medicine that she got so frustrated with every little thing.
she would call and hit the side rails with the call light nonstop to express her emotion. although i am not justifying those who tend to ignore her by waiting a little while before they answer her call, i can totally understand why they do it. i mean, if a patient calls with such urgency for the nurse to take off or put on a blanket, that pretty much defeats the definiton of urgent.
i came in and she was hitting the side rails with the call light, so hard that i almost thought the little thing will break into pieces.
“L, i’m here and would really like to help you. i know you are calling for a pain medicine. i have checked your chart and there is nothing i can give you at the moment. you just had you IV pain medicine 20 minutes ago, and your tablet pain medicine is not due until 9 tonight. i will try to call the doctor if there is something more i can give you, but you have to wait a little bit.”
that was our first exchange. the next exchanges were practically the same. every 10 minutes or so, she would call, and she continued hitting the siderails with the call light. and it continued to puzzle me because she totally understood what she was doing.
when i was about to lose it after a couple of hours of the banging, annoying sound, i asked: “do you mind if i ask you to stop doing that? the second you push the call light, i’m here, banging the side rails isn’t really necesarry. i’m here now. we need to respect other patients who are trying to rest.”
i realized that was the wrong thing to say, because she got more angry and in action, threatened to pull out her trach and feeding tube.
that threw me off the wall. frankly, in a perfect hospital, no patient should do that. i mean, why would you threaten your nurse with something that will have ill effects on yourself? the idea that she was implying was apalling to me. she was almost smugly saying “you better do what i say or i will pull the tubes and you will surely be in trouble!”
in a perfect hospital, a nurse should never succumb to playing games, but i was at my wit’s end, and i thought i didn’t have a choice.
“L. i understand that you are frustrated. i just want to remind you that pulling out those tubes will not help you in any way. if you continue to do that, even if i don’t want to, i will be forced to restrain you.”
nicely said. calm and firm.
she shook her head vigorously, begging off the restraint. for a second, we exchanged a look of mutual understanding. then, out of the blue, she started hitting the siderails. this time, with such passion, my ears started to hurt.
i imagined raising my arms in the air.
what i did for real was turn around and leave the room without saying a word. the remainig hours of the shift were proofs of professionalism. by that, i mean i took care of her because she was my patient, but i distanced myself to the point of denying her a sense of empathy. the routine went on like this: she banged the siderails everytime she called. i asked her what she needed and i gave it without any hint of compassion.
just when she needed compassion most, i did not have the energy to give it. i am embarassed to admit it, but it is the truth so i’ll say it anyway: my compassionate spirit flew out the window when my patience was sucked out from me.
where can you find patience when you REALLY need it?
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as for the comments on my last post, thank you.
it is fiction. just like this one, and this one.
my husband reads this blog. that should explain everything.
i thought putting friday fiction (as explained here) on the title was enough. i apologize if it was misleading. it’s just that sharing the fictional stories inside my head as a first person narrative is what i’m very comfortable with, and has sort of become a bad habit that is not easy to break. i do have plans to keep posting fictional stories in the same style, (as i said, just to indulge myself) and will appreciate suggestions on how to avoid confusion in the future.
thank you again.


Aw May,you are too hard on yourself,those kinds of pt’s try everyone’s patience.
Comment by ButtercupRN — April 22, 2008 @ 7:45 am
If we were saints we could find empathy for everyone, but we are humans trying to do our best. A patient like that will wear anybody out.
Comment by annemiek — April 23, 2008 @ 4:09 am
You did treat her with compassion, May, and she bashed it upside the head.
I’m sorry you had to go through with that sort of shift, with that sort of person, themselves in an awful situation. But you did your best, and I think all of us out here in blogland can readily see and appreciate that.
Comment by shrimplate — April 24, 2008 @ 8:33 pm
Ma’am May I know that you are a very caring nurse. I know this because no nurse who would actually care for her patient would feel guilty over not being compassionate with her patient.
And I agree with the other peeps who commented that we are only human. We can only give as much but there are times when we grow tired.
I’m impressed how you could still treat your patient with professionalism even if she’s trying to drive you insane.
Comment by edgar — April 28, 2008 @ 7:35 am