Monday, April 10th, 2017

Dealing With These Challenging Patients

December 8, 2010 by  
Filed under CNA Training

While getting the report, I heard bits of other reports. I worked like stage heart suddenly changed from a psychiatric ward. In Room 9 had a dying patient. Unfortunately, half of the family we wanted to  “do everything”, and the other wanted the patient to die comfortably. Room 2 was surpassed by the family from hell. Behind the door of 24 inmates to comply with melodramatic cardiac cripple. And of course there was my patient, who only wanted to drink coffee and be alone. As the day shift ended reports of those they met for the well-deserved drinks.

Only health professionals really understand that just because we can keep a person alive, does not mean we should. My patient had severe dementia, and now we’ll call him “Sandy”.Sandy was tall and had a gut a good size and had complained to the staff of the nursing home long-term, lived, he had pain, and stressed the right upper abdomen. Unfortunately, part of the work-up was a slight increase of cardiac enzymes, which meant that he wanted the documents in telemetry. They also ordered IV fluids.

I do not know what Sandy did for his life before his retirement, but I do know one thing, do not sit around. When he sat down, she was always busy talking to you or you see only sand. Most of the talks make little sense, but sometimes it does. Sometimes going to do what you asked for and sometimes not. Sometimes, if you have your way or tried to prevent, for example, the elimination of telemetry leads her to have a swing you. Some nurses follow orders without taking into account their own safety, but I’m not one of the nurses.

The day nurse who was assigned to Sandra was not one of those nurses and Sandy decide when the telemetry was simply plot “patient refused”.What would be good to let them know MD. Then one night it was clearly going to be a full moon, I called the doctor to let you know that the patient refused telemetry. His response: “No, she can’t. She can’t refuse.”Since I had taken the year long touch, he said“I’m fine dependent on drugs and then put back on the telemetry. The report, clearly the master of his domain, and then said“Do not want your drugs until if possible and wait until you are tired or falls asleep, then put back on telemetry“.No problem.

I continued with the treatment of sand and my other patients that night. While the mapping, I heard the family from hell had climbed things and asked the householder. The lamb heart awoke and melodramatic behavior specialist who was called had just had a “chat” with the patient after the second explosion.

Around nine p.m.,  while starting an IV, I hear the “staff emergency” alarm is triggered. For those of you who work for hospitals, which are high tech, you already know what I’m about to tell you. On a typical eight-hour shift, I would say that the “staff emergency” alarm goes off at least three to four times. I stopped running the “emergencies” about a week after it was installed. But the evening was special, remember?

I finished fourth and led to the chamber with sand, just in case. Sandy knew she did not need the IV or infusion fluids have been, she was on IV, while four employees tried to stop him, including the charge nurse, I would call “Biscuit”. Now you should know that Cookie is about 6’2 and 200 pounds of muscle and the best man ever. But Nice Biscuit means business and is not easy to hold and most of the time people talk about things in or out at will. Sandy, however, would have none of it. Biscuit quickly helped back to bed and kept the pressure on the former site IV, which bled profusely today. Sandy was now in a volatile atmosphere with all staff in the room. That is what I wanted to enter the room and exit Biscuit stand out in the lobby.

Remember that the sand came with abdominal pain if there were only pieces of ice in 48 hours. During this time, has repeatedly called for coffee. I asked the staff to leave the room and ask Sandy “would you like a cup of coffee?”Sandy immediately says “Hell, yes”. I have a motion that staff outside the door for coffee and quickly out to Sandra, who has already begun to calm down a bit. A staff member was paged and hospital care to my phone. Soon, Dr. NoHelpAtAll remember and began giving orders to haloperidol IM. I repeated the order of IM haloperidol and should not have been able to contain my irritation of the road. This step is particularly quick to return to this sort of thing and quickly changed the order of instant messaging or email, asking if the patient would be willing to take the PO Mediterranean. I said, “Of course, as long as it’s with a cup of coffee”. This order is five minutes before the end of my shift, which worked perfectly for me. The next turn would have to sand the pill, coffee and start the IV.

Although we were very pleased that our visit has completed most of the employees that night would be back the next day. I try to let things work at work, but hear with my husband, still waiting for me. Because he is so cute, I try to make people laugh and want to change a little history to this end that I done for you, dear reader. In any event, telling stories helps me to come back the next day.

The part of the report, the next day was not as tense and the moon was higher. Arena is still not wearing a telemetry, and had a smoother operation, but had an IV hidden under a pile of gauze. Not one to sit still, she was walking with the staff and at one point wanted to be in the waiting room with about five families visit their relatives. Visitors sand laughing and everyone was happy. When tired of the sand, I wanted to see the rest of the plant, but was too tired (could be some Haldol). An aide of his wheelchair to the floor and sand serenade us with songs if asked. All I could give is “Mary had a little lamb” and continued with the song “and that lamb was loaded”. Gotta love the day after the full moon.