June 17, 2010
In any line of nursing, you will have your good shifts, and bad shifts, awesome patients who you mesh well with, and then, well, there are those more challenging patients that really test your patience. I was once put through the ringer with probably the most frustrating, challenging patients I've even taken care of. She was pregnant, completely and totally wasted drunk, and in preterm labor. She kept begging me to help her because she was cold and thirsty. But she refused to wear clothes or a gown, kept throwing the blankets off of her and vomiting all over her bed. I can't tell you how many complete bed changes and bed baths I did the night she was in. I've never been threatened so many times with bodily harm (I was pregnant at the time, go figure, but I was never in any real danger, as she was VERY small), cursed at so many times, and just plain abused. Multiple times I had to convince her that she needed to keep her IV in, that she should vomit in the basin, and shouldn't get up and walk down the hall naked. I tried to get her to put a gown on to help keep her warm and she grabbed it, blew her nose on it and threw it at the tech helping me. She purposefully peed and defecated in her bed as I was getting ready to put in her foley catheter...all because I wouldn't give her water, not because she refused the catheter, that she was ok with. She was vomiting - we don't give people more stuff to put in their stomachs when they are vomiting. I developed a real respect for ER staff and psych nurses for having the patience to deal with drunks and people you can't reason with. There were several times I wanted to shake her shoulders and get her to listen...I could have reasoned better with my kids than her I think. It was very, very frustrating. The bad thing was is she was in preterm labor. She did agree to let me do things to stop her contractions. I wasn't ever able to pick up contractions because when she was awake, she never sat still, but oh, she would shriek when she had one. We gave terb, Mag Sulfate and eventually we had to transfer her out to a hospital for higher level of care in case she delivered. Because of inclement weather, she had to go by ambulance...which meant that I had to ride with her. I admitted her right at the start of my shift and arrived back from the transfer 5 minutes before my 12 hour shift ended. I have never been so exhausted mentally as I was that night. But I was able to maintain my cool, and somehow, she seemed to trust me. Well, trusted me more than anyone else. Other nurses came in multiple times during her tantrums and she threw things, hit a couple of them but she never hit me. Eventually, I told everyone else to leave and the patient and I came to an understanding. I'm not saying it ever went smoothly, but she did eventually cooperate with me, and she never actually hit, bit, vomited on me or kicked me like she threatened. I never found out whether or not she delivered preterm or not, but I never saw her again. I just hope she delivered a healthy baby and got the help she needed.