Thursday, May 29, 2008

depressed pt

I am currently doing my cardiopulmonary placement on the general surgery ward, where most of my patients have undergone some type of upper or lower abdominal surgery
One patient that I was treating had been diagnosed with terminal cancer a few months ago and he was admitted for surgery to try and remove the cancer. Once he was transferred to my ward he was convinced that he was going to die during his stay in hospital. The first day that I saw him was day 1 post- op and he was very pessimistic. When I was checking his wound we found that it was weeping and needed to be redressed. His response to this was to swear at himself and the kept repeating ‘I’m going to die’. I tried to reassure him but he was so sure that he was going to die in the next week. When I took him for a work the insertion of his IV started bleeding. Although only one drop of blood came out from the bandaging the pt again began swearing and repeatedly saying that he was going to die. Again I tried to reassure him by telling him that he wasn’t dying and that it was only one drop of blood but then I remembered that he had terminal cancer and was likely to die in the next few months. After that I had no idea what to say to him because I didn’t want to keep telling him that he wasn’t going to die but what else could I have said in that situation? It was only one drop of blood so the pt was clearly upset about his diagnosis and because of that was making a big deal out of a small bleed that was not going to make him die. Does anyone have any suggestions about what to say/ do in this situation because it caught me by surprise and I had no idea what to say.

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