I am on my cardio prac on the general surgery ward, I was assigned a pt who was admitted for an emergency laparoscopy. A 49 year old, their past medical history revealed obesity and high cholesterol. Socially they were an excessive ETOH drinker 1-2L/day and smoker 1-2packs/ day.
On seeing them day 1 post op I walked in seeing my pt walking with a frame back from the shower. Objectively I observed their red eyes, flaky white skin and shaking tremor in their hand. As the pt was too tired from ambulating to the shower and back my treatment was education on deep breathing exercises and the importance and benefits of ambulating ASAP post op. On hearing this the pt was extremely verbal in explaining how they had worked in hospitals for so many years now. My pt was very uncouth and rude in telling me that “You bloody well don’t need to tell me what to do,” and comments along the lines of that. It wasn’t meant to sound angry or aggressive but the way my pt talked to me was plain rude. At one stage my pt raised their hand in a mock slap; reflexively I stepped back but I interpreted it as part of their character. Although compliant with requests to ambulate my pts personality was very off putting and they weren’t a pleasant pt to work with. Rude comments about doctors and complaints about everything when I was preparing the environment. A harmless pt overall, but they just had a mouth that wasn’t very nice.
My attitude to this was to take it in a laugh it all off, I kept a pleasant attitude towards them and kept my mind on the task at hand. Initially I was very weary about my pt and did not know how to respond to the rude comments that were made. So I just ignored them and did my job.
Has anyone encountered a pt like this? if so what did they do?
2 comments:
hey lkay. I havent had a patient like that before, but i think its a great idea to just laugh it off and keep the positive attitude towards the patient (i would definitely struggle to do this). I think understanding that the patients mood is probably being altered by nicotine and alcohol withdrawals would help me to keep my cool around the patient.
I've had a few patients like that and I agree they are hard to handle and they make you feel stupid about asking monitoring questions, but I've done the same thing as you did, just sort of ignore the comments and attitude and get on with what you've got to do. I don't really think there is anything else you could really do, just hope they get discharged soon.
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