Just Plain... Mean.

You see, there are just some people out there in this world who are never, ever pleased no matter what you do. Just so happens that I had a patient like this.. we will call (name and identifying information has been changed) her, B. I had heard the horror stories from the nurses who had previously been involved in her care. "She's a witch in the worst sense" they would claim. I didn't doubt them in the least. Patients like these carry these reputations across units.

So my day began with report. I was told that this woman had refused all of her early morning medications, all of her early morning care, to include turning. You also must understand that this was no small woman by any means. And so when I went in to do my assessment first thing.. the darling was sleeping. I took the opportunity to attempt waking her, and telling her what I was going to do, but she just mumbled and kept on sleeping. I got to listen to her heart, her stomach and such. Take a peek at the IV site, looked at her legs which were wrapped in kling. Thought I would come back in a bit to finish up the rest of the assessment when we was more alert. Didn't take long for her to wake up though.. breakfast soon arrived.

And she awoke. And the complaining began. Since I was told she had refused her 0600 meds, I didn't open a single one until I got into the room. Of course, she didn't want to take any of them. Why take vit C? She doesn't need that, she said. I don't want it, she continued, I know you all are trying to just dope me up. I shook my head. I explained each and every single medication to her at that time that I would be giving her. All of the vitamins, the anticoagulants, etc. She mumbled and grumbled... no way was she taking this many pills. She couldn't do it, unless she had applesauce of course. So applesauce she got. And all those pills disappeared down her esophagus. :) Took some maneuvering but it was done. Phew!

It was a never ending battle with this woman. All day long, either she wasn't sitting right or the food wasn't right or the light was too bright. It was on and on and on. It wears your patience down, but I killed her with kindness. I politely explained every aspect of her nursing care when I was involved. But it didn't stop her endless insults to everything and everyone around her. I don't know if she was just miserable or just plain, well, mean.

In the early afternoon, I had queried the cna assigned to her if she had even attempted to give this woman a bath. (of course these are to be done in the mornings.. but this cna.. well she lacks the drive and initiative to do her work). She told me that this woman had refused her bath. (After my many encounters with this patient, I didn't doubt this was the case.. however) I told the cna that this patient could not do for herself, but if she refused her bath, fine. BUT she absolutely must have foley care done no matter what. She had to have it and please go do it. Even if she refuses, just get the stuff ready and do it anyway. She will comply. (see I had this feeling that all the cna had to do was get the bath water and stuff ready and the woman would allow her to wash her up... and guess what? she did!)

Nevertheless, it was a trying day with this woman. Luckily, she took a good afternoon nap after her bath and some scheduled xanax. And that allowed me to focus entirely on another patient of mine... who didn't make a complaint all day long. In fact, this patient was expected to pass at any moment in time. It put the complainer in perspective.. she was lucky that she could talk and tell me how she felt... about everything in the world. My other patient couldn't even tell me she if she was having any pain at all. The only voice she had that day was the "death rattle" and the longer the day went, the louder that voice got. No matter what I did, that voice never faltered. You try to make your patients comfortable, even in their last few hours, but it isn't always possible. Whether because they are miserable humans or unable to tell you what it is they need. All we can do is our best in every situation.. and move on from there.