Author: Connie Kragt
“Watch out for that one”, was the warning. They were referring to one of the patients that would be under my care for the next twelve hours. I instantly raised my eyebrows and took an extra big swig from my coffee cup. I could sense the fatigue surrounding the night nurses as they conveyed the events of the past evening.
Mr. Bell was the “problem child” of the ward. Physically he was doing alright but he was labeled a “walkie-talkie”. Patients who can walk are a prized commodity to nurses. The fact he could get around with minimal effort was a welcomed bit of information. I prompted the night girls to tell me more. It appeared as though his “talkie” ability was causing some problems. Mr. Bell was slightly “off” in his thinking. This is a fairly common state of about one-third of my clients. I sincerely appreciate the patients suffering from dementia who are pleasant, generally compliant and polite despite their disease.
Mr. Bell was seeing mice in his room together with numerous reports of a stranger being there as well. These are common types of delusions so I still couldn’t understand why Mr. Bell was so frustrating to the nurses. It did not take long to understand the key issue: not only were these hallucinations entirely real to Mr. Bell, but he felt that they were most assuredly the fault of everybody on staff. The mice were the fault of the kitchen staff and the strangers were spy nurses. Because of his “walkie” ability, he had made his way to the nurse’s station all night long and his “talkie” ability allowed him to complain endlessly.
Nurses are people, patients are people and sometimes bad shifts are just a result of people not getting along. The rest of the assignment seemed just fine so, hoping for the best; I received Mr. Bell into my care.
I decided to handle Mr. Bell with a serious approach. Sometimes fighting fire with fire is a good tactic. I abandoned my usual friendly banter and stuck to going about his assessment matter-of-factly. I didn’t argue when he recalled his hallucinations. I shook my head in disbelief when he told me the kitchen staff tried to feed him mice. I was understandably appalled when he whispered, “There was a spy amongst the staff on nights”. I played the part of shocked spectator with skill, even if I do say so myself.
During his pessimistic paranoid rant, I carried on his physical assessment. I had just put the blood pressure machine on his arm and began to inflate the cuff. As soon as the cuff began to get tight, Mr. Bell began to tense his body and yell. He was sure his arm had lost its blood supply and was soon about to fall off. He reported that I didn’t know what I was doing. The cuff relaxed just as he said, “You must be a student nurse with a lot to learn”. It took all the control I could muster to tell him that I had been a nurse on this very ward for over ten years. Obviously unimpressed he said, “Stuck in a rut are you?”
Some days you just can’t win for trying.
© Copyright, PeopleMenders, 2009. All Rights Reserved.
About the Author
Connie has worked on the Internal Medicine Unit in a hospital in British Columbia for twelve years. She began there as an entry level LPN and is now one of the most senior LPN's on staff. The Internal Medicine Unit is a specialized acute care unit. It is a busy ward with a variety of specialized treatments for which she has received training to handle.
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