I come on shift and find that Susie Q Patient is one of my assignments for the evening. Susie has a history of some mental health issues. Susie is a little impulsive and sporadic in conversation, so I set her bed alarm before I leave the room after taking her initial vital signs. I'm afraid she will try to get out of bed on her own and end up falling.
Within a few minutes I hear the bed alarm go off. I come in to find Susie on her way out of bed, and there is a strange smell. "Are you smoking?" I ask. "You can't smoke in here, this is a hospital."
"Oh, I didn't know that, just help me out and show me where I can go to smoke."
"No, it is a hospital wide policy, you cannot smoke anywhere on the grounds of the hospital." At this point I am still trying to locate the dang cigarette. Finally I find it, IN BETWEEN THE BED AND THE RAIL. Yes, please do what you can to burn down the hospital.
I dispose of the cigarette, then as I am pulling her pack out of her bag (charge nurse told me to confiscate them), she offers me her lighter, too. Well alright, I will take that too!
Story two: (Less funny, more warm-and-fuzzy)
Mildred P. Oldlady has just had surgery that day. She is anxious about recovery, and Mr. Oldlady is not doing much to relieve her anxiety.
I do what I can to be reassuring, anticipate needs, etc. Standard plan of care on my part.
Toward the end of my shift, it's clear that Mildred will be needing a catheter inserted. I go to let her know, and she starts freaking out. Completely unexpected response. Come to find out, she's never personally had a catheter, and the only bystander experience she's had was extremely negative. Just the mention of catheters brings up all sorts of emotional memories for her.
Holy smokes, looks like I'm going to need to do a little bit of holistic care here.
When I come in to do the actual procedure, I do a whole lot of explanation. I tell her just about everything I'm doing and why. I tell her what she can expect in the following few days related to the catheter. I have her tell me a little more about her fears. I teach her a simple breathing exercise (4x4 breathing) to help focus her energy.
When I have finished, she says she hardly even felt the catheter go in. She is visibly more relaxed than she was when I had first given her the news about needing a catheter.
I come in a little later to check on her, and she says she has been doing the 4x4 breathing ever since I had left the room, and she loves it. I make sure to come say goodnight before I clock out, and she says she will not forget me, and that I have made a difference for her.
Ah, patients like Mildred and situations like this are why I am becoming a nurse!
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