Overheard at work

1. Two elevator repairmen in the lobby this morning: “I don’t know how those Seaman systems work.” I snickered, because I am really mature.

2. A medical student: “What’s water boarding?” I overreacted. “Are you SERIOUS? You have never heard of waterboarding?!” I gave her a two minute synopsis on so-called advanced interrogation techniques vs. torture, the Geneva convention.

3. A patient: “Someone is taking medications out of my purse!” I rocked this one. No ableism intended, but I am known as the “crazy whisperer” at my site. I didn’t come up with that name. A lot of practitioners / caregivers take an adversarial communication style with patients that are combative, delusional, or simply question or want to refuse treatments. I try as hard as I can to meet them where they are. The patient is intermittently in florid psychosis, is paranoid, and is refusing treatments, tests, meds and food. She is sick, in many ways, and some of her meds can literally be a matter of life and death. I had a good, long conversation with her. I am going to let her use her home inhaler if she informs us, instead of confiscating it and making respiratory document every administration. I am ordering sealed cans of dietary supplements to her bedside to accommodate her fear of “dirty hands” contaminating her food. I told her that her 1:1 sitter will help keep track of her belongings, trying to establish trust with her sitter and to help her feel more secure. I let her know some of her meds are refuseable, even though she has been involuntary committed and deemed confused and inappropriate. I find that when patients feel like the have some respect and control, they are more secure and cooperative. She immediately agreed to her most critical meds, and is much more calm.


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3 responses to “Overheard at work

  1. I’m new to your blog, but wanted so desperately to comment on this because I appreciate that you met that patient with such kindness, respect, and accomodation. Thank you.

    Oh, and also: 1. I would have snickered too =)

  2. Good for you!

    I think it’s hugely important for caregivers and medical personnel to take the people they’re caring for seriously. I see a HUGE amount of the opposite of that kind of respect in the field of institutional care for people with developmental disabilities, where their efforts to communicate are often brushed aside as irritating or pointless “behaviors” to be ignored or quashed. It’s a very dehumanizing policy, and it would make me very upset if someone treated me that way. As luck would have it, I can speak, but plenty of people with my condition can’t, so there’s a strong sense of “there for the grace of God go I” in these matters.

    Anyway, good for you addressing your patient’s fears and helping her find ways of taking her meds that work for her. I think you’re making it clear to her that you’re on her side, and I think that would make a huge difference to someone who’s been hospitalized for a psychotic break. That’s a terrifying thing to experience, and you might’ve made it a lot less scary for her by doing what you did.

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