Monday, June 3, 2013

Better

The patient had come up from surgery lethargic and still somewhat out of it. As the night wore on, though, he did not stay that way.

He was in pain. He was somewhat confused. The confusion resulted in restlessness which exacerbated his post-operative pain. His restlessness continued and eventually resulted in his arterial line being ripped out. There was blood everywhere. We eventually had to place him in restraints.

He was yelling and demanding for more pain medication. We did our best to manage his pain, but he was a chronic drug user and it was hard to find the right balance between just enough and too much.

He was angry. He was yelling and cursing. He was trying to hit his nurse. She called me to the room. She needed help, she needed assistance, she needed orders.

He had ripped out another IV and was trying to rip his catheter out of his penis and pull the monitor leads off of his chest. He was wild. He continued to curse and yell. He was partly confused but as I stood there and looked in his eyes I knew that he mostly was not.

He was angry. Things continued to escalate. He was yelling, spiting, hitting, cursing. There were six people in the room and we were all holding him down. We placed him in 4 point restraints.

I hate cursing. I beyond hate it.

The last few years I have worked in environments in which people talk like sailors, men and women alike. I’ve heard the f word used over 20 times a day as an adjective, a verb, and a noun. (I don’t even understand how that makes sense.) My office is frequently made up of people saying these things and there is really nothing I can do about it - I have to continue working with these people. I don’t have to listen to it from a patient, though. I don’t have to listen to him berate his nurse.

“Stop talking!” I said. I pointed a finger in his face. “You will not talk anymore. You will not say those words and talk ugly about your nurse!”

He started mumbling.

“Stop!” I was beyond frustrated. “You will not talk.”

The room was still. Everyone stared at me.

I felt frustrated. I felt angry. I felt bad. I had shamed a grown man like he was a little child. I felt like a principal lording over him.

He started mumbling again.

“Stop talking! You will not talk!” I yelled at him.

I felt horrible. He was embarrassed. But, all of a sudden he was calm. We could now give him the meds he needed and relax him.

In time everyone started to file out of the room. They were no longer needed.

I was so frustrated with this man. Why did he behave this way? Why did he respond like a child? Why did he treat his nurse the way he did?

I went back to his room later. I wanted to check on him and his nurse.  

“You need to apologize to your nurse,” I said. “You should not treat her that way.”

“I’m not apologizing to her!” he said.

“Well you should.” I said. “You need to be better. You need to be better than this. You need to act better than this.”

I stopped myself.

Better.

I don’t know this man. What is "better" for him? Was this "better" for him? Did he know what "better" was? Did anyone ever model "better" for him?
 
Maybe I should have modeled "better" for him instead of shaming him.

Funny how even the most horrific and frustrating events can cause us to evaluate our own thoughts, behavior, judgments.  

2 comments:

Michael Russell said...

I have never been more proud of than at the conclusion you draw at the end of this (I am nearly in tears, as you have seen before in our relationship). Do not treat yourself to harshly here. You did what was necessary. Then you recognized that, for all the anger on display, what you had in front of you was a suffering being and, in the end, the compassionate (and healing) response to anger is as much kindness as you can muster. Well done, Grasshopper, well done. Dr. R.

Michael Russell said...

That should read "proud of you" of course.