We have a varied mix of patients at the hospital at any given time. For the most part they are very friendly and appreciative of what we do for them. Occasionally we run into someone who is just so soured on life in general that they set out to make everyone as miserable as they are. I like it when I have those grumpy patients. Yes, that's right, I said I liked having them. I look at them as a challenge and love to win them over to my side. Everyone I work with knows that I enjoy that particular patient and they usually try to give me a shot at them.
A couple of weeks ago I was getting report and the day shift nurse laughed as she told me that she had the perfect patient for me. She went on to tell me that he was a very grumpy man and that nothing anyone did could make him happy. He was admitted for CHF a couple of days before and was doing very well clinically. His labs were great, his lungs were much improved and he would probably go home the following day. The problem with him was his nasty attitude and hiccups. Yes, that's right, hiccups! Apparently he is plagued with them. He told her that he had had them for 3 weeks and that when he has them at home he takes a certain medicine for them. She had put a call out to his doctor and asked for an order for the medication to give him. After a couple of hours (which is about normal call back time for his doctor) the doctor called back and gave an order for the medication in IV form. She wrote the order and sent it to pharmacy. It took the pharmacy about an hour to get the medication up to our floor. When it arrived she brought in the IV pump, tubing, and medication and was going to administer it to him. He threw a fit! "I don't want it now, you can just use it yourself! I asked for that medication over three hours ago! You people are terrible! Just take it away, I don't want it!" She tried to explain to him that it takes a while to get the order and then get the medication from pharmacy. She told him how sorry she was that it had taken so long but that it had been out of her control. He would have none of it. He continued to berate her and went on to obstinate and almost verbally abusive to her.She left the pump with the medication in his room even though he'd asked her to remove it from his room. So now, I was the lucky one to get to reenter his room and try to calm him down.
Before I even entered his room I said a prayer that God would give me the right words and the right attitude to make him happy. I made sure that I had a big smile on my face and went in there very calm and serene. He was lying on his bed with his eyes closed but I didn't think that he was asleep. I very gently touched his arm and said his name. He opened his eyes and looked at me like I had three heads. I introduced myself and told him I would be his nurse until 11:00 pm. I noticed that he still had his hiccups and after taking his blood pressure and doing his physical assessment, commented on how miserable it must be to have hiccups for so long. I asked him if I could hook up the IV so that we could get the medicine into him. The order had been for the first bag of meds to be given over an hour and if he still had the hiccups one hour after that infusion to give him one more bag of meds. He became very angry as he told me about how he'd asked for the medication long ago and that it had taken too long to get it and that the nurse from day shift had not taken good care of him. He ranted and he raved and I was determined not to let him get to me. He said that they might as well not put call buttons on the beds because no one comes when you push it anyway. He was just livid and nothing I was saying was getting through to him. I had to fight every impulse not to snap back at him. I've had many unpleasant patients, this guy took the cake! He was one of those people that just loves to be miserable. I think he wanted to see me upset so that he could justify his position. I would not give him the satisfaction. The meaner he got, the nicer I got. I am a toucher by nature and I gently touched his arm as I talked to him. I told him that I was sorry that he'd had such a bad day and that I was sorry that it had taken so long to get his medicine. I told him that day shift was over and that we were going to start over brand new with my shift. I promised him that I was going to the nurses' station and telling them that I wanted to be notified immediately if his call light came on. I finally convinced him to let me start the infusion and asked him if there was anything that I could bring him right then, a drink, a snack, anything. He asked for a Sprite and I RAN to get it for him. I went to the nurses' station and told them to call me, not the nurses' aide if his call light came on.
After the infusion was complete he still had the hiccups. I told him that in an hour we could run the other infusion. He would have none of it. "Just forget it, I don't want it!" Nothing I said could convince him to give it a try. He would rather have something to complain about was what I deduced from it. But still, I smiled and was nice to him. I didn't wait for his light to go on, I kept checking in with him to see if he needed anything. Around 9:00 he said to me, "I guess Kim isn't coming tonight." I asked him if Kim was his wife and he said, "No, she's my girlfriend". I wondered who in their right mind would be his girlfriend!!! I said that I was sorry that she hadn't come to visit but maybe something had come up and she wasn't able to get there. He went on and on about how selfish she was and how he didn't care anyway.
About a half hour later my phone rang (we carry hospital cell phones), it was the nurses' station calling me to tell me that his family member was on the phone and wanted to talk to me. I took the call and it was "Kim". She was upset and said that he had told her that he had been asking for hiccup medicine all day and no one would give it to him. He also told her that he hadn't had anything at all to eat which I knew wasn't true because I had made it a point to take him his tray myself and I also picked it up when he was finished and he had eaten everything on his plate. Not to mention the times I'd been in there to offer him drinks and snacks. I explained to her about the IV medication and his refusal to let us give it, I told her about his supper tray and the snacks. She then sighed and said how she knew how hard he was to get along with. She said that what he was really mad about was that she hadn't come to visit him but that she had two jobs and just couldn't make it that night. I felt sorry for her all the while I wondered why she would stick around for the abuse he gave her.
Somehow we made it through the shift and I didn't once let him get my goat. I smiled every time I talked to him. and I was nothing but nice to him. The next evening when I came in I noticed that I didn't have him again. A good friend of mine, Melody had him and I explained to her how best to get along with him. She nodded knowingly and set about to see him. He was being discharged and she took his paperwork in for him to sign. A few hours later Melody came to me laughing. She said that she had discharged him and that he wasn't any happier than he'd been the previous day for me. But then she said this; "Melissa, do you know what he said about you? He told me that the nurse he had the evening before had to be "smoking grass" because NO ONE IS THAT NICE!!!!"
Go figure! Sometimes you just can't win. The old iceberg!
