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Saturday, April 2, 2011

Chronic Nursing Home Syndrome

If you've worked in a hospital, and definitely if you've worked in a nursing home, then you've taken care of the dreaded and irritable patient with Nursing Home Syndrome.

Yep, you know who I'm referring to here. They are the patient who has spend so much time in a bed, and has been taken care of for so long, that they lose touch with the emotion of empathy. They become oblivious to the feelings of other people. All that matters is number one: me-me-me-me-me.

You walk into the room to give a breathing treatment, and the whole time you're in the room they have a bunch of chores for you to do: pick up my foot, put it on the pillow. No, not like that. Yes. Yes that's good. Now dear, can you rub the lower part of my back, I have the slightest itch... and can you get me my water.. no, you'll have to put the straw to my lips... yes, that's good, now can you put a pillow under my right leg. Yeah.. that's right. Just like that.... I have a headache. I need my pain medicine... My...

By now your treatment is done and you high tail it out of there. You don't even bother asking her if there's anything else you can do for her, because the last time you did that you were in the room another 20 minutes assisting the nurse with a bath.

Yet this is where we notice one of the advantages of being an RT as opposed to an RN: when you're an RT you can leave when you're done. RNs have to stay in the unit and listen to her wails of ,"Nurse! Nurse! Oh, nurse!" every time the nurse sits down.

If I haven't described this patient well enough, allow me to provide you with some other signs and symptoms of CNHS.

They are worse than clock watchers. They usually call you 30 minutes, or maybe a whole hour, before the treatment is due and say something like, "I was coughing. I need a treatment now." You have to resist the temptation to say something like, "Look! You can't have a treatment every time you cough."

Well, if you can resist that temptation you're better than me.

Then you leave the room and sit down to chart, and you hear her fake coughing again, "Hack! Hack! Hack! Hack! I NEED ANOTHER TREATMENT RIGHT NOW!"

"I'm sorry ma'am, but you can't have a treatment every time you cough!"

"Well why not!" She wails. "I need a treatment."

"Are you short of breath. Maybe we need to call the doctor."

"No, I'm not short of breath. I'm coughing."

So you leave the room, sit down to chart again, and you hear: "Nurse! Nurse!"

"I'll deal with her," you say as you notice the nurse rolling her eyes and not budging. You see, you have sympathy for that nurse, whose been in that room a gazillion times. "Should I shut her up while I'm in there?" You mumble out of the corner of your mouth. The edges of the nurses lips curl up slightly.

"My head hurts," the patient says as you re-enter her room.

"Can she have pain meds," you shout out to the nurse.

"She... just... had... some...," the nurse says out loud in a sarcastic, vexed tone (not at you, but at the patient.)

"Nope! You just had some. You need to relax. You need to find something to do," you say to the patient.

You see, these patients want sympathy. They want you weigh on them hand and foot -- literally. Every little tinge of pain is SEVERE because they want medications to help them relax. They want to feel coddled. They want to be doted. And they can never be doted enough.

The cure for CNHS is to ignore them. I know that sounds bad, but it's true. Yet in this world of sue happy patient's families, and money happy hospitals and nursing homes, and hard working nurses and RTs, it's hard to ignore them. So they result in long, burning feet days for anyone taking care of them.

It's patients like this who cause RT and RN burnout, apathy, and irritation. They are the reason we become blunt. The next time an RN or RT takes care of you in a hospital, and he's blunt with you, or maybe even looks a little irritable, think CNHS.

1 comment:

SRL-TX said...

I encountered something similar in my clinical experience. A constant complaining patient with family members who remained silent because no doubt they had heard all of this before. I just held his hand and told him I was sorry he was going through this. He ended up apologizing to me for being so grumpy. Also a patient who told me not to even come in the room because he did not believe in breathing treatments. I told him I understood and asked if it would be o.k. if I took his vitals just to make myself feel better-he did and we had a great chat. Still would not let me do the second treatment.