Communication in Nursing
Summer 2016
Journal #4
July 27th marked a day that I will never forget. It was the day I experienced my first death of a patient. Rewinding back to two days prior, that previous Monday, was the day I had my first interaction with the patient. The interaction took place at Maimonides hospital on a Progressive Care Unit.
The patient was a 74-year-old male Jewish patient, who was under the care of another nurse on that Monday, July 25th. I was standing by my district documenting my notes when a lady walked up to me asking if I can please help her father transfer to the bedside commode. I responded promptly even though I had heard previously from other nurses about how “nasty” of an attitude the patient had; and also that he had thrown a urinal at a nurse the week before. Regardless of this fact, patient care comes first. I walked into the room, which was filled with the patient’s wife, daughter, son, and father. The patient screamed “OH SHE CAN’T HELP ME, I NEED MY OWN NURSE.” I nervously smiled then introduced my self, and explained to the patient that his nurse was currently on a break and that I will help how I can. This patient was about 5 feet 11inches tall and about 230 pounds, and was extremely verbal about his feelings of not wanting me to help him. However, he kept saying he needed to use the commode as soon as possible. I kept on a brave face, and told the patient that I want to help and that I just needed to get him out of the tangled wires first. He repeatedly insisted that he did not want my help; his family however was very friendly and kept telling him that I was only trying to help. As frustrated as I was with this patient, I kept a smile on my face, which in my head would help the patient recognize that sometimes people really do want to help. I figured this gesture would slightly change his attitude, however it did not, so I kept detangling his wires. As I was about to help him up off the chair and on to the commode, his nurse walked in and said, “it’s okay Monique, I got it”. The patient then sneered and said, “I told her she couldn’t help me”, but the son was nice enough to say “thank you very much, we appreciate you trying to help”. I walked out of the room thinking to myself thank God he was not my patient. A lot of times as nurses, we try to put our best food forward, and the effort we make to be the greatest of help to others go unrecognized.
Two days later I got assigned to this patient. All I could think about was how ungrateful he was and how hectic my day will probably be with him. I decided to try my friendly approach, and hoped for the best. I walked in to the room to find the patient sitting on his chair looking out of the window. I introduced myself, and asked him how his night was. He responded calmly, and quite friendly, which I was taken aback by. For the next three hours, in between my assessment and administering his medications, he was making jokes with me and engaging in different “small talks” which was a complete shock to me.
That morning, the patient was scheduled for a procedure, and when escort came for him and we had gotten him onto the stretcher he began to have distressed breathing and kept saying he did not feel well, and was nauseous. To make a long story short, he became tachycardic, tachypneic, short of breath, and cyanotic and a code had to be called. 55 minutes later, resuscitation was not successful and the patient was pronounced dead at 12:26pm.
As I look back at this story, as sad as I get about it. I am most proud about how well I communicated with this patient. No one saw his death coming, and all people remembered him for was the bad attitude he had. However, I saw a nicer side him before he died, and I am happy that I did not let my previous experience with him change how I cared for him on that present day. As human beings we tend to want to treat people how they treat us, or we block communication and disconnect from our patients because of their “nasty attitude”. However God had his plans for that day, and I believe the communication that took place between my patient and I was great for the both of us. We learned about this in class, about our Mental Model, and how we often prejudge or treat people based on how they treat us or what we know previously know about them. However I knew better than to let this block my communication, so I did better.
PS: I later found out that the patient died from a massive pulmonary embolism.
