Last night I admitted a patient who came up to the unit around 1030 (I get off at 11). So I was trying to get some of my paperwork done for the night shift. On the ER fax her diagnosis was COPD exacerbation and cellulitis (deep tissue infection). She came into the ER because she was so short of breath she couldn't walk, so what do you think she said to me when she came upstairs?
She has to take off her oxygen mask to say to me "help me downstairs so I can go smoke."
Now her right leg was so swollen that even the slightest movement was painful for her but she didn't care. I tried to convince her to stay since it was so late but she refused "I don't want to answer any of your questions and I don't want to listen to your lectures, baby. Just leave me alone." (mind you she is sating around 86% during this)
It is always hard dealing with patients like this, firstly because you know that these behaviors are just harming her, but at the same time it is an addiction. But if you are so short of breath you can't even walk, why go and smoke? I just don't understand it. And if you don't want to accept any of our care, why would you want to stay at the hospital?
Many of these patients just don't care about solving their heath problems, which is (in my opinion) the worst part of dealing with med surge patients. I find it very dis-satisfying dealing with patients who don't care one way or the other what happens to them, they still smoke and they still let their diabetes go out of wack because they just don't care. I mean it's not EVERYONE but it does feel like I deal with that a lot..
I can't wait to get a new job....