Wednesday, October 22, 2008

Weeks 2 #2 - confrontation

Today, I had an interesting encounter with a patient.
I went to review the exercises i had given him the previous week and wanted to teach him some more leg strengthening Xs as he had requested some. However he wasn't feeling up to doing them, as he was SOB after he had been walking. I decided to make a compromise with him so that it was a win-win situation. I said we didn't have to do the leg exercises but if he could to do the UL Xs i had given him, so that i could see that he was doing them correctly, and go for a walk with me tomorrow that i will leave him for the rest of the day. Considering physios seem to be the most hated profession on the ward, he was happy to do it so i would go away.
I went and got his theraband, and he stated that he thought the theraband was the reason why he was getting his itchy hands. I had a look at his hands, noticing they were a little red, and asked him why he thought the theraband was making them itchy. He then said it was he is allergic to latex.
He said that he really liked using the theraband as he found it versatile and was able to do his own Xs and wondered if there were any latex free gloves he could have so as to continue to use the theraband. I then went to find my supervisor to tell her the situation, and if she knew he was allergic to latex and ask whether the theraband does actually contain latex. She said she had no idea he was allergic and doesn't rememerber it being documented in his notes, and told me to go check if I could find the documentation anywhere.
After checking the pt's bed file and current medical history folder, there was no evidence of my pt being allergic to latex. It was only when we looked through the 'old medical notes' that it stated he was allergic to latex, which the theraband contained.
So i was left to break the news to him that he was no longer allowed to use the theraband and I gave him the option of using .5 or 1 kg weights. WOW he was not a happy man! I told him that we had found in his old notes that it said he was allergic to latex, and i legally had to take the theraband of him (to save my butt!!!). And didn't he cause a storm! 'I'm not doing my exercises unless i have the theraband!'
I believe i handled the situation well. I waited until he finished having his rant and calmly stated the reason i had to take the latex of him, and until we could find appropriate gloves, he could not use it but he may use the weights that I had and showed him in my hands. He didn't talk to me for a while, turning his head away, but i waited. I then asked him which weights he would like, and after a while he stated he wanted the 1 kg ones even though he 'wouldn't use them anyway'
i then apologise for all the inconvience, but he contiued to ignore me, so i thought i would leave him alone and leave. So i said bye and that i will see him in a couple of days.
I went and reported back to my supervisor about his attitude and the overall outcome when a nurse found me and said my pt asked to see my supervisor and was apparently throwing his socks around saying 'i'll use these as gloves just give me back the theraband.' My supervisor tried to calm him down, and restated what i had said, which i thought was good of her, so as to not contradict the things i had told him.

Overall, I thought i handled the situation well. I'm not usually a patient person but i believe I was very pateint in this situation as i would have usually probably given up a lot quicker and just left the room, but instead i tried to reason & compromise with him, because i know he must be frustrated with his health deterioration, or the attitude may have been because of some of the medication he is using.

If i was to improve anything in that situation, it would have been my communication. I felt as though i didn't really know what to say to him, to make him understand that he was allowed to use the theraband and to calm him down. I guess thats something that comes with exprience with dealing with grumpy patients!

Hopefully he will speak to me the next time i see him and allow me to treat him!

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