our patient:

  • doesn’t take his medication, we inform him about the risks and document. He says he’ll take them ‘later’, never does.
  • refuses his insulin, we inform him about the risks and document as well as chart.
  • refuses his blood thinners, we inform him about the risks and document.
  • turns his phone obnoxiously loud, also talks loud.
  • insults us several times every day, gets passive-aggressive.

this is not psychiatry, patient is a young, AOX4, fully competent adult.

Fine, you’re a free man and free to do with your life what you want. But why go to a hospital in the first place if you are going to behave like this?

Yesterday we found him unconscious on the floor, vitals were normal, didn’t hit his head. He is being released tomorrow. Doctor agrees.

I have the feeling we’re going to see him again very soon, but he is the biggest asshole I’ve met in my nursing career.

Why do people behave like this? we are literally trying to give him some quality of life and he attacks us each time we open the door. why?

If any of you is a nurse and has some insight, I’m all ears.

Do please notice that I’m not asking how to deal with people like this: we document, chart and move on, but to understand why in the fuck people are like this.

  • intensely_human@lemm.ee
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    9 months ago

    Sounds like he’s unconsciously suicidal, and only feels real when others are responding to him. The hospital is a narrow environment where he doesn’t have to face the full complexity of life. When you are paying attention to him, it gives him a sense of being valuable.

    He won’t protect his own life, because he knows himself and he knows life. But he’s afraid of death, and recruits you to protect his life for him. You don’t know the full him, so you don’t have the hatred that he does. He knows this, so he knows you’ll try.

    You say it’s not psychiatry, but perhaps it should be. Guy sounds like he’s got zero motivation to fix any of his health problems, and that’s worth looking into more deeply.