grumpy patient

I usually inform patients (and nurses) first thing in the morning that I will be seeing them later in that day. I was going to see a patient for the first time and upon reaching the ward, I learned from a nurse passing by that the patient is in the bathroom. Upon knowing that I’m seeing that patient for the first time she immediately warned me that the patient has a grumpy demeanor and is very irritable. I also read his file and learned that he has dementia. There were entries there saying that the patient is very upset that he has to stay in the hospital, that he is not very keen to do physio and that he declined physio many times already. Since I have not encountered anyone like that in that particular placement I got very anxious and thought, “What if the patient shouts at me and tells me to go out as soon as he sees me?” So I tried to think of strategies to try and convince him to do physio in case he refuses to participate.

So later that day I went to this patient’s room and found him in bed watching tv. My anxiety escalated exponentially with each step I took towards him. The moment he opened his mouth I braced myself, ready to hear some profanity but instead he said, “Hello there” in a very pleasant tone. So I was thinking to myself, “What? Is this a precursor to some tirade later on?” I was half expecting to be out of his room in 5 minutes but I ended up providing him with exercises, education about his condition and building rapport in 45 minutes. At one point within that period he told me I looked a bit tense. I was surprised because I tried my very best to conceal my anxiety.

At the end of the session he thanked me for getting him to do those exercises and for explaining to him everything. He said he it upsets him that the others (health professionals) spend so little time explaining to him the procedures that are being done on him and exercises he’s doing. I then realized that that is one of the possible reasons why he was so grumpy and upset.

I also learned from that experience that while it is good to prepare yourself before seeing a patient, it is not good at all to ‘overprepare’ to the point of getting yourself anxious. I was lucky that the anxiety did not impede with the effectiveness of the treatment. This situation happened in my three-week placement in 3^rd year as well. I didn’t know how to handle it that time so I was very defensive throughout the treatment session.