Saturday, May 19, 2012

Being the Bigger Asshole

One of the most challenging things about my job is that it doesn't matter what names a patient may call me, the substances or objects a patient throws at me or the way in which they may try to hit, kick or spit at me. It doesn't matter if the patient is in the wrong or that their behavior is completely inappropriate. No matter what happens - while I am on the clock, I have to act professionally and be the bigger person.

Many of the patients I work with are at least marginally respectful. However, I work on the most intense Mental Health Unit in the hospital, so this means we deal with the most ill patients who often times have extreme and out of control behaviors. In my four years working there as an RN, I have been screamed at, threatened, hit and called some of the most offensive names known to creation. I have been peed on, laughed at and blatantly disrespected by the patients I care for. Needless to say, it can be positively draining and emotionally exhausting.

Most of the time, I am able to just laugh it off or let it go when a patient does these things because I know that they are not well and need my compassion and understanding. Normally, it doesn't bother me for more than a few minutes and then I am able to get on with my life. For some reason, last week was different. Like a dried up dingle-berry on a poopie butt, the events from this shift were clinging to my psyche. Let me explain:

The other day, one of my patients was a man who I have worked several times in the past. The first part of the day went very well. He was calm and overall cooperative. I thought we were shaping up for a good day, until after lunchtime when he began insisting we let him into a group room that was closed at the time. I tried to explain to him that patients are not allowed into group rooms without a staff person. He was not hearing a word of it. What would be a non-issue with the general population, turned into a massive decompensation of all rational behavior. He began yelling and threatening to hurt us. He began trying to hit and kick us. I finally told him that he either had the choice to gain control of his behavior or we would be calling a code and giving him meds.

His response to this was to open his pop bottle full of the most disgusting concoction imaginable and throw it all over me. Earlier in the shift he had told me that he mixed honey, milk, tea, coffee, ranch dressing, syrup, salt, orange juice, sugar, mountain dew and other random food bits together and was sipping on it during the day. Well, it was now all over me and took nearly two washings with soap and water to get the stickiness off my face and arms.

I was livid and my blood was boiling rapidly in my veins. I felt violated, abused and just plain pissed off. Of course though, I handled myself in a calm, professional manner when all I wanted to do was tell him exactly how I was feeling at that moment in a less than professional way. I wanted to throw myself on the floor and show him what the business end of a real hissy fit looks like. I wanted to say ridiculous things, throw food and scream the most obscene profanities I could think of. Instead of the bigger person, I wanted to be the bigger asshole in the worst way imaginable.

We proceeded with the code and medication administration. All was relatively fine until about an hour later when the same patient voided an excessively large amount of urine all over himself in the lounge area. Well, guess who the lucky nurse was who got help him get cleaned up? Yep, that would be Yours Truly. So, not only did I have to conduct myself professionally with a patient who completely disrespected me, I had to help clean up him AND his giant piss mess.

Praise be to all holiness that I have a reasonable amount of self control because I am pretty sure that I would no longer be employed if I had just an ounce less. After my shift, I got in the car and cried all the way home. I threw my purse and keys where ever they landed and immediately tore off my scrubs. I proceeded to cry the whole time I was in the shower, frantically trying to scrub the grossness of the day off of me. Talk about a mess of a human being. After a shower and a nice nap, my spirits were beginning to rise again. I was at least able to speak in coherent sentences without bursting out in a blubbering crying fit. However, I am pretty sure that my blood pressure still sky rocketed every time I relived the experience in my mind.

At this point, I think I am mostly over it. And truth be told, given the choice again, I would likely take the high road  instead of the massive spaz-attack I have been day dreaming of. At the end of the day, would it really be worth it? Would I really feel any better about the situation? Likely not. I guess there is some merit in the high road: even if you don't get to be the bigger asshole, the good part is that at least you don't have to feel like one.