The Patient I Worked On

Lessons From a ‘Difficult Patient’

I had a patient who was very difficult during rounds and had to do a very hard thing to show you I would be very upset by it.

We were in the ER and he had multiple problems that was affecting his care. The first was he wasn’t able to get on his feet, his back had twisted, his legs were twisted and he had a lot of pain, but he was getting worse. He was an elderly gentleman but not a very heavy patient. In my training I was taught that this is one of the signs that you should not work on, it is just the old saying “The more you struggle the less you can recover”.

We worked on him for nearly 4 hours and by 3:00 he was able to sit up in his chair or use a walker. He was really trying to get out of the chair, move around more and have better pain management in his back. I had him up and moving around the hospital floor after we finished, because he was using a walker with one foot.

His second problem was he was unable to walk down the steps. He had a lot of pain from the lower back and his legs were paralyzed. We worked on this and I was able to work on his pain. My job was to make sure he could walk down the stairs and he could get down the steps.

He would get up from the chair and move a couple steps, he would then lose feeling in his legs and he would have to go down the steps. We worked on this for the last hour of the day, and every time I came he would get back up, he would work to get down the steps. He would go down four times and then fall back up. I did not know how we were going to fix this and was looking to the next shift to help him.

When I arrived on the floor and went to look to see if he was okay, I could not see him anywhere. I was hoping that at any moment he would get up and get up to a chair and just start walking around. He was on the floor and just not going anywhere. I asked the nurse how I could be more help and she was very condescending. It is very difficult to work on someone like this. She was like, “What can I do, well get a paper towel for that gentleman, just pick him up, let

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