Nurse: “Hello, how are you this fine morning?” Broad opening.
Patient: “Not good I suppose. Am I in hospital?”
Nurse: “ Yes. And do you know why you are here?” Seeking information .
Patient: “ No, I guess it’s because…scratches head … (short silence) …what am I doing here? Where is my daughter?” ( Tries to get out of bed)
Nurse: “Try to calm down Tom, you are in good hands. Your daughter brought you to hospital because you had a heart attack. But you are fine now, no need to worry.” Giving information
Delegate your assignment to our experts and they will do the rest.
Patient: “ Where is she, my daughter?”
Nurse: “She will be with you shortly sir, I just need you to relax and calm down. I am going to ask you some questions and will need your answers please. Okay?” General leads.
Patient: “ Listen young lady, unless you bring my daughter here right now, this conversation is over. ( turns on the opposite side ) And get these needles off me!”
Nurse: “I understand you are upset and confused sir, its okay for a person who just had a stroke to experience that.” Accepting .
Patient: “ Don’t tell me you understand my situation. You are not the one lying on a hospital bed after a heart attack.”
Nurse: “ You know, you remind me of my aunt, we used to be so close and she was always this person who would always make you laugh. One day, we were at the park and she suddenly collapsed and I could not do anything because by then, I was not a nurse. I felt as if my whole world was collapsing, because as I called out for help, she just lay there still, holding her chest.” Encouraging comparison.
Patient: “ And then what?” (turning to face me)
Nurse: “Well, some good Samaritans helped me get her to hospital where she was admitted. You see at first, she did not want to admit that she had health issues. That is one stubborn lady, but I still love her. It was not until later on that I came to realize that she was covering up her health issues so that she could protect me. She did not want to make me worry and so, she was very harsh to the doctors.” Encouraging comparison.
Patient: “Is she alive, your aunt?”
Nurse: “Yes, healthy and kicking. Eventually, she realized that if she did not receive treatment, she would break her promise never to leave my side. I thank God she had a change in heart and listened to the physicians.” Encouraging comparison.
Patient: “ Can I share something with you?”
Nurse: “Yes, please do…” General leads.
Patient: “ I have known for many years that I have not been well, but did not want to make my daughter worried because she is all I have. She has gone through so much lately and has not been herself and I thought bad news may make her sad. So, I pretend that I am okay so that we can spend my last days on earth. You know something funny, I always wake up knowing this might be my last day on earth, so I ensure I spend my time with her well so that in case I have a stroke and don’t wake up, I will go knowing I made her happy.” (Gets emotional and starts breaking down.)
Nurse: “And what do you think she will feel once you depart from this world? She will feel disappointed and sad, angry, betrayed, and upset because you two were close and still you still lied to her.” Encouraging comparison.
Nurse: ( Silence)
Patient: (Crying). “Well, I did not think of it that way. I guess she will never forgive me for that. So, do you think it would be good to tell her the truth? What if she does not forgive me for lying to her all these years? I can’t live knowing I have let her down.”
Nurse: “Look sir, the best thing you can do is to be open with your daughter. That is what I would want if you were my father. She may get upset but she will come along because she wants you to get better.” Encouraging comparison.
Patient: “ Can you help me do it madam? Please? I don’t want to see the look on her face when she finds out.”
Nurse: “It’s okay sir, I will be here with you and will help with anything I can. And have you considered seeking therapeutic counselling? I have known many patients who have gone trough it well and are now happy with their families undergoing treatment. Suggesting/Therapeutic
Patient: “ I don’t like counselling, people always judging me because of what I did and telling me stuff I don’t want to hear. Plus, it’s a waste of time, I am already old, I don’t want someone coming to tell me what they think is right or wrong because they went to some fancy school.”
Nurse: “Why don’t you give it a try, for your daughter, and if you don’t like it, then you can make your decision. Just do it for your daughter. It’s the least you can do after keeping this from her for so long.” Suggesting/Therapeutic
Patient: “ Well… I do suppose I can do it for her. Now I need your best doctors to help me. Who would you recommend?”
Nurse: “Every doctor here is qualified to treat you, and they are the best you can get so you don’t have to worry about that.” Giving information .
Patient: “ And nurse”
Nurse: “Yes” Exploration.
Patient: “ Sometimes I forget things, like when we plan to do something, like this time we planned to go fishing on a weekend. And I totally forgot. My daughter was really mad at me because she had cancelled her plans with her friends. It was not the first time and its been getting serious over the past couple of years. Now I have to write things down so that I don’t forget.”
Nurse: “Its good you have shared that. That is a health issue that is common among the elderly. You will get proper diagnosis from the doctor and will be educated about your condition and the best way to go onwards so that you can leave healthily.” Giving information
Conclusion
For this interaction, I believe my exploration of the personal issue I had with my aunt made the patient emotional. I did not minimize feelings and the patient’s vitals almost went up. Even though I was trying to connect with the patient, it would be good to ensure I minimize feelings and try other means of connecting with the patient.
