Attention on Ativan
Yes, this is another nursing post.
I've had a REALLY anxious patient for the past couple of days. She questioned every part of her care (which actually is a good thing. I like when my patients are involved in their care. It's like they are paying attention to what I do) and then became agitated when we answered. Sample conversation: what does my EKG show? Answer: Sinus Rhythm with PVC's. What are PVC's? Those are when the bottom part of the heart pumps blood a little too early. Why do I have that? There are many causes, but in your case infection, stress are most likely the causes. I thought the conversation was going really well. Negatory. She was freaking out. I didn't know why. I really wanted to give her Ativan (anti-anxiety drug). But I was thinking that if I told her why she was getting Ativan, she would freak out some more, and not really like me either. Why not give it to her without telling her? I don't particularly like excluding patients from making decisions in their care.
So, since Ativan wasn't an option, I tried something not often practiced in standard Western medicine: empathetic listening. I had to start out with an apology. Then, every time I did something, I told her in the most non-threatening manner I could what was happening and why she shouldn't worry about it. Then she started talking. I learned WHY she was so agitated, and I let her keep talking (and yes, I spent a lot of time in her room. Fortunately my other patients were stable). The amazing thing: she stopped calling so frequently. She calmed down, and she started listening to suggestions in proceeding with her care plan (basically, that's a fancy way of saying that we now had two-way communication between the doctors and her. She made suggestions, they made suggestions, we made progress).
Do I think Ativan could have accomplished that? No, not like that. Giving some attention takes way more time than giving Ativan, but the results are much longer lasting. Less side effects, too.
There's another side to consider, as well. I was calmer by talking to her. I guarantee I was happier listening to her than giving Ativan to her and acting like I knew everything (which is so far from the truth). She gave me some advice: Don't make your blessings turn into curses, and always turn your curses into blessings. In other words, my reaction determines my happiness.
I think I had some good karma blessings thrown in. I had originally been scheduled to work 4 days this week. I got re-scheduled to 3, and then I got a Saturday off that I had been wanting free. All with minimal effort on my part. My reaction: happiness. If you choose happiness, and if you share happiness, it will find you.
I've had a REALLY anxious patient for the past couple of days. She questioned every part of her care (which actually is a good thing. I like when my patients are involved in their care. It's like they are paying attention to what I do) and then became agitated when we answered. Sample conversation: what does my EKG show? Answer: Sinus Rhythm with PVC's. What are PVC's? Those are when the bottom part of the heart pumps blood a little too early. Why do I have that? There are many causes, but in your case infection, stress are most likely the causes. I thought the conversation was going really well. Negatory. She was freaking out. I didn't know why. I really wanted to give her Ativan (anti-anxiety drug). But I was thinking that if I told her why she was getting Ativan, she would freak out some more, and not really like me either. Why not give it to her without telling her? I don't particularly like excluding patients from making decisions in their care.
So, since Ativan wasn't an option, I tried something not often practiced in standard Western medicine: empathetic listening. I had to start out with an apology. Then, every time I did something, I told her in the most non-threatening manner I could what was happening and why she shouldn't worry about it. Then she started talking. I learned WHY she was so agitated, and I let her keep talking (and yes, I spent a lot of time in her room. Fortunately my other patients were stable). The amazing thing: she stopped calling so frequently. She calmed down, and she started listening to suggestions in proceeding with her care plan (basically, that's a fancy way of saying that we now had two-way communication between the doctors and her. She made suggestions, they made suggestions, we made progress).
Do I think Ativan could have accomplished that? No, not like that. Giving some attention takes way more time than giving Ativan, but the results are much longer lasting. Less side effects, too.
There's another side to consider, as well. I was calmer by talking to her. I guarantee I was happier listening to her than giving Ativan to her and acting like I knew everything (which is so far from the truth). She gave me some advice: Don't make your blessings turn into curses, and always turn your curses into blessings. In other words, my reaction determines my happiness.
I think I had some good karma blessings thrown in. I had originally been scheduled to work 4 days this week. I got re-scheduled to 3, and then I got a Saturday off that I had been wanting free. All with minimal effort on my part. My reaction: happiness. If you choose happiness, and if you share happiness, it will find you.
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