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The Story of Mr. Smith: Part I

Updated: Feb 27

By Matt P. RN — PART II COMING MONDAY JUNE 19th!


Nursing is a profession where you encounter people from all walks of life. Our patients are usually assigned to us; we don't get to choose who we care for. Most patients come to the hospital not because they want to, but because they need to be treated and cared for. Because of their condition, patients are likely to be easily annoyed and short-tempered and often put little or no effort into participating in their plan of care. So, this is where my story begins...

difficult patient

I was assigned to care for Mr. Smith, a 65-year-old male diagnosed with liver cirrhosis. He was a bit withdrawn, but always had the tendency to shout at his caretakers - even his nurses. He was your typical uncooperative, snobby patient.

How many times did he pull out his much-needed NGT? Probably more than the number of times he refused to have it reinserted. The stubborn Mr. Smith didn't even want his vital signs taken; he would just sleep as much as possible to try and avoid nurses coming and attending to his medical needs. And so, it was very difficult for me when I was assigned as his nurse, as well as for my colleagues, to give him proper nursing care.

I am the kind of nurse who is very cheerful and loves to exchange stories with my patients. My colleagues know that when I’m missing during breaks, they know they’d find me in my patients’ rooms chitchatting or saying long goodbyes. With that personality embedded in my character, I get to know my patients well and establish a good rapport not only with the patients but also with their families. However, with Mr. Smith it was different. Very different.

How could I possibly give the best quality nursing care if Mr. Smith was being hard on me as well as on himself? What could I possibly do to help him? And how could I approach him to have even a small conversation? That was my dilemma. I decided that I would have to try a unique approach to get him to cooperate.

I managed to keep my cool with Mr. Smith many times as I tried to understand him better. There were times that I would wait for him to reach out his arm and offer to have his blood pressure taken, but he would deliberately hold his arm firmly at his side.

There was one time when my patience with him was tested beyond my limits. On a bright, sunny, and wonderful day, a perfect day to work, Mr. Smith needed to empty his bowels. As his nurse, I needed to help him since he couldn't ambulate to the toilet without assistance and didn't tolerate standing up for very long. He felt that needing someone to help him was bothersome and shouted at me. I simply apologized for “troubling” him but explained that I was his nurse, and it was my job to care for him. Every time that I went into his room, I would ask him how he was doing and encouraged him to feel better. Most times I was met with only a straight face and no acknowledgment whatsoever. Most of my colleagues were giving up on him but giving up was the last thing I would do with any of my patients. Even if Mr. Smith was giving up on himself, I would not give up on him.

When the doctors ordered a clear liquid diet to prepare him for NGT removal, I spent an hour feeding him. With a gallon of patience and a bucket of perseverance, I was able to establish a rapport with him. It took a long time but, finally, I was able to have small conversations with him. When I asked about his life and his work when he was young, he raised his brow and gave me an unkind look. Right there I knew I had overstepped my boundaries. After a moment of eerie silence, he took a deep breath and looked at me again with a defeated demeanor.

He smirked and with an irritated look on his face, he said, “You’re annoyingly persistent, aren’t you?” I was just ready to give my most elaborate apology when he said, “This is my second life, you know?”

To be continued....


For more stories like this one, pick up a copy of Off the Chart A Nurse's Journey

of Heart and Humor at https://amzn.to/3RHn0nm

Published by Jennifer Tipton / This post may contain affiliate links.

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