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Battling Through Stereotypes and Identifying the Unique in Patient Behavior

Published November 7, 2013 11:47 PM by Lorenzo Ortega

Now that I have become more deeply immersed in the hospital lifestyle I am beginning to see the situations in which many different patients are stereotyped. For the last month and a half I have been working as a full-time RN in my hospital's CVICU. Previously it was just part-time, about twice a week on average. This more consistent scheduling has allowed me to witness some situations where I have seen patient's behavior stereotyped, at times causing a disruption in medical and nursing treatment. This was no surprise to me as I had seen this behavior before as a student and a new nurse, but recently I had been thinking more introspectively about the topic.

In one case I had a patient who had chronic anxiety. The patient's physical condition and diagnosis would provide anxiety to anyone in a similar situation, but according to the physicians this was an extreme case. There was data that was being ignored about the patient because the medical and nursing staff were referencing the fact that it was all due to his chronic anxiety. During a night that I care for this individual there didn't seem to be any signs of anxiety, and the patient was even asleep, but the vitals didn't sit right with me. A call was made to touch bases with the night physician, but again, few interventions were given and things stayed how they were. It was frustrating to see nothing happen.

Another night I can recently remember had to do with a patient being "needy". In many instances I can see this as being a true statement. Some patients need more and ask for more from the nursing staff. This can be due to various reasons, but what I have always noticed is the underlying nature of this "needy" behavior. All of these patients have had an extreme loss of control in their lives. Whether is be a sudden change, or a very drastic change happening over a longer period of time, people struggle to adjust. Human being's lives are struggles to begin with, but adding a life threatening or serious disabling illness into the mix and I'm sure I would become "needy" too. 

One thing that I have also found interesting is that being aware of patient norms can be helpful is finding slight changes in patient condition. Since I have been working more hours I have a lot more shifts in a row or close together than I had before. This allows me to identify what is normal for each patient and identify subtle changes that I may not have noticed in the past. Although consecutive shifts can be physically demanding, they allow for more easy mental processing of data, especially during day two and three.  

posted by Lorenzo Ortega

1 comments

It is heartening to read of your observations and concerns.  As a Psych. CNS, I have been concerned about what I frequently see as ignoring the emotional needs of patients and labeling them as mental health issues--therefore not as important to be addressed.  Delving under the surface and actually talking to people about their lives and experiences provides a much richer understanding of the reasons for what is seen and gives nurses a way to alleviate some of the anxiety, thereby improving clinical outcomes.  Thank you!

Barbara Barham November 16, 2013 10:03 AM

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