I have been working with a brain injury patient who has been designated a VIP. Everyone who cares for him knows his status. It has followed him to more than one unit. Being a VIP has not been as helpful as the title suggests. My facility is quick to point out that all patients are treated equally unless the patient is willing to pay to be in the luxury area. The same physicians and staff care for these patients but the circumstances are nicer.
I've worked with VIP patients in the past. The same things happened then as are happening now. The patient receives extra attention, be it nursing, medical or therapeutic. One therapist from each discipline is usually designated to work with the patient at a specific time that is blocked off for therapy. If therapy is missed, it is expected to be made up. When prioritizing is required, the VIP patient automatically goes to the top of the list. I am beginning to resent the situation I have been placed in. Each day an hour of my time along with that of support staff is dedicated to this patient. The time is blocked out and unchangeable. There is no cutting back his time to accommodate something else.
The pressure for him to improve is becoming overwhelming. His family admitted him with the expectation he would improve functionally. Someone is there for every treatment. Every day I'm pressed to describe some improvement from the previous day. Every time I go into the room I feel the pressure to make him better. It radiates off his family. It radiates off his physicians. Meanwhile he continues to plod along at his own pace, which is nowhere near as rapid.
There are days I dread entering the room. No matter what I'm able to facilitate, it won't be enough. Neuro patients fluctuate. It's the nature of the process. Days of downward fluctuation are more stressful. Days of upward fluctuation are worrisome because a new expectation develops. I can't make him do something his brain isn't ready for. I can't even get him to be consistent from one day to the next.
I'm running out of ideas. I've made progress with what I've been doing but it hasn't been enough. The underlying expectation is more. Get him to do more. I've been rethinking my techniques and trying to see where I can make changes. I keep asking myself what else I can do. What else I can change. I can't find an answer. Every time I go into that room, I feel the pressure to come up with that answer.
It's too bad my VIP isn't an average, everyday patient. There would be no pressure on him or me to make improvements. His family would be happy with the little changes I regularly make. His care could focus on him, not the surrounding issues. We could just keep plodding along and slowly get better.