Difficult Patients in the Sleep Lab
Difficult patients in the sleep lab are no surprise, nor are they a new phenomenon. What is new is the frequency with which they are showing up. Sometimes it feels as if the doctors are in a contest to see who can refer in the most difficult patient.
I come from a nursing background and so I can usually handle whatever comes through the door but now I am guided by a different set of standards. The safety net is different. For instance, sleep labs traditionally do not deliver bedside nursing care. Patient's requiring this type of care or help must be accompanied by a caregiver during testing. The paradigm we practice under is difficult for those outside of sleep to understand. They think we need a nurse for everything and -- to the other extreme -- that no patient should ever be one-to-one. (What is this selective blindness that some of us in healthcare seem to get when looking at other disciplines? But I digress...)
My point is that sleep techs will encounter difficult patients and we should be able to complete our testing while ensuring patient safety in our lab. Just this week we had a patient who was the victim of a gunshot wound in the past. She was blind and wheelchair-bound. She had a professional caregiver in the home, plus family, yet no one thought she would need any help during the sleep study or the MSLT.
I had a hard time convincing them, too. Fortunately, I was successful and she came with her aide. I believe this is the way it is going to be. The patients we see in the lab are going to be the more difficult to care for, sicker patients. We need to keep our skills sharp, be prepared for anything and have a plan for how to care for these people. I have a partner who works with me during the day ... I think we are lucky.