Mr. E was one of those patients that you loved to hate. This gentleman made a heartfelt effort, going out of his way to ensure that you had unpleasant encounters with him. He wouldn’t make eye contact with you because he didn’t deem you worthy of his attention. He wouldn’t answer questions, would cut you off in mid-sentence, and refused to listen to any information you gave him regarding his medication regimen, disease process, or plan of care. He’d interrupt you with “I know all that already” and proceed to watch TV. The only value you had to Mr. E was your ability to bring him pain medication, which he asked for every two hours with religious punctuality. Mr. E had graced the unit with his presence numerous times within the past month, all for the same reason: Exacerbated Congestive Heart Failure. It did not help his cause any that he had MRSA of the blood stream, which required all staff to put on a gown and gloves before entering his room for any reason. He was forever on “Contact Isolation”.
After being in the hospital for a week, Mr. E returned after one day of being discharged, for his usual complaint. His simple-minded fiancé, as always, didn’t leave his side for any reason, despite his litany of impolite commands and rude lashings. She wasn’t what anyone would consider a “bright” woman. She quite possibly had some type of learning disability or mild form of retardation. There was an element of codependency between the two that was frankly nauseating. The attraction each found in the other was puzzling. Of course, before the nurse could even get Mr. E settled in the bed, he was already asking for his Dilaudid (which is a potent narcotic that’s eight times stronger than morphine). Never mind that his lungs were full of fluid, his blood pressure barely enough to sustain life, and his level of oxygen in the blood was too low. His pain medication was his priority.
Mr. E was 45 years old and had an ejection fraction of 10% (meaning his heart was barely able to pump blood through his body). He had a crappy heart – literally and figuratively speaking. It was no wonder why he was an angry man. He was angry that his life would soon be coming to an end. He is terrified man. Dying is a very lonely experience. It separates you from others and the world itself. There is true irony in his “Contact Isolation” status. His displaced anger at us did keep him isolated from loving contact with others, creating boundaries that exceeded the gloves and gowns we wore. I wonder if his distancing actions were protective in a way – without having that meaningful connection with others, he wouldn’t have that to lose (thus no grieving) as he died. I felt compassion towards Mr. E, because I understood that no amount of Dilaudid can take away the pain that one feels as years of unlived life slowly slip away, and day by day, you drift further apart from humanity while propelling closer to the unknown.
After being in the hospital for a week, Mr. E returned after one day of being discharged, for his usual complaint. His simple-minded fiancé, as always, didn’t leave his side for any reason, despite his litany of impolite commands and rude lashings. She wasn’t what anyone would consider a “bright” woman. She quite possibly had some type of learning disability or mild form of retardation. There was an element of codependency between the two that was frankly nauseating. The attraction each found in the other was puzzling. Of course, before the nurse could even get Mr. E settled in the bed, he was already asking for his Dilaudid (which is a potent narcotic that’s eight times stronger than morphine). Never mind that his lungs were full of fluid, his blood pressure barely enough to sustain life, and his level of oxygen in the blood was too low. His pain medication was his priority.
Mr. E was 45 years old and had an ejection fraction of 10% (meaning his heart was barely able to pump blood through his body). He had a crappy heart – literally and figuratively speaking. It was no wonder why he was an angry man. He was angry that his life would soon be coming to an end. He is terrified man. Dying is a very lonely experience. It separates you from others and the world itself. There is true irony in his “Contact Isolation” status. His displaced anger at us did keep him isolated from loving contact with others, creating boundaries that exceeded the gloves and gowns we wore. I wonder if his distancing actions were protective in a way – without having that meaningful connection with others, he wouldn’t have that to lose (thus no grieving) as he died. I felt compassion towards Mr. E, because I understood that no amount of Dilaudid can take away the pain that one feels as years of unlived life slowly slip away, and day by day, you drift further apart from humanity while propelling closer to the unknown.
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