As a nurse one runs into some very saddening/ maddening situations, some that cause not only the individual nurse, but the entire nursing staff to be thrown into conflict with their beliefs of non-maleficense and a patient’s right to autonomy. I always strive to never cause any harm to a patient and treat them kindly despite behaviors that could lead one to not want to act or treat someone is such a manner. Additionally I believe an individual should also have the right and be supported in making decisions about their healthcare, but when the decision is in effect, taken away from them, who has that right? When the nurse and stand staff struggle with the decision that is being made, it complicates the picture, leads to a lot of frustration and nurses feel helpless Several years ago there was an incident of a pt that received a kidney transplant, but during the immediate post operative course the patient, suffered a respiratory arrest, was anoxic for a period of time leaving the pt with anoxic brain damage. This was an individual who, prior to surgery, was a fully functional person.
After time in the ICU the patient was able to be on the nursing floor; trached, unable to swallow, g-tube, very limited ability to walk, or transfer to a chair w maximal assistance of typically 2 staff members. The individual also tended, what seemed to be intentional, to try and injure nursing staff, by pinching, kicking and biting.. I was often assigned to this pt, and on several occasions had been nearly kicked, definitely pinched and scratched. When put in those situations, the immediate reaction is to become angry, and in when I’m put in that situation, I don’t even want to go to the pts room.
In this situation, I had to step back and try to look at the big picture. It was very difficult to know exactly what the patient’s intention was. I had no way to know what the pt