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5 Patient Misbehavior Typically, misbehavior by patients, nurses, or doctors is not spoken or written about. However, inappropriate situations do occur, whether through thoughts, smiles, stubbornness, noises, or various lifethreatening events. Some of the events these stories recount involve relatively minor tomfoolery or refusal to comply with medical advice, while others touch on more serious ethical breaches. Some even illustrate a more profound clash of values, as in one nurse’s sympathetic account of a patient who strenuously resisted the efforts of nuns to “convert” her before death. Improper Location of False Teeth After finishing nurses training I found a job at Pleasant Acres Nursing Home in Altamont, Illinois. During my orientation as a new nurse I had to have a week not only following the other nurses on their routines but also the activity director, whose early morning duties included shaving the men. I had never shaved a man before but figured it couldn’t be too difficult an undertaking. Was I ever wrong! I proceeded to shave this old gentleman who apparently had not yet put his false teeth in place. Besides that, he kept moving his mouth in a chewing motion the entire time I was trying to shave him. Needless to say, that little incident tired me out for the whole shift. Charlene Vaught, Portland, TN, August 2, 2011 The Woman Who Wouldn’t As I entered the room the patient in bed 303 looked directly at me with a smugly satisfied smile. Her smile was not the usual facial expression one sees in a hospitalized woman who has advanced cirrhosis of the liver. 96 Tales from Kentucky Nurses Puzzled, I continued and introduced myself as the in-charge nurse for the afternoon. As I spoke I noticed her bloated face, pasty white pallor , and abdomen too large for her thin legs and arms. Purple striate mottled the glistening taut skin, and her umbilicus [belly button] had disappeared with the distention. Liver failure, I mentally recorded. Her appearance fit the nursing shift report of a patient in rapid physical decline, but her demeanor seemed disconnected from this reality. Being trained to search until the pieces fit my nursing instinct on alert, I knew my assessment was incomplete. She spoke up and said to me, “I hope you are not here to convert me! I have had enough of that tactic.” I said, “What do you mean, convert you?” She said, “Haven’t you heard my story yet? The good nuns want me to reject my twenty-year marriage, then ask the priest for absolution and sprinkle holy water on me while I beg for salvation.” “Why would they want you to do that?” I asked her. “Because I live in a second marriage and it is unholy in the eyes of the good nuns,” she disgustedly grimaced. “It’s like this. I was a practicing Catholic when I married my first husband, and we had a miserable marriage so we divorced. Nevertheless, in the eyes of the Catholic Church I now live in adultery. So the nuns come daily to my room, pray over me, and beg my repentance. But I will have none of it.” Her bellowing voice left no doubt of the pending outcome. When she spoke, her short, thinning brown hair seemed to become alert. In a nebulous way she appeared jovial about the rebellious encounter . Her mannerisms conveyed that she was enjoying the attention and the opportunity to declare her right to self-determination. As her body failed daily, without reprieve, I wondered if this power struggle represented one last opportunity to gain control over her fate. I said to her, “That must be uncomfortable.” Her response was, “You better believe it! But that’s enough for today. I think I need a nap.” “I will be back to check on you, but let me know if you need something sooner, or if you want to talk.” Mrs. Thompson, which was her name, lay on the bed and slept soundly. In sharp contrast, the nuns were distraught. Each afternoon on the six following days they came to the unit to ask about Mrs. Thompson’s health, and when Mrs. Thompson allowed it they met with her. When they stepped off the hospital elevator their sorrowful countenance cast Patient Misbehavior 97 a heaviness that permeated the ward. Our bodies felt heavier. The nuns walked slowly, with hands folded, heads bent forward, seemingly deep in contemplation, praying for guidance, certain that it was their...


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