My patient was an elderly woman with severe dementia. She had tried to punch my coworker the night before, and frequently refused letting anyone touch her. I introduced myself as Katie, her nurse for the night. “Why I need a nurse?” she said, eyebrows furrowed.
“Because you are in the hospital, and I am here to take care of you.”
Her eyes got wide and she looked around the room. “You think this is the hospital? Girl, this is my home, what you talking about?”
I looked around the room and had a quick decision to make. I could argue with her and reorient her to her surroundings, which is the textbook correct thing to do, or I could make both of our lives easier. “Oh, I’m so embarrassed. I get confused sometimes. Yes, we are at your house. Your daughter asked me to come by to check on you. She must really love you!”
She nodded her head. “Yes, my mother does.”
“Well you have a good mother. Is it ok if I listen to you breathe?”
I did a full assessment on the patient with her full cooperation. As I finished, she asked, “How many blocks you cover?”
Blocks? Hmm…. “Eight.”
“You cover eight blocks? Wow! You crazy!”
The next time I came into her room, the question was repeated. My new answer was six blocks. This was still too high. The third time the question was asked, I said, “Four. How many do you cover?”
“Girl, I don’t get paid for that!”
But I do? What did I just tell my patient I do for a living? I could feel myself blushing.
A few hours later, the question was repeated. “I don’t get paid for that!” I said.
While giving report to the day nurse, I made sure to tell her the correct answer to the blocks question was four. 😉