“Good luck with that one.” They said as they all laughed in the therapy office as we were all huddling in front of our computers getting logged on and organized for the work day.
It’s not uncommon in a group of well-meaning healthcare workers to have a hard time with a patient, and apparently the patient that was on my schedule for two 1 hour long sessions that day was one of those patients.
I had a couple of new patient evaluations beforehand, one of which was a particularly unhappy woman who seemed to believe the entire world (at least everyone in the hospital) was out to get her. However, it wasn’t an entirely unpleasant 90 minutes, I just didn’t try to prove her wrong or prove my worth, I simply did my job.
The time came for my first session with “Jean” [name changed]. We walked, worked on wheelchair mobility, and some functional movement at the parallel bars. Entirely without any incident. We even laughed during the session!
She apologized for her behavior in prior days without being prompted and the hour was truly a joyful one. I told her what to expect for the rest of the day and when I would be coming back for another session. We also discussed what we’d work on together during that hour.
It turns out another short visit was added to her schedule that I wasn’t aware of and hadn’t been able to tell her about which started while she was still finishing lunch. When I arrived she was already irritated and needed to use the bathroom. She told me she used a bedpan, so when the CNA arrived to help transfer her, we had a kerfuffle.
Apparently, she actually doesn’t use a bedpan but normally uses a toilet. The world shifted on its axis and Jean became almost impossibly irate. Somehow, we were able to make it to the bathroom mostly in time, as she was screaming at me and the CNA.
Heavy topics came up during this time because she is planning to go home alone from IP rehab, but typically needs two people to safely get in/out of bed or in/out of a chair. So the healthcare professionals are all trying to get her to see their concern of her safety for going home. But that isn’t what she sees and no matter how hard we tried to tell her these things, it only seemed to enrage her more.
So, at that moment, I stopped trying to convince her to see it our way. How could she? What was she even feeling or thinking or believing in that moment? There is truly no way for me to know. I could just see that she was hurting. That was enough.
I stopped talking about safe transfers, about what would happen when she got home. I just did what I could to get a little more therapy done after the toilet transfer. It wasn’t the same joyful hour we had before lunch, but it was calmer by the end of our session.
I had two amazing insights during this session that I will certainly carry forward with me.
We are all living in separate realities. No one can see exactly what you see and it’s helpful to acknowledge that their truth is also true. Maybe, the best way to find compromise or connection is through this understanding.
My well-being is not dependent on how someone treats me. For the 15-20 minutes that Jean was caught up in her thoughts, angry and lashing out, I was calm. I didn’t know what to do, but I didn’t freak out. I kept trying some things until she also found a bit of calm. And I even was smiling at one point during the hour, not because the situation was funny or fun, but because I saw that even here I can be okay. So can you during challenging patient interactions.