My first patient had dementia and she made me miserable

Photo courtesy: Beerkopf

By Anna Thomas

I could not believe it when I was told that I am being assigned to the ICU. For a trainee nurse, the ICU is like the ultimate dream. The best and the most experienced nurses work in the Intensive Care Unit, the ICU as it is popularly known.

I could understand the reason. Covid was in its dying stages and staff strength was still to return to normal. Hospitals were struggling to provide healthcare.

That night I could not sleep. In the morning I tiptoed to the nursing station in the ICU and reported to the nurse-in-charge. She was not very pleased to see me, but had little option. A half-trained nurse was better than no nurse.

It was 8 am and the ICU was still waking up. “Go to bed number 7,” the head nurse said pushing the spectacles to the top of her head.

I walked gingerly towards bed number 7. From the corner of my eyes, I could see frenzied activity. Clearly, some patient needed urgent attention. A nurse and the resident doctor were at the bedside.

The patient in bed number 7 was an elderly woman suffering from dementia. She had been admitted late in the night. I could see the oxygen pipe stuck in her nostrils. There was a tube attached to the canula. Clearly, she was being administered an antibiotic. On the right side of her bed were the monitors. They were beeping loudly.

I could make out that she was over 80. Her hands were thin and wrinkled. Her face was shiny and there was swelling. Her head was propped on the pillows. She seemed half awake.

The monitors showed that her blood pressure and pulse were normal. There was nothing to worry. She was responding to the treatment.

I went and wished her a cheery good morning. There was no response. I made my greeting more personal and asked her, “How is she feeling, Patti?” (Paati is the address for grannies in south India.)

I had hoped for a smile. Instead, there was a scowl. She told me to go away, not to disturb her.

I meekly slipped to the end of the bed and looked at her file. She had been admitted with suspect Covid. However, her Covid report, which had come in, showed her Covid negative. There was therefore nothing to worry on that count. The other investigations were still to happen.

What I was not prepared for was her anger. When she saw me standing at the end of the bed she flew into a rage. She first tried to tear the tube through which the antibiotic was being given. When she did not succeed she started tugging at the oxygen pipe.

When I tried to stop her, she accused me of trying to kill her in a voice that could be heard across the hall. I froze. What would everyone think of me, was my first reaction. I desperately tired to keep my calm.

Even as she struggled, I restored the oxygen pipe, and begged her to stay calm. However, my woes were from over. Her next demand was to switch off the monitors as they were making too much noise. Obviously, I could not do so. So, I turned the direction of the monitor stand so that the noise may come down.

But there was no respite from her constant harangue. She wanted to be discharged, and allowed to go home. The senior nurse to whom I had been assigned realised my discomfiture, and came to help me. She too failed to pacify her.

We decided to return to the nursing station and observe her from there. Her moaning did not stop. But became louder, disturbing other patients.

The Head Nurse looked sternly at me though she knew that patients suffering from dementia can be impossible. I went back and stood at a respectful distance from her, hoping she would quieten down. She was better behaved when the doctors arrived, and checked her. They wanted her ICU stay to continue.

I took the capsule that was prescribed by the doctors. But she pushed my hand away. The capsule fell on the ground, and I had to bend down and search for it under the bed. All my entreaties were in vain. The same happened when the food came. She pushed the food tray away.

By now I was worried. My job as a nurse was to keep the patient happy and ensure all medication happened on time. The Head Nurse advised me to call her attendant.

When her son arrived, she broke into a litany of complaints accusing me of trying to kill her. I was close to tears. Fortunately, her son understood. It seems he was aware that her mother had dementia, and could be quite unreasonable. Thankfully, he persuaded her take her medicine and some food.

But since this was the ICU he had to leave, and I had to suffer the patient’s misbehaviour for the rest of the day. Finally, my duty ended and I handed over charge to the night nurse.

The next day was no better. Even the doctors were feeling the heat, and advised that she be shifted to the ward. I accompanied the attendant who wheeled her to the ward, and could not believe the change in her attitude.

She was smiling, and feeling better. Clearly, in her mind she had won. I wished her well, and left for the ICU.

I dealt with several dementia patients in future. But no experience was like this. It was literally baptism by fire.

Read: Act before dementia alters your parents permanently