Am I a caring person?

Something happened yesterday that made me really re-evaluate my opinion of myself as a caring person. At about two in the morning, the door to one of the bays on the ward opened, and I found myself face-to-face with an elderly gentleman who told me that I had to, “Stop playing this game”, and to let him out.

This is a common occurance here. “Confused” patients (often described as “pleasently confused” when we want to offload them – beware this phrase!) regularly present around midnight, and more often than not declare that:

• we are keeping them hostage
• this isn’t a hospital but a prison
• it isn’t actualy midnight because the sun is on outside (no dear, it’s the lights on the corridor)
• where’s my clothes?
• my wife was here a few minutes ago
• etc…

Almost always this can be attributed to a medical condition – pyrexia, hypoglycemia, UTI – which may be exacerbating already exsisting dementia or just causing the issues all by itself. In many cases this is reversable (a fan, some sugar) but we need to find out what the cause is first, and that is easier said than done.

This particular gentleman was insistent that we’d drugged him and dragged him from his home to what he believed to be a dodgy nursing home. Apparently, all the equipment we had was actually second hand, and our NHS ID badges were faked, with the aim of pretending to be the hospital. The other patients in his bay were in fact “heavies” who were pretending to be asleep, ready to beat him up if he misbehaved. His proof for this? I wouldn’t let him turn the lights on at three in the morning.

The joys of dealing with this chap went on and on, as he tried to leave the ward, break into female bays, repeatedly tried to wake the other people in his room, and make us phone his daughter at stupid o’clock am (yet more proof that we were in a conspiracy against him). How did we cope with this? Got him to sit at the nurses station with a cup of tea (“you’ve put something in it, haven’t you?”) and made fun of him.

Yup, you read that correctly. We made fun of the patient. Not made fun of him in an overly obvious way (throwing custard pies at him or using him as a makeshift drip stand), but in a more subtle way, amusing ourselves by the way we spoke to him and laughing at his responses to our questioning and actions, even those completely unrelated to him.

At seven, we relented to his constant requests for a phone call, and let the gent call his wife and daughter. At first, he didn’t believe them either (“they‘ve got to you too, haven’t they“), but after about half and hour of phone calls the message got through. And that’s when I began to feel awful. He started crying.

The chap grabbed my hand and shook it, and asked “Still friends?”. He apologised profusely as we walked him back to his bed, for swearing and at one point hitting us with a walking stick. He seemed absolutely mortified by the way he behaved, and so embaressed at his misunderstanding of the situation. He was still crying and saying sorry as I tucked him into bed.

And what had I done to help him? I’d laughed at him. I, and the other people working with me, had treated him like a game. Ooo, what’s that crazy old man going to do next? Oh look, he thinks we’re going to drug him, isn’t that a giggle? It was hard to hold on to the fact that he was actually ill, and needed our medical attention, and it upset me greatly that instead of just helping him I treated him as the source of a few cheap laughs. Sheesh, I’m even making fun of him now in my tone of writing about the incident!

Now, we do this a lot. Patients are a constant source of amusement to us. Should they be? I don’t know. As long as we provide the care they need to the best of our ability, is it ok to laugh? We did for this chap, did everything we could to protect him, and the other patients who he wanted to disturb. But was it right of us to treat him the way we did as a person?

In some respects, you’ve got to laugh, or else you’ll cry. It’s sad to see someone in that state, and even worse when you think, “that’ll be me in fifty years”. Laughing about it numbs the pain. And then, it’s our job. People in an office will laugh at their clients (they certainly did when I was temping), so should we be able to laugh at ours? But would I want the staff laughing at my grandad in the same state? Or my dad? Or me?

I want a nice conclusion to this post, but I don’t have one. I feel like I let the patient down, and although I can’t speak for the actions of the people with me, I let myself down. I’m trying today to be extra nice to the patient, though is this making it up to him or is it for me, to make me feel better about being nasty as I’m putting in hard work now? The important question is, was I a good carer, and I can’t answer that.

On another note, I’m determined that when (if?) I reach eighty-odd and if I still have my mental capacities intact, I’m still going to wander all over the place, make inane requests at night, and maybe even shit on the floor if the mood takes me. Because I have to deal with it in my job, I’m going to make certain the next generation has to too!