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Monica Phann, Nu’18

“As a medical-surgical nurse, I see patients with health conditions ranging from cardiac, psych, and renal to pulmonary, neurological, and GI complications. One day as I was getting a report on a patient, I was informed that I would be working with a violent, dementia patient.

I was told that the patient had kicked nursing assistants in the face, stabbed nurses with needles, and cursed out providers. I couldn’t help but feel overwhelmed and scared that the patient would hurt me as I tried to care for her during my shift.

Upon caring for the patient, I discovered that we spoke the same native language, Khmer. I began utilizing the translator phone and spoke to her to try to gain an understanding behind her violence and anger, aside from the dementia. She began telling me stories about her traumatic escape from Cambodia to the United States during the Khmer Rouge and how much she hated being the hospital because she was away from her family. It was then when I realized that the hospital was an unfamiliar and uncomfortable place for her. The hospital setting brought a sense of trauma and uneasiness to the patient.

I immediately called her emergency contacts and family members since there was no designated power of attorney. When speaking to the family, they informed me that they dropped the patient off in the emergency room because she seems more agitated and confused, more than normal, and lacked knowledge on how to care for patients with dementia. I arranged for a family meeting with the attending psychiatrist and social workers to help the family gain an understanding on dementia, how to care with patients living with dementia, and how the disease process progresses.

The psychiatrist informed the family that unfortunately there is no cure for dementia, but the best thing to do is to keep her in a safe, familiar environment with family who can watch her 24/7. Knowing this, I then worked with the social workers and the family members to create a calendar to coordinate who will be the patient’s caregiver each day of the week. After the meeting, the patient was safely discharged and sent home with her family.

This experience highlights the importance of interdisciplinary teamwork, cultural competence, and trauma-informed care. I was able to rally up resources for the patient and her family so they can best care for her in a safe environment. I learned that it is easy to judge patients based on their initial interactions, but everyone deserves to be given time and attention to figure out a proper plan of care.

By spending an ample amount of time with the family, I was able to educate them and address many of their concerns. It is not always easy to find time to sit down and educate when working in an acute care setting, but I felt that it was a priority to advocate for this patient and create a safe place for her. To this day, this patient’s story still has a place in my heart.”

To submit your own story, visit: www.nursing.upenn.edu/humans.