Patient Confrontation

Whilst on my neuro placement at Sir Charles Gairdner hospital I was assigned a male patient, 83 years old, who had had a left posterior cerebral artery infarct. On first meeting the patient he seemed very chatty and friendly and we got on very well throughout the assessments that I performed. He was a well educated man who had worked as an engineer for most of his life and fought in the Australian army. This patient was very happy with the assessments performed and was keen to begin treatment to help improve his high level balance.

The next day I went to treat the same patient and began to work through a few high level balance tasks such as getting him to stand with his feet together, these tasks were aimed so as to challenge his balance but not so that he could not perform the tasks assigned. He began to complain that this was too hard and that no one stands with their legs right next to each other in every day life. I reasoned with him and explained the importance of the exercises and why we were doing them. He became extremely agitated and then began to claim that I was a spy sent to Australia from Zimbabwe. He appeared to have a problem with the fact that I had come from Zimbabwe and refused to continue with any treatment. I then found my supervisor and asked her to talk to the patient on my behalf and asked about any strategies that I could use with this particular patient.

My supervisor had no luck with gaining compliance with my patient. We were then informed by some of the nurses that he did not seem to respond well to female nurses or staff and was extremely rude towards them. My supervisor suggested leaving the patient and having another attempt the next day. The next day proved no better and the patient refused to let me see him. My supervisor suggested allowing one of the Australian students to work with this patient.

This was the first conflict that I have encountered with a patient and I did not know how to handle it at first. I learned that there will be times when a patient will have their own prejudices against you and there will be nothing you can do. I cannot change who I am and where I come from but in these cases you can persevere and attempt to reason with the patient but need to know when to stop. I think that with more experience with patients we will all know how better to deal with any conflicts we may come up against with patients. The key is to keep a level head and not take it personally.