We had a 50-something year old man who was admitted to the ICU after a vascular bypass surgery in his left leg. When reading through his history, we found that he was in our hospital just 2 weeks prior and had a stent placed in that same artery. He was a heavy smoker at 2 packs per day and made the decision that purchasing his cigarettes was more important than purchasing his Plavix (a medication that reduces the effect of platelets, thereby reducing the chance of a clot forming in the newly placed stent, which would re-occlude the artery causing a lack of blood flow to the leg and foot).
This guy was a little rough around the edges… he was not the kind to say thank you to the nurses or doctors (but he looked appreciative after his massive, hourly dose of dilauded). When we helped him get in or out of the bed, he would scream and swear, and even reach to pull out his IVs or EKG leads out of aggression/pain. Its tough for many nurses (myself included) to have a lot of empathy for a person like this. When someone doesn’t take care of themselves, or have concern about their own health, it makes it difficult for the healthcare providers to have as much compassion, but we do take care of them. We do make sure that they get the attention that they need no matter how much energy it takes, but it is definitely easier mentally when you do have that connection.
