Thursday, August 4, 2011

Therapeutic Ignore

My ER BFF was talking to me the other day when someone came over the call light with completely asinine request the patient had made for the 4th time or whatever and she just said, "Uh, yeah. I think I'm just gonna therapeutic ignore that for right now." I remember at the time thinking it was kind of funny but sort of mean just because I am the type of sucker who immediately answers the call light regardless of how stupid the request is if I'm not doing something else really important, even if it's just to say "No, I'm sorry, I can't do that" yet again.
Until last night.
Last night my rooms became the unofficial frequent flyer unit. To the point that I'm pretty sure the charge nurse was afraid I was going to harm her physically. It was just realllly unfortunate timing, but I literally had three patients whose medical history and allergies I could recite to them as they were rolling in on the ambulance. I'm pretty sure the amount of Dilaudid I gave to any one of these people last night could kill the average horse. In my 4th room I had a woman who would scream constantly at the top of her lungs, until I asked her any kind of pertinent question, which she would then answer in a fucking baby voice. She too, wanted Dilaudid, but her blood pressure was too low so she pretty much kept that whole routine up the entire night. Awesome.
I tried telling the charge nurse that I had suicidal ideation with a plan, but she refused to put me in a psych room and give me a warm blanket and a sandwich, so I just had to deal with my lot. So after running back and forth getting everything one patient requested med-wise, only to be met with, "you forgot my Shasta", only to have her 5 minutes later vomit said Shasta (her 4th, btw) all over her sheets and the floor along with her life saving Kayexalate (I'm pretty sure to make a point about not getting Phenergan ordered), it totally switched to homicidal ideation. Only then did I truly understand the therapeutic part of the therapeutic ignore.
You know how they tell new parents that it's better to go outside and ignore a crying baby for a minute when you're about to snap instead of shaking the baby? Yeah, well. I think that same concept applies to nurses. When you start looking around your room for pillows for reasons other than keeping your patient comfortable, go outside a minute. Maybe scream, or break something. Go to the bathroom. Then come back. The conversation about Phenergan can wait just a minute. It'll be better for you, and your patient. Therapeutic ignore for a minute, and you'll be a more patient nurse.


  1. Except no baby deserves to be shaken, but some patients do.... ;) lol

  2. Therapeutic ignore...I like it.

  3. "I tried telling the charge nurse that I had suicidal ideation with a plan, but she refused to put me in a psych room and give me a warm blanket and a sandwich..."