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Wilkommen to my blog - my name is Karin Purshouse, and I'm a doctor in the UK. If you're looking for ramblings on life as a junior doctor, my attempts to dual-moonlight as a scientist and balancing all that madness with a life, you've come to the right place. I'm currently a doctor/research trainee in oncology after spending a year doing research in the USA. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Saturday, 24 May 2014

Battered and bruised versus confused

I've narrowly avoided being hit over the head with a walking stick.

I've also (literally) had my wrists slapped, been called a 'stupid cow', and had to wrestle for control for a telephone handset.  I've had to persuade patients that self-discharging themselves at 2am is not a wise move, and had to disappoint patients claiming to await their (long deceased) parents that they probably won't be visiting today.  I remember well one particular incident where a nurse nearly got punched in the face by an elderly patient.  My friend and colleague who was the doctor looking after them was distraught about eventually having to give the patient some mild sedation so that neither the patient or anyone else came to further harm.

This is a side of the ageing population people don't see, or perhaps even hide away.  Delirium. Dementia.  Call it what you will.  Sometimes patients are confused, and as a result can become agitated, distressed or even violent.

Having just finished another week of night shifts, I am all too familiar with this scenario, and yet I am still scared by it.  It can be a daunting prospect to be called to resolve these issues, and it's usually once the nursing staff have done everything in their powers to calm things down.  I always teach my medical students to remember that the person brandishing a water jug as a weapon is still a human being.  They have a life, family, friends, a career and hobbies.  And they would probably be horrified to see how they were behaving if only they could know.

When it comes to my patients, I always try to understand or see reason in what they are saying (or shouting).  Their rage almost always comes from a logical place - even if it does not seem logical to us.  I'd be pretty darn confused if I woke up in a strange place with strange people.  I try everything from explaining where we are and what's going on, to encouraging patients to talk about their wife/dinner/previous job.  Usually this diffuses any tensions, but not always.  I have only twice had to resort to using medication, and it is always with a heavy heart and a feeling of failure.

My German grandmother is 93 this year, and although my other grandparents are no longer alive I have been lucky to know most of them as an adult.  Granny Deutschland has had a life every bit as exciting as I could imagine, growing up in what is now Poland, living through the second world war, emigrating for a short time to South Africa and travelling the world with my grandad in their retirement years.  I see her in every older patient I see, and remember her life and adventures.  I imagine every one of my patients would tell me their stories if they could.

I'm off to Germany next week after yet another set of nights to replenish my stock of Granny Deutschland tales with my sister and niece.  Hopefully I will successfully dodge any further walking sticks or similar in the mean time.

In fact I am baking banana bread (with some creative ingredient substitution) and reading entries for a writing competition today, tucked up in my little cottage. Rock. And. Roll.  

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