a. It is normal for the patient to feel dependent. To a large extent, the patient is
no longer self-sufficient and must legitimately seek the help of others, having
involuntarily given up much personal control over simple everyday functions, such as
going to the bathroom, eating, taking a shower, and so forth.
b. Because of these inevitable losses of control, the patient may be inclined to
abdicate all control. In some cases, although the patient finds it difficult to be
dependent upon others, he or she may enjoy the advantages of being cared for and the
relief from responsibilities. In more extreme cases, the patient may react to this state of
dependency by exhibiting diminished self-respect and a fear that people will no longer
accept him or her as an adult. By discouraging unnecessary dependency, you are
helping the patient along the road to recovery and, at the same time, protecting yourself
from being taken advantage of.
2-11. STRANGENESS
It is not surprising that a patient should feel strange in an unfamiliar and often
bewildering hospital environment. Isolated from the security of normal surroundings
and the support system of friends, family, and work associates, the patient may
legitimately experience a sense of strangeness when confronted with unfamiliar,
embarrassing, and/or painful procedures. Who wouldn't feel strange and alone when
placed in an overpowering CAT scan? It is important for you to keep this in mind, so
that you do everything to ease this feeling of strangeness, and certainly nothing that
would aggravate it. It is, for example, poor practice and unethical to prepare an
extremely cold barium enema. The patient could die of shock from the excessive
coldness. Take pains to make procedures that are inherently strange as tolerable as
possible.
2-12. FEAR
A patient may be fearful for a number of reasons to include a fear of: the illness
itself, treatment or surgery, the pain and discomfort, the possibility of a long recovery,
permanent damage, or death. One's sense of fear is also influenced by the values,
beliefs, and attitudes of family and friends, and the impact of the illness on one's work
status. You must be compassionate, doing everything within your power to allay these
fears.
2-13. IRRITABILITY
A patient may become upset over minor matters. He or she may be restless and
impatient, provoked over the slightest interruption or discomfort. (This is especially true
of the elderly.) All of the feelings discussed earlier contribute to a lowered tolerance
level (higher irritability) that you must deal with even-temperedly. There is no control if
an irritable patient is confronted with an equally irritable health care professional. A
first-hand account of the consequences of health care provider irritability involves the
case of a Basic Medical Specialist (91B10) working in Korea. Pushed over the limits by
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