"The minute this LOL walked into our ER, I knew she was going to be trouble. She arrived with 6 relatives, each of whom was being continually, loudly reminded of their responsibilities. One had to hold the purse, another was to call everyone - she listed them by name - and let them know the LOL was in the ICU and about to die any moment, another one had to run out to the car to make sure the lights were out, the fourth was supposed to make the doctor see her at the triage desk because she didn't have the strength to go any further, the fifth had to take the purse because the first one wasn't holding it right, and the sixth was responsible for everything else."
"I don't think Queen Elizabeth has this many attendants. I knew right then we had a candidate for our Hall of Fame."
Reframing: Seeing the World Through the Lens of Humor
Some patients are more difficult than others. That's no secret - just ask any nurse! Humor provides a way to keep calm, cool and collected while managing difficult patients - and keeps the experience of caring for those difficult patients negatively impact the care you give your other patients.
"As you can imagine, getting LOL to agree to being separated from her entourage was challenging, and she became less and less compliant as things went on. It would have been easy to get upset, but instead I just focused on the fact that she was going in the Hall of Fame. In our hospital, we all keep a little mental list of our most memorable patients, the ones who were truly unique because they were difficult, demanding, so over the top - maybe you know the type? When someone's talking about the guy who insists the doctor stole his teeth - which are always, always, always in his right shirt pocket; they haven't been in his mouth as far as we can tell since 1973!- we say, "Oh, him! He's in my Hall of Fame!"
This Hall of Fame practice is what is known as a reframing technique. Taking a situation that's stressful, and choosing to view it from a more humorous perspective, is a valuable way to help you feel more in control. You're creating emotional distance between yourself and the difficult patient. You'll experience less of the physical symptoms of elevated stress.
The best thing about the Hall of Fame technique is it takes place entirely inside your head. Your patients don't need to know they belong in the Hall of Fame - it's probably not a really good idea to tell them they're a candidate! - for you to benefit from the stress-break and emotional distance humor provides. Comparing Hall of Fame stories with colleagues builds bonds, something we definitely need in the profession right now, while modeling appropriate stress-management techniques for more junior nurses.
"They never did admit my LOL to the ICU - no matter how bad your hangnail really is, they're not going to give you a bed for that! She left, with her half-dozen attendants checking her vitals every step and a half. It took her a little while, but she walked right out of the ER and into the Hall of Fame!"