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The Tincture of the Doctor's Time 医生时间的酊剂
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1353/nib.2023.0005
Holland M. Kaplan
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引用次数: 0
Am I the Bad Guy? 我是坏人吗?
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1353/nib.2023.0023
Tavishi Chopra
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引用次数: 0
When Is Enough, Enough? 什么时候够了,够了?
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1353/nib.2023.0020
Megan Homsy
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引用次数: 0
Breaking the Readmission Cycle 打破再入院循环
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1353/nib.2023.0010
Brian Hatten
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引用次数: 0
Every Patient is a Teacher—Especially the "Difficult" Ones: Caring for Patients with Borderline Personality Disorder 每个病人都是老师——尤其是那些“困难”的病人:照顾边缘型人格障碍患者
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1353/nib.2023.0024
Cara Connaughton
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引用次数: 0
Healthcare is Demanding: Patience is a Virtue! 医疗保健要求很高:耐心是一种美德!
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1353/nib.2023.0025
Andrea Torrence
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引用次数: 0
I Know You Have to Stay … I Wish I Could, I Wish I Could 我知道你必须留下来…我希望我能,我希望我能
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1353/nib.2023.0002
Megan K. Skaff
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引用次数: 0
You Can't Say "No" to That! (A "Difficult Patient" Story) 你不能说“不”!(一个“难缠的病人”的故事)
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1353/nib.2023.0006
I. Berg
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引用次数: 0
'Difficult Patient': A Reflective Essay “难相处的病人”:一篇反思文章
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1353/nib.2023.0026
D. McFarland
called the security team to put them on standby. Patient 1 had gotten up and left the room without my knowledge while I was still with patient 2. This was the perfect time to move patient 2 out of the room. Another nurse and I positioned the patient to move her out of the room and to safety. We did this successfully without patient 1’s knowledge, and patient 2 was placed in a private room on the other side of the unit. During that time, the other healthcare providers who had come to assist us found patient 1’s Facebook account and confirmed that the patient did, in fact, “go-live” on Facebook. After watching the many live sessions, we were led to believe that this patient was on the verge of a psychotic episode. The staff that gathered to help ended up calling the medical physician that was on duty and in the hospital. It was important to ethically and legally decide what to do with this patient because of her behavior toward the staff and patient 2. The incident occurred during the off-shift, and most physicians and higher administration were not on-site. The patient needed to be evaluated by a psychiatric physician, but there wasn’t one on call that night. We had to call and wake the administrator on call. The patient had not become violent, which made things more difficult because we have standard protocols for violent or physically abusive patients. The physician assessed the patient and confirmed that she was unable to logically and safely understand her medical condition. The patient disagreed with the physician’s diagnosis and became belligerent. She began to hurl degrading insults at every staff member that was present in her room. For whatever reason, she became most upset with me, and began to threaten me and other staff members on the unit. Our hospital had recently initiated a “code violet” protocol for threatening or violent patients. Once the patient voiced that she wanted to kill me, a code violet was called overhead, and the patient was immediately pink-slipped. When a code violet is called, a team of care providers responds to the location of the escalated patient or family member. Once the team arrives, the situation is assessed and a decision is made on how to handle the occurrence. In this case, the patient was considered homicidal, so the patient’s belongings were confiscated, which sent the patient into a state of hysteria. She became combative and had to be put in restraints. Both arms and legs were restrained. She was given a sedative, and was transferred to the psychiatric unit. While going through the patient’s belongings, I found a very large butcher’s knife in the patient’s purse. There were so many different emotions that flooded my mind and body. It is horrifying to think that the patient had that weapon in her possession the entire time. Somehow it had gotten through the metal detectors and security despite hospital protocol. This experience was grueling because it challenged me to use years of experience, a combina
我叫了保安队让他们待命。病人1在我不知情的情况下起身离开了房间,而我还在照顾病人2。这是把2号病人移出房间的最佳时机。另一名护士和我为病人定位,把她移出房间,转移到安全的地方。我们在病人1不知情的情况下成功地完成了手术,病人2被安排在病房另一侧的私人房间里。在此期间,其他前来帮助我们的医疗服务提供者找到了患者1的Facebook账户,并确认患者确实在Facebook上“活了起来”。在看了很多次现场治疗后,我们被引导相信这个病人正处于精神病发作的边缘。聚集在一起帮忙的工作人员最终打电话给值班的医生和医院。鉴于她对医护人员和病人2的行为,从道德和法律上决定如何处理这个病人是很重要的。事件发生在下班时间,大多数医生和高级管理人员都不在现场。病人需要精神科医生对其进行评估,但那天晚上没有医生值班。我们不得不打电话叫醒管理员。病人并没有变得暴力,这让事情变得更加困难,因为我们对暴力或身体虐待的病人有标准的治疗方案。医生对病人进行了评估,确认她无法逻辑地、安全地理解自己的病情。病人不同意医生的诊断,变得好斗起来。她开始对在她房间里的每一个工作人员进行侮辱性的辱骂。不知道什么原因,她对我非常生气,开始威胁我和病房里的其他工作人员。我们医院最近启动了一项针对威胁或暴力患者的“紫色代码”协议。一旦病人说她想杀了我,头顶上就会发出紫色警报,病人立即被粉红麻醉。当呼叫紫色代码时,护理提供者团队将响应升级的患者或家庭成员的位置。一旦团队到达,就会对情况进行评估,并就如何处理事件做出决定。在这个案例中,病人被认为有杀人倾向,所以病人的物品被没收了,这让病人陷入了歇斯底里的状态。她变得好斗,不得不被绑起来。双臂和双腿都被束缚住了。医生给她打了镇静剂,然后把她转到精神科。在检查病人的物品时,我在病人的钱包里发现了一把很大的屠刀。有那么多不同的情绪充斥着我的身心。一想到病人一直拿着那把武器就很恐怖。不顾医院的规定,它不知怎么通过了金属探测器和安检。这段经历很折磨人,因为它要求我运用多年的经验、战术、学来的技术和超乎寻常的耐心。对任何一个参与其中的人来说,结果都可能更糟。有人可能会受重伤,甚至丧命。我很感谢大家在这个案件中共同努力,结果对我们有利。在医疗保健领域,我们经常因为照顾不同类型的病人而把自己置于危险之中。这是一项艰巨的任务,但为了履行我们的承诺,我们必须有效地照顾那些需要帮助的人。
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引用次数: 0
Full Collection of Personal Narratives 个人叙事全集
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.1353/nib.2023.0027
Megan K. Skaff, Tyler Bendrick, David Vilanova, Holland Kaplan, Ingrid Berg, Miguel Paniagua, Marissa Blum, Eva V. Regel, Brian Hatten, Adam Bossert, Keva Southwell, Salvador Cruz-Flores, Melissa Cavanaugh, Megan Homsy, Novick Adrienne Feller, Clarice Douille, Tavishi Chopra, Cara Connaughton, Andrea Torrence, Daniel McFarland
Full Collection of Personal Narratives Megan K. Skaff, Tyler Bendrick, David Vilanova, Holland Kaplan, Ingrid Berg, Miguel Paniagua, Marissa Blum, Eva V. Regel, Brian Hatten, Adam Bossert, Keva Southwell, Salvador Cruz-Flores, Melissa Cavanaugh, Megan Homsy, Novick Adrienne Feller, Clarice Douille, Tavishi Chopra, Cara Connaughton, Andrea Torrence, and Daniel McFarland • I Know You Have to Stay . . . I Wish I Could, I Wish I Could • The Transformation: Power in Persistence and Perspective • Working with Patience: An Insight into Dealing with Difficult Emotions • The Tincture of the Doctor's Time • You Can't Say "No" to That! (A "Difficult Patient" Story) • Vertical Transmission: The Patient, the Student, the Teacher • My Patient, Teacher • Silent Screams; Lily's Story • Breaking the Readmission Cycle • It's Not Always Just a Rash • An Epidemic of Difficult Patients • It Is Going to Be a Long Clinic Day • Positive Change in Perception and Care for a Difficult Patient • When Is Enough, Enough? • I Had Never Heard Someone Use That Word Before • Dying is Difficult • Am I the Bad Guy? • Every Patient is a Teacher—Especially the "Difficult" Ones: Caring for Patients with Borderline Personality Disorder • Healthcare is Demanding: Patience is a Virtue! • 'Difficult Patient': A Reflective Essay Copyright © 2023 Johns Hopkins University Press
《个人叙事全集》:梅根·k·斯卡夫、泰勒·本德里克、大卫·维拉诺瓦、荷兰·卡普兰、英格丽·伯格、米格尔·帕尼亚瓜、玛丽莎·布鲁姆、伊娃·v·雷格尔、布莱恩·哈滕、亚当·博塞特、凯娃·索斯韦尔、萨尔瓦多·克鲁兹-弗洛雷斯、梅丽莎·卡瓦诺、梅根·霍姆西、诺维克·阿德里安娜·费勒、克拉丽斯·杜维尔、塔维什·乔普拉、卡拉·康诺顿、安德里亚·托伦斯和丹尼尔·麦克法兰•《我知道你必须留下来》我希望我能,我希望我能•转变:坚持和观点的力量•耐心工作:处理困难情绪的洞察力•医生时间的酊剂•你不能对它说“不”!(一个“难相处的病人”的故事)•垂直传播:病人、学生、老师•我的病人、老师•无声的尖叫;莉莉的故事•打破再入院周期•这并不总是一个皮疹•难缠患者的流行病•这将是一个漫长的诊所日•对难缠患者的认知和护理的积极变化•什么时候够了,够了?•我从未听人说过这个词•死亡很难•我是坏人吗?•每个病人都是老师——尤其是那些“困难”的病人:照顾边缘型人格障碍患者•医疗保健要求很高:耐心是一种美德!•“困难的病人”:一篇反思文章版权©2023约翰霍普金斯大学出版社
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Narrative inquiry in bioethics
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