A Man Named Joe
Nurse induces cooperation from an ornery patient by taking a personal interest in him

By Ann Quinlan, RN
August 18, 2003

It was my first day on my new assignment, a male med/surg unit, and before I'd been there 10 minutes, I was warned about Joe. If ever there was a patient from hell, my co-workers informed me, it was Joe, a Russian Jew who had already lost one leg to Buerger's disease and was well on his way to losing the other. He was 66 years old, looked at least 80 and spoke with a heavy Russian accent.

Because Joe's condition was deteriorating, he was a frequent admission to our unit for evaluation and treatment. At that time-the late '50s-patient stays often were measured in weeks rather than days as they are now. Thus, Joe had become a familiar and somewhat unwelcome face on our department: familiar because of repeated admissions and unwelcome because he was one holy terror of a patient who was not only sicker but more cantankerous with each admission.

Joe hated everybody and everything. He especially despised his morning bath and fought it tooth and nail, stiffening when we tried to turn him and refusing to cooperate in any way. And the barrage of complaints: The water was too hot! The water was too cold! The nurse was rubbing too hard, or not hard enough to get him dry. He had soap in his eyes. He was getting a chill. And on and on.

As the "new kid on the block," I hadn't been assigned to Joe's morning care during my first week of orientation, but I often helped his nurse by holding him over while she washed his back and changed the linen. Sometimes, he would swear and shake his fist at us, and I'm sure he'd have taken a swing at us if he dared. My luck couldn't last forever, though, and the next week I took my turn as Joe's a.m. care nurse.

Determined to get the job done quickly and cheerfully, I forced a smile as I assembled soap, wash basin and towels.

"Time for your bath, Joe."

"I don't vant bath." His standard response.

Well, I said to myself, I don't want to give you a bath, either-that makes us even-but you must have a bath, so let's get on with it. I wasn't about to let this old curmudgeon buffalo me!

I thought about explaining the benefits of a daily bath, but I figured he'd heard that spiel before. Perhaps, though, a little small talk might distract him from the tirade of complaints that I knew was about to erupt. It was worth a try.

"I understand you were born in Russia, Joe. Where in Russia?" He gave me a one-word answer, some obscure village I'd never heard of, but as I patted his face dry, I kept on talking.

"When did you come to America?"

Again, a one-word answer. "1919."

I was no history buff, but that date rang a bell. "Wasn't that about the time of the Russian Revolution?" I asked. "Why did you leave?"

"I hated Reds," he said. "I was White Russian. I fought for czar."

My ears perked up. "Really? I'd never met a Russian before Joe, let alone a White Russian. Tell me about it."

He spoke hesitantly at first, but when he began to realize that my interest was genuine-and with a little prodding on my part-he began to tell his story with increasing enthusiasm. And what a story it was!

He talked about the events that triggered the Bolshevik Revolution, the chaos, the power struggle, the rise of the dictators. Soon, Joe found that he had an audience, and he seemed to relish his newfound celebrity. Each morning, he told us more about his childhood in czarist Russia, stories laced with the culture and history of the country he had once loved. It was almost like taking a course in Russian history.

But I learned a lot more from Joe. I learned a lesson that no nursing arts instructor could have taught me-that in dealing with our patients, we must remember that within every sick or disabled body lives a real person with a history uniquely his own and with a basic need to share life experiences with others. After all, isn't that what nursing has always been about-the patient? Not the computers, not the monitors, not the infusion pumps-of course, we must be proficient in these areas-but the heart of nursing is the patient.

I've never forgotten this fascinating man or the valuable lesson I learned from him.

Learning, of course, is a two-sided coin, and I think Joe learned from us that friendliness begets friendship, that interacting with others is a joyful part of human existence. I can't say that Joe had a miraculous change of personality overnight, but he did become more responsive to treatment, more cooperative with his caregivers, and-although he probably would never admit it-I think he even learned to enjoy his morning bath!

Ann Quinlan, RN, is a native of East Liverpool, Ohio, who cannot remember when she didn't want to be a nurse. A 1952 graduate of the Presbyterian Hospital (now the University of Pittsburgh Medical Center) School of Nursing in Pittsburgh, she worked in the obstetrical department at Magee Hospital in Pittsburgh and as a school nurse in Baldwin-Whitehall Schools in the city's suburbs. During this time, she attended evening classes at the University of Pittsburgh. In 1973, she received her bachelor's degree in education from Kent State University. After 37 years working as a nurse, she retired in 1995, but still retains RN licenses in Ohio and Pennsylvania.

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