Many of our patients request night sedation, hospitals are noisy places, the lights are left on, and it's difficult to sleep when the patient next to you is snoring like a trooper. But this request wasn't from the patient. It was from the nursing staff.
You see, the patient was old. He was wondering. He didn't want his bed. He wanted to sit in the chair between two other patients. He'd woken another patient, and demanded that 'she' get out of bed. That man wasn't confused, he wanted to stay in bed and sleep.
The nursing staff stated he was aggressive.
I walked to the ward, late at night, dreading a demanding patient.
I found a lovely gentleman, quite happy, easily led back to his bed space. Did he want a cup of tea, 'oh yes', said he. Into the kitchen, a quick cup of tea made, cooled down with plenty of milk. Gratefully recieved, he started to drink.
Off I toddled through the hospital. BEEP BEEP, my bleep rang out.
'Doctor, you must sedate him, he's keeping the other patients awake, Mr Smith is now sitting at our nursing station refusing to get into bed as he's keeping him up.'
I explain that I can't sedate one patient for another's comfort, that I can't sedation would increase this patients risk of falls, of head injury, of broken hips, and that it's just not ethically correct. It's not good enough. I suggest moving him into the nursing station area, where won't bother the patients in the bay, where the nurses can keep a close eye on him and reduce the risk of him falling. 'He is aggressive and won't let us move him', i'm told.
Back to the ward I march. This is a care of the elderly ward, they should be able to cope with this. The patient is perfectly amiable, he walks with me, he sits on a chair in the front area. I collect his chair, a foot stool, a blanket. I tuck him up.
Off I wonder, down to the next patient. I hear no more about this man overnight. Sometimes it's the simplest answers which work the best.
