"What can we do to...?"

Asking the patient what she wants.  It's such an essential, yet commonly overlooked aspect of care.  It's easy to walk into a room and ask a patient, "How are you feeling?  What can I do for you today?" when the patient is calm, but oftentimes I have a patient who has already been redirected multiple times and butted heads with all of my CNAs before she gets to me and by then, she' on the verge of hysteria--sometimes, hysteria compounded by dementia.  And that's not an irreversible disease.  Until the quetiapine or Ativan (which they often refuse in suspicion) kicks in, the storm continues and we are all helpless in it.  About 60% of the time, by some stroke of luck, my gut instinct kicks in and I break through the deluge of tears and incoherent crying when I blurt out: "Ok, I see you're really upset.  What can we do right now to make things better?" And often just that offer alleviates the situation.  Sometimes my patient who is suffering from aphasia will wail the only coherent thing I've heard from them all week,like "hurt!" and point to a body part.    Or they'll shout a family members name.  Or sometimes they'll say, "I just feel confused and alone."  Or sometimes, it's just a need for coffee and toast and someone to just sit there and ask them "What can I do to make you feel better?"

It's such a simple question.  But it's why were nurses.

http://www.washingtonpost.com/national/health-science/how-i-discovered-an-important-question-a-doctor-should-ask-a-patient/2015/03/09/ca350634-bb9c-11e4-bdfa-b8e8f594e6ee_story.html