Thank you to the College of Registered Nurses of British Columbia for permission to adapt their case study.
Right from the beginning, Nico feels a little put off by his new dialysis client, Mr. Stedman. Nico’s clients have always responded to his cheerful and upbeat manner, but Mr. Stedman does not.
He's non-communicative and unsmiling, responding to Nico’s questions with monotone one-word answers. For the first few weeks, Nico works at building a rapport with Mr. Stedman but it seems his efforts are ignored. His attempts at client teaching also seem ineffective — Mr. Stedman makes few changes to his lifestyle or diet. Although Mr. Stedman begins to warm to other staff, after a month, Nico still feels unable to connect with him. Feeling powerless, Nico rationalizes that he cannot do anything else and Mr. Stedman won’t change. He begins to spend less time with Mr. Stedman, finding ways to minimize contact and conversation.
Nico stews about Melissa’s remarks during the rest of his shift. At first, he feels defensive. After all, Mr. Stedman doesn’t take care of himself and doesn’t talk during his visits. Nico knows he really tried to build a relationship with Mr. Stedman, but didn’t get a response. What else could he do?
Nico approaches Melissa at the end of the shift. "I'd like to talk about Mr. Stedman. I know I need to try a different approach and would appreciate any suggestions."
Nico dismisses Melissa’s comments. He believes that he’s done what’s necessary and that sooner or later, Mr. Stedman will come around.