Worried I was aggressive in hospital?

[rhythmisadancer3]

Hi, really embarrassed about this and I know nobody on here can fix that directly but I guess I’m just hoping that by posting it might get it off my chest a bit!

basically I got a bit of a telling off from a doctor and whilst I think it was probably more to keep me calm than to actually give me in trouble, I feel so embarrassed in case maybe I was behaving out of order or badly and that’s why they were annoyed at me?

for context I had an emergency cardioversion because of an unstable arythmia. They had started to sedate me but I think they said I became really unwell quickly (I think maybe really low blood pressure) and so they had to do the cardioversion immediately or something along those lines. I was really unwell but was still awake and had very minimal sedation. When I say I felt the whole thing that’s an understatement- it was horrific. I’ve never been electrocuted but I think I probably know what it feels like now! I actually remember the shock in my entire body from my neck to my toes and my body sort of jolted up with it like something from a horror movie. Needless to say I screamed the place down. I remember wailing to the doctors and nurses that it hurt so much and I was completely hysterical, like inconsolable. I wasn’t screaming (after the initial shock!) but was wailing and sobbing. Really embarrassing but I think I had such got such a fright.

the doctors and nurses were amazing with me, and they were reassuring me and calming me down but then I remember they became really serious and strict and were basically saying ‘(my name) stop it now. stop it NOW. Stop this behaviour now.’ And were being really firm as if I was in trouble. I think realistically it was more to stop me freaking out because they knew we would have to do it again because it hadn’t fixed the arrhythmia. But part of me is like, was I behaving really badly? Or was I being loud and out of order or aggressive and that’s why they were annoyed? That bit is a a bit of a blur so whilst I want to believe they were just being firm to keep me calm, part of me is like was I cursing or flailing about or behaving out of order? Obviously I’ll never know now either way but I’m a worrier and I’m like oh god was I behaving aggressively or something and that’s why they were annoyed at me?

they were brilliant- really helpful, had an entire team of people working to help me and they were amazing. I guess I just hate the thought that I was possibly behaving aggressively or agitated or something to have caused them annoyance or upset when they were so kind to me

haha sorry long rant. I know nobody can tell for sure and I’ll never know either way so I’m just going to move on. Just thought I’d post on here in case anyone has had similar and can reassure me that it was probably just them trying to calm me down!

I would be happy to have been saved. Despite the trauma. So would my kids and husband.
*meant to reply to @saltandvinegarchipsticks

This reminds me so much of when I was basically told to stop screaming during my (accidentally) unmedicated back to back labour and instead funnel the energy into pushing. At the time it felt like being scolded but I pushed DS out in about 20 minutes so clearly needed to be told! I imagine they were just trying a different tactic to help you calm down

@Bumble2016 i had a similar experience in labour, was fully dilated very quickly and the midwives were quite stern with me, to prevent me going into full blown panic. I was very argumentative with them, which is not like me. Afterwards, I had a chat with the two midwives that I had been a bit difficult with, and they couldn’t have been more lovely and reassured me that my behaviour hadn’t worried them.

So OP, I think any experienced medical staff will be tolerant of unwell patients panicking and the way they spoke to you was part of trying to get you the treatment you needed.
Sounds like a dreadful experience for you, don’t stress yourself out by worrying what anyone thought of you. Mind yourself x

Ermmm, well done 👏

as a few others have suggested it sounds like asking to debrief with someone who was there might be useful.

obviously with all the usual MN caveats about not being able to give specific advice.... the issues when patients have dangerous tachydysrhythmias is that a) on their own, the rhythms are dangerous and can cause rapid, catastrophic cardiovascular collapse, and b) all of the sedative drug options used to make cardioversion comfortable can precipitate cardiovascular collapse too. (Probably the most cardio-stable analgesic/sedative drug that we sometimes use for a compromised patient is ketamine, and that can really affect a person's perception of what went on and can cause some impressive 'fight' reactions, so it may be that that's contributing to how you recall things now (not suggesting that it wasn't painful/upsetting, but just that ketamine can do some weird things)). c) when someone's circulation is very compromised it takes a lot longer than normal for the sedative medication to get to the brain, but in that time a patient can become peri-arrest and you have to hope that enough of the drugs have reached the brain that they won't remember it.

someone raised the issue of capacity and consent - if someone has a malignant dysrhythmia causing cardiovascular collapse and hypoperfusion of the brain (which is the only scenario in which doing a very lightly sedated cardioversion would be considered), then it's a best interests type decision at the time unless that person has a valid advanced decision stating that they wouldn't want to be cardioverted. When it really is a life-and-death moment, sometimes if the patient survives to make a complaint then that's really the best result you can hope for - it's anxiety inducing for the people making that decision as well as flipping unpleasant for the patient. It's really never the intention to cause trauma, but it is usually better if someone actually survives to hear an apology rather than doesn't survive.

Literally no one working with you would remember anything about you other than it was a flipping horrible procedure to have had. Occasionally HCPs do have to go a bit 'mum' and be quite direct if patients are putting themselves at risk - it's not usually because they are cross/annoyed/anything else, but sometimes a change in tone is needed to break a cycle. When patients become agitated and very mobile with it it increases myocardial oxygen demand and that can turn an already hairy situation into one that's even worse so it is important to somehow get a degree of control.

With insight that all of the above is very general and may/may not explain what really happened, hopefully it might help with some idea of what sort of things HCPs might've thinking about when this happened. Hope a debrief is useful if you do ask for one. (doi fwiw, am an anaesthetist and i hate doing sedation for emergency cardioversions for all of the above reasons)

Well done you too!
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I think most healthcare professionals (the good ones anyway) know that we can have our extreme medical emergencies, or we can win popularity contests, but we can't do both at the same time. You wouldn't have been there at all if there hadn't been something seriously the matter and the effects of illness and the treatment for it can produce out-of-whack effects. None of that is your fault. The people looking after you will have seen it all before and worse. But as pps have suggested, perhaps a debrief with an expert on the procedure you had, why it was necessary and how it produced the effects it did would help to clarify and demystify the details. It may make the experience a little less frightening for you.

A&E nurse here. I can honestly say they wouldn’t have been annoyed or angry at you. They could see that the nicey nice approach wasn’t working to calm you down so switched to the stern approach which often works. Sometimes we have to do that, we don’t enjoy it. You really have my sympathy having to be shocked without full sedation, I was involved in doing that to someone recently in a similar situation (blood pressure pretty much nonexistent and about to die basically so we didn’t have time to fully sedate) and it was awful for our patient too…although luckily for him the first shock did the trick. Please don’t worry about what the nurses, etc think, they will have seen it all before.

Other situations where the rescuers have to be cruel to be kind-
hostage retrieval like the Iranian embassy siege
forcing stricken mountaineers down out of the death zone on Everest
Pam Bales' solo rescue of a hiker in a blizzard (who was, unbeknownst to her, an attempted suicide...who in hindsight was glad she had saved him).

OP I would say, from a criminal court perspective, had you been aggressive beyond a reasonable level security and or police would have been called.

i would write them a thank you letter and get it off your chest and move on.

If a patient is screaming in pain and for a procedure to end, surely the team should stop and calmly establish consent, rather than sternly telling the patient to be quiet in case they need to repeat it?

Depends upon whether they want them to live/save the leg/not bleed out, really, doesn't it?

Sounds really traumatic!
@rhythmisadancer3 hope that you are on the mend. I can assure you that they will have seen worse!

If you’re really unwell and needing resuscitation, we’d give you the treatment (in this case cardioversion) regardless as it’s an emergency treatment and lifesaving.

Dont worry too much about bring hysterical - it happens a lot and in your case is justified.

Try to focus on recovering and getting better now.

and, if in the future, you start feeling the same symptoms, seek help earlier rather than later. But hopefully you will be all sorted now.

I do struggle with being told to calm down as I battle panic and meltdowns due to CPTSD and BPD/EUPD so I hear ya. What can help me is if the person telling me to calm down doesn't raise their voice and reminds me to slow down my breathing. Then as my minds starts to clear I can start to tell myself they don't mean to be invalidating, they just need to get whatever is being done out the way. I tend to warn healthcare or admin staff in advance that I struggle if possible but it isn't always possible in a full on medical emergency. It has taken me a lot of time and work to get to this place though where I can do that and slow down the fight or flight.

@rhythmisadancer3 please don't feel ashamed or worried about your reaction, it's completely understandable and I'm pretty sure it happens a lot in hospitals. i bet the the staff won't be judging you at all.

Gosh my Mum had this done due to AF and an out of sync beat and beta blockers didn't work. They very heavily sedated her, she said she knew nothing of it.

I wonder if you had enough sedation OP? But if it was an emergency then they may not have had chance.

No I didn’t. I had barely started to get the sedation when they did it but that wasn’t their fault, they didn’t intentionally not sedate me enough, I was too unwell for them to not cardiovert me immediately because my blood pressure was crashing x

Honestly I just feel unbelievably grateful to them

i staggered into a&e struggling to breath and they immediately sorted me out, it was like something from a movie I didn’t even sit down they immediately helped me

And i realise that if you’re in resus and have multiple doctors and nurses all rushing round to help and everyone is shouting and it’s chaos then it’s usually because you’re pretty unwell so I’m just so grateful to them for helping me x

You obviously don't need to at all (and from reading previous posts it sounds like your reaction was completely normal from their perspective) but maybe you'd feel better if you dropped in with a thank you card and some biscuits or something :)

Honestly OP they'll have seen and heard way, way worse. Once, a nurse was trying to gauge the state of my brain after an accident and I'd briefly been in a coma due to oxygen deprivation (I was fine in the end, actually once I woke up I got well really quickly) and apparently I got offended or something in my confused state because I told her archly, "I do know how to read you know, I have a PhD". Once I remembered this I was absolutely mortified, but my friend who is a doctor thinks its hilarious and said "Oh my God, that's nothing, we have people accusing us of kidnapping them and stealing their organs, threatening us, everyone knows its just the drugs and the hospital confusion". The staff won't be thinking about it anymore.

You poor thing, how traumatic and scary for you! I know the feeling very well, being unwell/delirious/panicky in hospital and the horrible embarrassment after. As a clinician I can reassure you it's very normal. It happens to many people for all kinds of reasons, some even panic at the sight of a needle. Many unexpectedly lash out after anaesthesia, or get combative in the recovery room. Staff have to be firm to keep you safe, but ideally they should stay calm and not panic you or make you feel bad. I guess they panicked a bit as you were so ill, they had to act fast. Maybe they were a bit inexperienced or stressed. It wasn't your fault.

I still remember waking up hysterical after surgery 20 years ago, I was mortified and not fully present although out of Recovery. It was day surgery and I somehow pulled out the IVs and got dressed before the recovery time was up. They tried to sedate me with morphine, which made me panic more as everything suddenly felt like a dream. I kept trying to leave, and eventually 2 security gaurds took me back to bed, one either side while I kicked them trying to wriggle out. Then they held me face down on a bed, arms behind my back, while a doctor injected me (presumably a sedative, I vaguely remember someone saying haliperidol.) To their credit they were very kind and calm, but the doctor got panicky as whatever he injected wasn't working. I kept thinking I had to escape, then slipping into waking dreams, the doctor kept telling me to behave. As if I was acting up to make his day harder, or not reacting appropriately to the meds! I was also furious at being injected in such an undignified way, surrounded by men, jeans pulled down. The doctor kept increasing the dose and the 2 security gaurds were saying 'she's still resisting' ! So embarrassing to come round with such vivid memories, and security gaurds lingering. But it can happen to anyone, even medics. You're not fully present, your body reacts to shock and pain, your rational mind keeps wandering off. They've seen it all before and won't judge.

I should add, every time I've had surgery something embarrassing seems to happen, even light anaesthesia. Last time was a couple of years ago, I had a radical hysterectomy. It was Nuffield and they're all extra nice and not rushed, very kind, but for some reason I took against the surgeon when he came to see me in my room. I'd just woken up again, and while the first wake up went well, in Recovery, this time I was in pain and didn't want to be touched. He was admiring his neat stitches out loud, checking the drain, being jokey, and I told the poor man to get out. I even shouted at him to stop touching me, and demanded he increase ' all the sleeping meds', accusing him of waking me up. He took it well and sort of backed out of the room apologising. I shouted at him to stop laughing!

He left me in the care of a very kind, graceful male nurse, who told me all about his mum for some reason, and kept admiring my slippers while anxiously strapping my legs into those pulsating cushion things that prevent DVTs. He was so kind and understanding it softened the experience a bit.

Try to focus on the staff who were reassuring and calmed you. I know it's hard but aftercare is important. I still have an intense fear of waking up from anaesthetic and what I might do/say!

Coming round from anaesthetic I grabbed the hand of a guy I assume to have been a male nurse (I don’t really remember him but I thought he looked like a young Ray Liotta), refused to let go, explained he was my boyfriend and I loved him very much.

I think that hospital staff have very likely seen it all.

I have had multiple marriage proposals and declarations of love from patients of all ages and both sexes immediately after they've woken up. Fortunately I don't think most people remember!
Apparently when I had surgery in a different hospital to my own, I spent all the time I was in recovery trying to persuade the staff to defect and come to work with me. I have zero recollection of it, but it sounds plausible!
Honestly,there is nothing we haven't heard before and nobody thinks badly of patients who behave out of character.

Thank you so much everyone, I feel so much better about it all 💝

handed in some chocolates and a thank you card because the staff really were amazing and I have a lot to thank them for

also I found out on the discharge letter that it was 100j I was cardioverted with when awake so I feel slightly less dramatic after reading that realistically of course it’ll be painful getting shocked with that!

and on a plus note, at least I now know that I’ve got a great set of lungs on me after how much I screamed the place down 🤣

thanks again everybody

Just copped your username OP, nice one 😆