[Anagray]

Hello everyone. I am a telemetry tech and I'm also in school. I will probably be coming back to my unit when i gratuate from RN program.
I have been working on my unit for over a year and i noticed that many times, patients don't really understand what's going on and have to ask nurses to "translate" to them whatever the docotor said.

One of the wors things i have observed personally is the following:
a man in his early 60s was admitted late pm with a heart attack. I did an EKG on arrival, which showed significant damage, blood results also came in bad, but amazingly he was in sinus, allert, cheerful, with very little chest pain, no respiratory problems, the only thing that was abnormal was his BP, he and his family awaited the doc to come in. in the mean while, we carefully watched the monitor to make sure everything he was OK.
The md arrives, looks at the EKG and bloodwork, walks in the room and says something to the effect that we can not do anything for you at this point.
The patient apparently went hunting with his sons, picked up the deer carcas and got serious pain in his chest and arm. He figured he pulled something, so he didn't get to the hospital until 3 days later.
So, they way md made it sound was as if this guy was on his death bed. The family broke into tears after md left and the guy who was joking around with me the whole time before, now looked like his life was over.

Of course, the nurse once again had to go in and explain to them, that he wasn't dying, and he wasn't - even though the damage was serious, he was released home only 4 days later.

I felt horrible for these people that day. the md never came back to correct HIS damage.
I am wondering if anyone has found themselves in the same position - comforting/educating the patient after the MD unreasonaly freaked him/her out.

[ERRN5778]

hi anagray,
i've had a similar situation happen to me, i was taking care an elderly woman was very sick....blood work was done and so were other tests...well it turned out that this patient was in renal failure...md found out, literally went into the patient's room (family members were at bedside) and in short said, "tests came back today that showed that your wife is in renal failure." and with that he shrugged his shoulders and left the room! i stood there is digust and felt horrible for these people (especially for her husband). so i was left to comfort and educate the patient and family members after the md had left.

[arkansas_girl]

That's horrible! I am glad I haven't ran into any MD's like that! My MD gave me some sample meds once for cramps, and then after I take like two of them I began to have really bad chest pains. Turns out I wasn't supposed to take that med with one of the RX's I had. I was soooooooooo mad. I know I should have looked up the pill first, but sheesh! Anyways.........I vowed that when I become a RN to make sure that the patient is getting the right stuff and won't be harmed like I almost was. Ok...I'll stop typing now!

[Dinith88]

Anagray,

Obviously, there was no acute MI going on or he would've been cathed (or thrombolytics started). I'm guessing that "there's nothing we can do for you" had something to do with the fact that the MI happened days ago.
If the guy was 3-days 'post event', the damage was done, and thrombolytics and/or ptca couldn't reverse his infarction. You mentioned his labs were bad. Do you mean troponin? Troponin can stay elevated for 2weeks post MI.

Anyway, i agree wholeheartedly that the mark of a competent nurse is his/her ability to 'break-it-down' to the family. Not only is family/pt teaching good for 'informing' them, if done gently/intelligently it can go a long way in helping to alleviate their anxiety.