Horrible night

Nurses General Nursing

Published

Specializes in Neuroscience.

Ever have a shift that is so bad, you have to do everything in your power to not call in to work? That's me, right now, because of one patient. More specifically, the family members. In the room at least eight times every hour.

"The patient can't breathe." Saturation is 99%.

"The patient is in sooo much pain". She can't have anything besides what I'm giving her because of her condition. Asking me that every fifteen minutes doesn't mean she's going to get her medication three hours early. I can't change the time, but you can wait for it to pass. Also, do you want her liver to fail? Because that's how you get liver failure. No, the patient can't have 2 percocet Q1 hour.

"But she slept so much better last night!" Was her nurse in here eight times an hour? That would make it pretty hard for me to sleep, bet it makes it hard for her to sleep too.

"I need you to put her head up." In the middle of shift report? Are you actually serious, or are you a demented demon just here to torture me? Oh, you're going to keep screeching so we can't get through shift report until I do requested task? Fan-freaking-tabulous.

Tell me how to nip this in the bud. I did a lot of teaching last night, and of course I didn't respond with the above, but tell me wise ones, what do I do?

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Education seems to be what usually saves me but I know you've already tried that. Even if I know they can't have anything more, I still usually page the dr and ask. That way, they think I'm doing something and seem appreciative even if I tell them the dr said no and sometimes the dr will come up with something that I hadn't even thought of. Now granted we have a pa there until 5am so it isn't like I'm waking anyone up but still worth a shot if your hospital is set up like that!

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I would call the doctor and see if her pain medication could be changed or increased in dose/frequency. It sounds like almost all of her calls revolved around pain and discomfort. If the doctor says no, at least you can pass on to the family that you tried.

And I have a quick cautionary tale. I once had a patient a lot like yours. She called constantly and was super-dramatic. When she called saying she "couldn't breathe", I sighed and went to go check her vital signs. They were perfect, but it turns out she was having a heart attack. If a patient feels like they can't breathe, always take that seriously ...even if they seem "fine".

Also! You deserve a break from this patient. Ask to have the assignment rotated when you go back tonight.

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Specializes in Neuroscience.

I would be worried about an MI, except she's on telemetry, and the patient didn't show any signs of distress. It's just the family member. At the very beginning of the shift I taught about the monitor, when to worry, and when it's probably just a false alarm because equipment needs to be changed.

HR was great, QRS and ST interval looked perfect. O2 sat 99% and a beautiful pleth. I did call the doctor at the beginning of the shift to see if we could add something for the pain. Can't because it's a neuro issue. Neuro is so stingy with the drugs, but I understand why. Taught about that as well.

I would love to just give this patient away, but I probably won't. Tonight is my last of three, and I don't work again until next Thursday.

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Specializes in Critical Care; Cardiac; Professional Development.

When I had one like that I never hesitated to request not to have them back. Someone else can take a turn.

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Sorry you had a rough night. The interruptions during report!! I had an elderly gentleman come up to me and interrupt report because his family member needed repositioned. I told him, "we are in the middle of report, but we'll take care of it as soon as we are done." He took on an aggravated tone and said, "And when is that going to happen?

I stared blankly at him for a moment and said , " right after we're done with report." He stared back for a minute before walking away grumbling to himself.

Some people just don't get it.

That patient won't be around forever, just keep smiling! I agree with the other posters to check with the doc if possible. Or can you involve RT? "Hey, 324 keeps c/o difficulty breathing, SATs are fine, maybe I'm missing something. Can you check him out?" Let someone else pet the family for a while. :sneaky:

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