Nurses who don't seem to get it....

  1. Recently I was hospitalized with a badly broken ankle w/compartment syndrome, along with ripping loose all the muscles/ligaments/tendons on the opposite side. I want to testify to one thing -- the books say compartment syndrome causes "pain out of proportion to the actual injury." No cr*p!!! I would rather birth six babies and have 1200 kidney stones than go through this again!!!!!! And yes I have had bad labors and a year's worth of kidney stones, so I know of what I speak!!!!

    I was admitted to the hospital ER around 5:30pm. The ER staff, for the most part was very good. The OR staff the next day was very good. The floor staff, well.....I hate to say it, as this hospital was where my RN daughter worked (she has since left for non-related reasons), but they were lacking in good sense. Or at least one particular one of them.

    The first night, they did not give me the call light. But wrote their names (RN and PCA) on the whiteboard and told me to call them on their hospital provided cell phones. I was very upset, freaked out, in a lot of freaking pain and alone. I couldn't find the call light. Couldn't get my brain clear enough to actually look in the right places for it!!! Took me forever to find my glasses to read the blasted board, and then when I called, their phones rang and rang and rang..........At no time during the night did they answer those phones. I was soooooooo relieved when the day shift aide came in and I could send her for the nurse to bring me some pain meds!!!!

    The next night after I had over four hours of surgery to repair my ankle, I called out to tell the nurse my affected leg was having very painful muscle spasms. She came into the room and looked at me like I was a nut. She says, you just had pain medication an hour ago. Yes, I said, I know that. But this muscle is spasming and the pain medication is NOT helping that!!!!! I bet it took me at least five to ten minutes of crying and trying not to, to make her realize that morphine an hour ago does NOT make a newly wildly spasming muscle stop spasming. She ended up calling the surgeon to get me something to make it stop. (Or maybe to make me stop, I don't know.) She seemed to think that little shot of morphine should have relieved all pain for hours and did NOT seem to realize that I had edema, plus two surgical sites and muscles in a severe contracting phase in the surgical area causing excruciating pain!!!!!!!!!!! The leg was not and has not ever been casted, so it was possible to see and feel the spasm!!!

    I'm sure she was thinking, oh they repaired her broken leg, she should be fine. But it wasn't "just" a broken leg. The compartment syndrome continues after the fracture is repaired, the localized edema continued and then my whole body became edematous for several days after it was repaired, making everything hurt, including the operative site. (And devil's advocate, I myself didn't know this til after I got out of the hospital and got access to a computer and looked it up.) However......

    This was on an ortho floor, in a "magnet" hospital. Maybe that night shift nurse wasn't used to ortho, maybe they pulled her from GYN or something. But if I ever see her again when I'm a patient, I'm rolling my w/c the other way!!!!! I was so glad the third night when she wasn't there!!!!

    Ortho is not my thing, altho I have worked on ortho floors occasionally. But if my patient was honestly in pain, I think I would try to find them some relief instead of standing there arguing with them. And maybe just maybe look up the diagnosis online and get a quick clue of why they were in more pain than I "the nurse" seemed to think they should be.
    Sorry, this was over five weeks ago and it still rattles my cage. :typing I am still w/c bound, non weight bearing for another three weeks at least. So this was NOT your average "broken leg".
    Last edit by KaroSnowQueen on Aug 14, '08 : Reason: clarity
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  2. 24 Comments

  3. by   RN1982
    I'm sorry that you went through that Karo. I understand what you mean. It's frustrating to be in pain and not be able to get a hold of the nurse even though they give you that spectralink number. Did you talk to the manager at all? If it was me, I would have called the house supervisor.
  4. by   KaroSnowQueen
    No, I didn't. Probably should have, but had more complications the next day and the rest of my stay was a big blur to me at the time. Maybe this just stands out as one very clear memory in the blur, but it still aggravates me.
    They did have a real person call me to do their post-stay survey (has PG moved on to real people rather than the paper surveys?) and I did mention it to them.
  5. by   UM Review RN
    I'm rather surprised that you didn't have a PCA. I thought most ortho patients got one for the first couple of days.

    I know what you mean by the pain of spasms. There I was, chest tubes front and back and in walks the RT trying to get me to take a breathing treatment while I was trying to not breathe so my whole ribcage didn't start to spasm. (I'd gone all night without pain meds because they couldn't get an IV started.)

    He really copped an attitude when I refused the treatment until I had pain meds, and he kept insisting that the breathing treatment would make it better. (Better to keep him on schedule, maybe.)

    In comes the day shift nurse, does a quick assessment, and out she goes, promising to call the surgeon for pain meds. Finally, I had to breathe -- and my whole side went into a horrendous spasm. Which caused me to have a blood-curdling yell that woke up the entire hospital.

    Which brought the nurse running with the pain meds. After an IM and a few minutes of the trying-not-to-move-a-muscle plan, I was good to go (to sleep).

    The moral of the story: don't be stoic, don't be shy when you're in pain. If you can't find the call bell, find your voice and HOLLER.

    PS Glad you mentioned it on your survey too. This will give them all a heads up on the pain control issue.
  6. by   RN1982
    Probably not much you could say or do now. Unless you feel like writing a scathing letter to the manager of the unit. All the docs ordered for you was morphine? The half life isn't even that long. I'm surprised they didn't put you on a PCA pump. I would have rather had a PCA.
  7. by   puggy232
    After reading your post I thought the same thing why in god's name didn't you have a PCA? The doc who did your repair dropped the ball too-he had to know post op pain- your should have came out of surgery with PCA there ready to go.
  8. by   birdgardner
    That stinks Karo. I'm sorry you had someone so clueless and/or scared to call the surgeon.

    Having the call bell AND a PCA doesn't always get you help either. When I had my adrenal gland out, I pushed the call bell at 0300 and 0315 to get OOB to the toilet for the first time, no answer, dangled myself, unplugged the pumps, got there leaning on the IV stand, nearly keeled over, pulled the call bell in the john, no answer, got myself back to bed, plugged the pumps back in, put the cuff back on, got a BP of 80/42 and decided to lay off the morphine. It was so flattering to be trusted to self-nurse, and me not even a student yet.

    Next day I kept saying I'm getting too much fluid, my face and fingers are very swollen, please ask the doctor to slow or stop the fluids, BP was good with no morphine - oh, you're fine - I left weighing 12 lbs. more than I had 36 hours earlier, very near to AMA'ing.

    What is it with some nurses?
  9. by   RN1982
    These are the type of situations where I would have to pull "I am a nurse" card. I'm sorry I know the floor nurses are busy but call lights should be answered in a orderly manner maybe 5 minutes but not a half hour. This aggravates me to know end.
  10. by   leslie :-D
    stories like yours and angie's, tick me off.

    that said, i could see me writing a nasty letter while i was writhing in pain, making certain it was delivered.
    nothing like the reader 'feeling' the heat of the moment.

    it's important to try and discuss pain mgmt before the surgery.

    karo, here's to an uneventful recovery...

    leslie
  11. by   Vito Andolini
    Scary, scary stuff. I hope you guys who've had these awful, terrifying experiences will inform your state and federal legislators. This type of thing happens largely because nurses are overworked, as you know.

    The other people to inform are the state boards of Nursing where these events took place so that they can look into why these nurses were so inept. That is, is there some education or experience or orientation lacking, in addition to too large assignments?

    If you don't inform, who will?
  12. by   mpccrn
    pain is what the patient says it is....sometimes it's hard to believe when the patient rates the pain a 10 and is sitting there talking on the phone or visiting with family and friends, eating, drinking etc. sorry you hurt.
  13. by   sissiesmama
    Karo - Hello. I hope you are feeling a little bit better. I am SO sorry that you received treatment like that. That is just inexcusable!! I had a nurse like that taking care of me when I was in the hospital on telemetry. I have to tell you, when I saw the helpful, understanding nurse who at least ACTED like she cared how much pain I was in, I could have kissed her!!

    And, I understand if it ignorance (she/he just doesn't know), but PLEASE don't stand there looking at me like I'm crazy. If I say I am in pain and am upset, crying, or something, PLEASE don't think just because you gave me this pill, or that shot, that there's no possibility that I didn't get complete relief, or have another sx or problem, (muscle spasms). Look at my site of pain, spasms, ect. and at least give me the benefit of the doubt.

    In my care I was admitted to telemetry with acute pancreatitis and HTN, with 1st degree AVB and BBB. The nurse had the nerve to actually throw my port. tele pack into my lap. And then to top it all off, after she hit me in the belly(where I was hurting in the 1st place) and then tell me that "the 12.5mg of Demerol given 1-2 hours ago hasn't helped, esp. after the tele pack incident.

    My dh is a nsg. sup. at this facility, and this is where I was working at the time. I would not expect that kind of (mis)treatment to a stranger on the street!!

    Hope you feel better soon, Karo. We will keep you and your family in our prayers.
    Anne, RNC
  14. by   RN1982
    It really saddens me that nurses would treat their patients like this. I know that I use to say that I would never tell another nurse that was caring for me as a patient that I was a nurse myself. But the sad fact is, is that I shouldn't have to let my nurse know that I am a nurse so that I would get better care or be treated as a human being.

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