So I had a patient last night, chest pain r/o MI with a history of fibromyalgia, depression, and anxiety. No known history of memory loss or dementia- normally independent at home.
She would NOT stop crying. Literally. I'm taking report and she's screaming- I assess her and she's c/o "I just don't feel good" Forty questions later we determine that she has 8/10 leg pain, which is a chronic problem for her. Her vicodin is ordered 1 tab TID (scheduled) and was given at 2000. It's now 0000. So I call and get the ordered changed to 1-2 q4-6h prn, and give her two. I also give her (scheduled BID) Klonopin 0.5mg. No sooner than she swallows the pills she's screaming "oh my god, help me, my legs hurt" etc, etc, etc. I very nicely tell her I know she's in pain, that the med will take about 30 minutes to take effect, and ask what else I can do to help in the meantime. "Nothing" Half hour later I ask if the pain is improved, and she states it is, but starts crying about: SOB (LSC, 98% RA, but she's hyperventilating, and we give her O2@2L as ordered), "I want my socks off"- okay, well you were capable of putting them on, so take them off, I'm too hot, I'm too cold, I'm hungry, I'm thirsty, and my personal favorite "Oh GOD, Oh GOD I just can't stand it, HELP me OH WHY OH WHY do I have to suffer this way"- a statement made not because of pain, or shortness of breath, but get this- lady partsL ITCH!! We are not talking about an alzheimer's pt- this is an alert, oriented, normally independent 60- something year old. ARE YOU KIDDING ME? I end up calling the doctor more than once, giving extra klonopin, etc, but nothing I do can console the woman. Yes, I lost my patience. Yes, I completely lost all empathy when the woman screamed like a banshee over the blood pressure cuff, repeatedly took off her O2 and c/o shortness of breath, etc. But I tried EVERYTHING I knew to help her, and spent over 4 hours trying to calm her down (breathing exercises, visualization, pain meds, anxiety meds, hand holding, ice packs, warm packs, positioning, etc) only to hear the next shift judgementaly say "You mean to tell me she's been like this all night????)
