Things Change, People Change ;=)

[CaLLaCoDe]

Please don't get me wrong, the nurse I got report from yesterday morning is a darn good one. Described a patient of mine to a tee. The epidural, the dilauded 0.2 for threshold pain (that he called way to often for, besides it was ordered every 15 minutes, he thought it to be every 2 (thank God!); The below the knee amputation with an incision that was resolving, that he had refused to be painted with betadine; the SCDs to the other leg to prevent another BKA; His refusal to be moved in bed saying "I hurt way too much!", "perhaps you could order a Trapeze for him to allow him to move himsef; the temperature brought down lower with IS and pulmonary toiletting. "He's wanting coffee, I said no, he's on a clear liquid diet, the coffee's acidic, don't let him manipulate you into giving him coffee!" All of this hit my ears in the morning and I thought to myself, you've got a busy day ahead of you!

Well, things were entirely better. Once again, I reiterate, the night nurse is excellent. He got out of bed with some assist from me to a chair holding a pad to his wound to his abdomin: asked for dilauded 7 times during my shift, mainly during transfers, tolerated the removal of his compression sock to his amputation and application of betadine, overall a pleasant patient. Even shaved himself! Had received Asterix SC yesterday, but I wasn't too overly concerned for him bleeding. I know that things can change rapidly with a post op patient and it makes the one giving report seem like a liar.

Ever have this happen. Where you get report on a patient and think to yourself: OMG, I won't have a chance to help my other patients and turns out to be a goodie? The painting you receive in the morning can be entirely different from the one you paint during the day?

[CaLLaCoDe, BSN, RN]

[color=#483d8b]i've had more experience with patients who have been reported as being wonderful patients with supportive, wonderful families being the opposite when i get them. in fact, as soon as someone starts giving me report about what a wonderful patient this is, i can feel my gut start to clench. invariably, they're sundowning or psychotic by the time i get into the room . . . sometimes i think my co-workers report the manipulative, demanding psychotics as "so sweet and friendly" just to mess with me.

i am glad that the night nurse gave me a heads up on a potential problem child rather than describe him as "wonderful."

i remember getting report from a day nurse once, when i was working nights and she said,"oh, he's such a nice kindly old man." and later when i asked him to turn on his side to assess his skin he barked, "get out of here, don't you know not to come into a person's house unannounced." and he held his mouth shut and cursed the "uninvited stranger" while i cajoled him to take his oral ativan. ah, the memories!

[onetiredmomma]

Sometimes, late at night when a person can't sleep they focus on the negatives..pain,adjustment to an amputation, loneliness, etc that makes them needier than they are during the day. Sometimes it's a personalilty clash between a staff member and a pt. And, sometimes it is sundowner added to a full moon added to short staffing.....

[UM Review RN, ASN, RN]

This brings one fella to mind -- the DOC told me not to go into the room. Apparently the pt had just fired the doc and made his point by throwing a wadded up ball of paper at him.

But he took one look at me and decided to like me, I have no idea why.

Seems like the tiny "cute" LOL 's are the ones who try to kill me the most frequently.

You just don't know everything from report, so I always do my own assessments and form my own opinions.

[RNperdiem, RN]

This happens a lot to me as well- that overwhelmed feeling upon listening to report.

Now that we are required to go into the room and check IV pumps as part of report, things have improved. Being able to see everything makes a patient seem more manageable somehow.