Was I wrong? - page 2

Bear with me for this is going to be a little long. I was covering part of a shift for a co-worker on my scheduled day off. The shift was 7am-730pm and I was working 9 to 3:30 for her on the regular... Read More

  1. by   Rocknurse
    Your co-workers behavior is despicable. You absolutely did the right thing. Nurses who judge chronic pain patients disgust me. I would report it to your manager and suggest that she enters some kind of education reinforcement program as she obviously doesn't grasp how to nurse pain in her patients. She should not be allowed to continue this behavior....how many people will she hurt? This kind of ignorance has no place in nursing and deserves a severe reprimand. What she is doing is harmful and the reason why so many pain patients are distrustful of healthcare providers.
  2. by   Munch
    Thank you guys. I will definitely NOT be covering for this nurse again(though maybe its better for the patients if this nurse isn't around much). I will definitely be saying something to the manager about this. I work in an inner-city hospital with a HUGE sickle cell population. It really bothers me to think how many patients have suffered needlessly in the past because of this nurses judgments. She's been with the hospital for years so sickle cell patients and chronic pain patients aren't anything that is new for her.

    She was so mad though she was practically foaming at the mouth. She didn't like that I "went over her head" and got the patients orders changed. Since when am I her subordinate anyway? As far as the drug seeking patient goes she thought I should have checked the patients history which I actually did after..and this patient didn't have what I would call an excessive history. Actually she had a handful of ED visits but left after receiving a couple of IV doses of pain meds. See how it works in our ED with SCC patients after 3 doses of IV narcotics if you aren't feeling better after the 3rd dose you are admitted. If you are feeling better after the 3rd dose you can go home if she was really a talented seeker no way would she say she was feeling better..she would say she wasn't feeling better to get that admission for pain control.

    I don't know who made her lord and master of pain management but I will definitely be speaking to the nurse manager and the doctor that usually covers that floor just to keep the bases covered. Even if this patient was a drug seeker I would rather treat 10 fakers than miss 1 patient that might be genuinely suffering.
    Last edit by Munch on Feb 9 : Reason: Spelling
  3. by   not.done.yet
    Not only were you NOT wrong, you were dramatically in the right and I encourage you to go a step further and escalate your concerns over what this nurse said and how she behaved. We all know that sickle cell is unbelievably painful, that they are pretty used to being undertreated for their pain and that they are at risk of being both tolerant to pain medications and written off by people with a chip on their shoulder about pain med administration. Thus behavior can seem manipulative and the entire therapeutic relationship can break down before it even gets started. Obviously you helped this poor woman a great deal.

    I applaud you. Big, standing, hands above my head applause.
  4. by   Munch
    Quote from Been there,done that
    That was now YOUR patient, you acted correctly.
    Your co-worker does not administer /or seek pain control for sickle cell patients. YOU must write Nurse Ratchet up.. and advocate for future patients.
    Exactly my thoughts. She wasn't in the hospital on the clock working. Her patients were now MY responsibility. I was on the clock on the floor using my license to care for them.
  5. by   Munch
    Quote from not.done.yet
    Not only were you NOT wrong, you were dramatically in the right and I encourage you to go a step further and escalate your concerns over what this nurse said and how she behaved. We all know that sickle cell is unbelievably painful, that they are pretty used to being undertreated for their pain and that they are at risk of being both tolerant to pain medications and written off by people with a chip on their shoulder about pain med administration. Thus behavior can seem manipulative and the entire therapeutic relationship can break down before it even gets started. Obviously you helped this poor woman a great deal.

    I applaud you. Big, standing, hands above my head applause.
    Thank you. This patient didn't seem irresponsible or even tolerant to a huge amount of narcotics anyway which says to me that she was responsible and trying to take care of herself. Her home meds were nothing crazy she was taking oxycontin 40 TID at home with oxycodone 15mgs for BTP q6hrs PRN. That isn't anything ridiculously high. Ive had patients both with sickle cell and other chronic pain patients on A LOT more meds. Ive had chronic back pain patients on 100mcg fentanyl patches with huge amounts of PO short acting narcotics for BTP. This girl just needed to break the cycle. NYC can be very cold in the winter and we all know cold can bring on a crisis for these poor patients.
  6. by   Crush
    Once you assume care while your co-worker took a break, then patient was your responsibility. You acted correctly. Well done.
  7. by   SpankedInPittsburgh
    Yeah you reported uncontrolled pain to a doc who decided to change the medication regimen based upon new information. All you did was give your observations to a doc who placed the orders accordingly. This is as it should be. You did nothing wrong. In fact you advocated for a patient who sounded like they were in uncontrolled pain. Good Work!!! As far as the mean-butted nurse, oh well. Its the price of doing business in our profession and you did her a proper by giving her something new to moan about for eternity. If she felt strongly about this she had an opportunity to take it up with the ordering physician. I bet she did no such thing
  8. by   UrbanHealthRN
    I agree with everyone else- awesome advocacy for the patient! My other thought that I don't think has been mentioned yet, is, by actually listening to the patient and caring for her in such an appropriate way, you may have even boosted her trust in some of the doctors and nurses (aka you) who were responsible for her care.

    It sounds like this wound up not being the case with her medical hx, but when you're dealing with patients who are facing substance abuse, mental illness, whatever, that trust can mean the difference between opening up and asking for help or continuing an unhealthy habit. All in all, super good job!
  9. by   RNrhythm
    Quote from Munch
    I would rather treat faked pain then not treat potentially real pain.
    Thank you for this. You clarified my feelings on pain treatment in 12 words.
  10. by   Munch
    Quote from RNrhythm
    Thank you for this. You clarified my feelings on pain treatment in 12 words.
    It makes me sick to think of how many patients who were genuinely in pain were dismissed by this nurse and others like her who are quick to judgment. I know the whole drug seeker and pain medicine topic has been discussed before but its like my co-worker was taking my patient potentially being a drug seeker personally(I don't think she was a seeker though). She said she had patients with real complaints and problems needing her attention. Well I did her a favor then by getting this patient a PCA. Now she doesn't have to administer that morphine q2hrs like she was before.
  11. by   SobreRN
    You did not do anything wrong. It is not you co-workers place to appoint herself as the patients' un-asked for 12-step sponsor and take her inventory.
    Even drug seekers can have pain and it has been my experience that those with sickle-cell crisis get labeled more frequently, in part, because they are young. I do not believe anyone who is never going to acquire sickle cell anemia or ever worry about passing it on to their kids should sit in judgement as they do.
  12. by   dimari
    You did the right thing but her behavior makes me think that maybe your co-worker is the addict and has been stealing the patient's morphine for herself (I've witnessed this in previous hospital jobs I've held). She might be furious that the PCA won't require her to get narcs every 1-2 hrs. Just a thought.
  13. by   VivaLasViejas
    I agree with the previous posters. You did everything exactly right and advocated for YOUR patient like nurses are supposed to. Don't let the other nurse undermine you, and don't take it personally (though I know it's hard not to). She wasn't there for the patients, you were. Good work!

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