ok...had an orientee with me "the other day"...we were scheduled to do the am visit of a bid dressing change..no pm visit due to md appt..also to draw H&H due to moderate to heavy frank bleeding from wound....called to verify that the last nurse had left supllies in the home and to let them know we were running a little late..just as we were leaving the office, family calls to say no am dressing change needed per md office due to bleeding risks and appt early afternoon....still plan sn visit to assess and for venipuncture...
we arrive, pull in the drive and one of the dtrs comes flying out of th edoor " ya gotta hurry..she's losing alot of blood!! she's dizzy!! she's gonna pass out!! she's bleeding everywhere!!"
so we go flying in the trailer...to find the client in bed..complaining of dizziness and nausea...bp initially ~186/90, then ~194/92/...leg wound dressing had shifted during hs, so is only covered by 4x4s and 1 abd..other abd and ace wrap had shifted down to ankle...ther eis significant strikethrough on the remaining abd...but this is not new...i mean, the wound takes 3/4 roll of 3inch kerlix to pack..we were drawing and H&H because of the blood loss...but it appeared to me that based on the descriptions i had heard fromthe otehr nurse who had been here, that the bleeding was slowing down...meanwhile, before i had done the INITIAL bp, dtr on phone to 911.."she's dizzy and bleeding, she's gonna pass out..she' sbleeding everywhere fromboth legs..." WHAT THE F_EVER..anyway, ambulance comes,...fine with me, take her off my hands....get back to the office later, was able to talkto surgeon's nurse, passed the whole story on to her..had spoken to her fromth ehome, but was obviously unable to give her the full scoop...she also shares with me that the daughter who we were to eventually teach to do the dressing change, who btw, confided in me that she didnt think she could do it after all, had told them " yeah, ican do it..i watch ER shows on TV all the time..."
anyway..no point to this story..not looking for advice...just needed to vent to uninvolved parties....
Sep 14, '02
Yeah! It's not just pts and family who don't listen and completely get stuff backwards. Nurses do it to. I was on call last friday PM. At 10 oclock at night this nurse calls me from a hospital. Says she has a pt being d/c'd that night, wants to know when the nurse will be there. I informed her we had gotten so many referrals by 4PM, that saturday was full. I could not promise this pt would be admitted the next day, it may be 2 days, but would pass the info to the next day's oncall. She says well.. it's not my problem, and hangs up. I reported as I had said and also reported to my sup. The next work day I find out this nurse made a complaint to my don that I had said we always stop taking pts at 4pm and I had refused to take this pt altogether. We are a small outfit and are very busy with a small staff. The hospital nurses think were just sitting by the phone hoping someone will call. It's not like ER called 4th floor with new admit and 4th floor nurse said NO. We have one nurse per day on wknd who answers all calls, does scheduled visits and SOCs and takes spur of the moment admits. sometimes there just isn't enough time in the day , what can I say? Once I sent a guy to the hospital with Dr.s permission cause he was dying, the nurse at the hospital calls the same doc, says there's nothing wrong with this guy, why's he here? The doc then calls me, says what the hell? I swear doc .. he's as bad as I said. 6hrs later the guy dies. Sheese!
Sep 17, '02
Oh the joys of home care! I recently joined your ranks after 20 yrs of hospital nursing with the thought that I would have more time with my kids- WRONG. I spend my evenings planning the next day's itinerary (thank God for Mapquest!), calling patients to arrange visit times, finishing paperwork from the day. Who ever designed the OASIS is evil and cruel -16 pages long!!!!!!- are they all like that of is it just my agency????? my boss asked me why more good nurses (like me!) don't go into homecare, and I told her that if I told anyone how much paperwork is involved they would choke! But the ability to make someone comfortable and recover in their own home is such a priviledge, and for the most part, my patients have been really nice and appreciative. And I don't deal with hostile or incompetent MDs or short staffing in the PACU, anymore!
Sep 17, '02
Isn't that how home health works? LOL. Good thing your orientee got to see emergencies in action. People think we in home health don't have emergencies, we do.
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