Student nurse, What I saw very upset....

  1. During my med surg clinicals this week my pt. had larnyx removed, stoma w/yonker (sp) & ng feeding tube. Pt was to be d/c but feeding tube came out....Dr was paged & paged & paged.....mad he had to come in to replace. Nurse tried but couldn't get it in. Dr. came in no conversation w/pt...took tube did not lubricate put it in. Then requested largest suture you can find....took this thing that looked like a great big fishing hook & put it through the middle inside part of pt's nose!!!! Did not numb it, spray anything on it, did not tell pt what was going to happen just rammed it through......finally. Then tied the suture so tight the pt's nose was indented.When I realized what had just happened I just about died........I was furious & started to cry & left the room. I feel so guilty........I can't get this pt & the look on face & eyes out of my mind. There were two nurses in the room & I gasped & looked at them, they held the pt's hands down while he did this. Iwas gone a few mins & went back, afraid what else might happen to pt. I thought if anyone touched pt again like this again they will go through me first.The Dr said to the pt...won't be going home today & walked out! I got the cold shoulder after this from the nurses...not real obvious but you could feel the chill in the air when I was around. I stayed w/pt & did everything I knew how to help after this. Is this how things are done??? As a student should I have said something when I figured out what was happening??? I feel so horrible & I have cried & cried. Don't we act in the pt's behalf & best intrest??? My instructor said there was nothing I could have done.... I am not so sure.I feel like I should have said or done something. Thanks for reading this & your input would be appreciated. I am just sick........
    Last edit by crb613 on Sep 29, '05
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  2. 30 Comments

  3. by   misschelei
    Wow that sounds very dramatic! Is the patient able to complain if he felt mistreated through some other means of communication? Or are we talking about someone who is unable to advocate for himself?
  4. by   Marie_LPN, RN
    Did not numb it, spray anything on it, did not tell pt what was going to happen just rammed it through......finally.
    I thought i was going to vomit when i read this (all of it really).

    The sad thing is, had this pt. had the ability to scream, that MIGHT have affected whether the pt. received any numbing medication or not.:angryfire

    This isn't the first time i've heard of a mannerism this barbaric. There were stories (that made it to the paper after the doctor was sued) about a surgeon who wouldn't numb the site where an incision for a G-tube was made, and the pt. was given sedation. Needless to say, that pointy 11 scalpel blade was felt, as evidenced by the pt. thrashing and the tears that rolled from his eyes. He later said that he felts all of the pain "on his belly." I feel lucky that i never have to ask the surgeons if they want anything to numb with, they are very insistent on pt. comfort!

    But if ever see such happening, you can bet i'll report it.

    One of the nurses should have spoke up for the pt. you are speaking of and asked if the doctor would like some lidocaine (or similar) for the pt.

    And i think the only reasons why the instructor is saying nothing can be done is that she didn't see what happened, and that there's a good chance that the two nurses might go against the words of a nursing student. Definately not saying it's right, i'm just trying to think of a reason why she would say that.
  5. by   crb613
    Quote from Marie_LPN
    And i think the only reasons why the instructor is saying nothing can be done is that she didn't see what happened, and that there's a good chance that the two nurses might go against the words of a nursing student. Definately not saying it's right, i'm just trying to think of a reason why she would say that.
    She said, "There was nothing I could have done about it." My instructor was just outside the door on her way in as I came out. I don't know if she did or said something or not........she is a very tough lady w/alot of experience so maybe that's why I felt the chill in the air, when I returned. When I said the nurse's held the pt's hands I should clarify....They did not just use brute force but, did keep then down never the less. One nurse was patting the pt's hand after the fact. I have not been able to speak to my instructor alone yet but I am going to......I need to know what I can do in the future as a student & a human that does have compassion & feelings for those unable to speak for themselves. I know I will never let anything like this happen in my presence again student or not...........If I am kicked out of school for speaking up then so be it, I feel like I was a partner to this & it's an awful feeling.
  6. by   luvltc
    I was crying by the time I finished reading this.

    I am so sorry that you had to go through this. Nobody, not you or the patient, should have had to experience this. :angryfire I would suggest talking to your instructor and expressing your concerns. We are always thought to be the patient advocate.

    Was this patient unable to communicate otherwise? Somebody needs to stick up for the patient.

    God bless you for your compassion. I hope this does not turn you away from the nursing profession.

    Keep up your kindess.

    Hugs to you!
  7. by   crb613
    Quote from 5scardiacnurse
    I was crying by the time I finished reading this.

    I am so sorry that you had to go through this. Nobody, not you or the patient, should have had to experience this. :angryfire I would suggest talking to your instructor and expressing your concerns. We are always thought to be the patient advocate.

    Was this patient unable to communicate otherwise? Somebody needs to stick up for the patient.

    God bless you for your compassion. I hope this does not turn you away from the nursing profession.

    Keep up your kindess.

    Hugs to you!
    Thank you, but I don't feel kind...I feel like I was part of this. This pt can't speak because of the larnyx just being removed. It was just done ~2 wks ago. I communicated with this pt with pen/paper/lip reading. I will say this is the first time I have even considered not being a nurse....If this is nursing then no I do not want to be one, but I do not think this is what it's about just the oppsite. In the brief time w/instructor I did say exactly what you commented on....I thought we were taught to be an advocate for the pt....she replied you are a student.....the RN should have spoken up. Well
    neither one of them did.I can't just pass the buck & go on like it was all some else's fault, I was there too. I should have said/done something when I figured out what was happening.I just couldn't comphrend that this Dr was actually doing this. I have prayed to God to forgive me & help this poor pt. I will never forget the look in this pt's eyes.
  8. by   misschelei
    It sounds like this patient was really hurt. Why did he not complain? That's what I would want to get to the bottom of then take it from there. This is a personal choice. You have to decide how far you are willing to go with this and consider the potential consequences. The best advice I ever got from my preceptor as new grad was "Choose your battles wisely."
    Don't let this scare you off from nursing. You will be a good nurse.
  9. by   crb613
    Quote from misschelei
    It sounds like this patient was really hurt. Why did he not complain? That's what I would want to get to the bottom of then take it from there. This is a personal choice. You have to decide how far you are willing to go with this and consider the potential consequences. The best advice I ever got from my preceptor as new grad was "Choose your battles wisely."
    Don't let this scare you off from nursing. You will be a good nurse.
    Could you please tell me something, is this common for the site not to be numbed or the pt pre-medicated? I was told by someone from the ER that it would be worse to use a needle to numb the site 1st??????? I don't know if the pt will complain or not I hope they will. This pt is intelligent & kind but is a little older & maybe has the idea the Dr will do what is best. I can tell you that I will if asked, back the pt up if they do complain. I have even considered advising the pt of this myself. Thank you for saying I will be a good nurse.
  10. by   Marie_LPN, RN
    It's not common for it not to be numbed at the facility where i work.
  11. by   SouthernLPN2RN
    Quote from crb613
    Could you please tell me something, is this common for the site not to be numbed or the pt pre-medicated? I was told by someone from the ER that it would be worse to use a needle to numb the site 1st??????? I don't know if the pt will complain or not I hope they will. This pt is intelligent & kind but is a little older & maybe has the idea the Dr will do what is best. I can tell you that I will if asked, back the pt up if they do complain. I have even considered advising the pt of this myself. Thank you for saying I will be a good nurse.
    In some cases, the injected lidocaine may cause unwanted swelling, but they could always use some type of topical instead. This pt was treated horribly and that doc needs his crack cleaned out with a pointy-toed boot.
  12. by   CrunchRN
    This type of thing is exactly why we do need you to become a nurse. I don't know how this should have been done, but a little explanation and compassion, and a chance for the patient to write down their wishes in the matter should have happened at the very least.

    Please do not let this sour you on nursing. That patient needs someone like you. This is not your battle. It was up to the nurses involved to advocate for this patient. Report it to your instructor and let her deal with it. When you are a nurse I expect that something like this will never occur on your shift.

    Best of luck, and I would definitely want you to be my nurse.
  13. by   crb613
    Quote from CrunchRN
    Please do not let this sour you on nursing. That patient needs someone like you. This is not your battle. It was up to the nurses involved to advocate for this patient. Report it to your instructor and let her deal with it. When you are a nurse I expect that something like this will never occur on your shift.

    Best of luck, and I would definitely want you to be my nurse.
    Thank you, and you are mighty right....I will be like a pit bull having a bad day!
  14. by   barefootlady
    I am sorry this patient was treated in such a uncaring, unkind manner. I am sorry you were a witness to this incident, but I feel very sure you will be a very vocal patient advocate when you are in the work place. I do not expect your instructor to do much reporting of this incident. The school will not make waves at the facility for fear of placing the program in danger. I think you should consider this your first taste of how patients can be assaulted and abused by physicians in todays healthcare settings and nurses are helpless to stop many abuses from taking place.
    Please feel free to report this physicians conduct to the Medical Director of the facility, the Ethics Officer, and the State Board of Physician Licensure. I do not think without a patient complaint much action will be taken but it will be on record somewhere of his abuse. If you do report this it may have a negative effect on your standing at school also. Give careful consideration to your actions. Please seek some stress counselling and support. Even if you students just get together and chat, it will release pressure and form bonds between you students.
    I wonder why no one considered this physician needed a consent to suture a tube in place. I was taught if it involved stitches, a consent was needed or it was a crime. Just a thought from my dim past.
    I wish you luck and please do not let this stop you from seeing the good in nursing and most physicians really. Have better days.

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