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Been there,done that 42,185 Views

Joined Aug 4, '09. Posts: 5,328 (73% Liked) Likes: 20,465

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  • May 23

    This is the type of crap that really ticks me off. She has stage 4 cancer, probably with mets and is most likely terminal- she has a freaking good reason for being in pain! I can't stand providers that don't take that seriously.

    I don't hesitate to tell providers when things don't match up- 10/10 pain yet talking away on the phone, playing on the phone, laughing and being loud with visitors or saying they are in so much pain they can't sleep but every time you round on them they're asleep and they can't stay awake to have a conversation, etc. I really can't stand under treated pain especially when there is a very good and clear reason for it.

    I had a patient come up from the ED one time. They were admitted for a PE. They had been in an accident, went home, came back for majorly surgery, went home again, and then ended up with a good size PE. I requested a PCA pump and the freaking resident made some idiotic comment about why is she having so much pain suddenly. I couldn't believe it. I didn't get the PCA pump for the patient, but I didn't hesitate to page (and I hope I annoyed the crap out of that idiot resident) any time I needed more pain meds for the patient. I never got the level of pain control I wanted for the patient, but I got it down some and knew I did my best. I documented out the wazoo too. Guess what the patient had when I was back in for my next shift... A PCA pump! Imagine that

  • May 22

    Willing to use common sense over policies. Says, "I can help", frequently. Will listen to your whining and understands sometimes you just need to whine and you know there is no solution. Says "I can help", frequently. Gets support from their bosses.

  • May 22

    Quote from tsm007
    This could be a fun topic.
    You had a stage 4 cancer patient who didn't get adequate pain relief. I fail to see the fun in that.

    All I got from the on call doc was "does she look like she's in pain?". She never did put any new orders in. This is bugging the heck out of me. Not so much that there were no new orders put in. I get it if you think the pt's a drug seeker and you don't want to prescribe, but since when are med orders determined by whether the nurse thinks the pt looks like they are in pain?
    It doesn't bother you that no new orders were put in? Your terminally ill patient had pain that her current meds didn't touch and you allowed the on call physician to do nothing to help the patient? Unless you've left out a lot of details from your post, it seems like you completely failed to advocate for your patient. I know I sound judgmental. I am being judgemental of the way you handled this. The fact that the physician asked a rather odd question, shouldn't have resulted in your patient not receiving effective pain relief.

    Who cares if your patient "looked like", or didn't "look like" she was experiencing pain. When a stage 4 cancer patient say that they're experiencing severe pain, you believe them. Trying to figure out if they're "drug seekers", has no place in this specific context. That's what I would have told any physician who questioned my request for additional pain medication orders, and I think that's what every nurse should do.

  • May 20

    My dogs are treated very well, just saying...

  • May 16

    Sleep apnea can make you feel like you can never get enough sleep. Just an idea.

  • May 13

    I've gone home and introduced myself to my husband as his wife today.

  • May 2

    Was an awesome monologue. Go nurses.

    Something we all learn about but probably never see; highlights how important nurses and nursing education are.

  • May 2

    If 50mL of the wrong saline concentration is enough to cause shock- there would be a LOT more dead people than there currently are.

    This apparently scared you enough to make an impression- which is good. But learn from it and move on.

  • May 2

    If her shock was caused by sepsis, then IV fluids had nothing to do with it. She had an overwhelming infection - I'm sure you know this, deep down.

    This is a medication error, though. One I'm sure you won't be making again.

  • May 2

    It is unbelievable how these places take advantage of nurses. Specially new nurses who are willing to try hard and don't know who is who in the zoo. The good thing is, you can walk out. I would not even take a job like this, as I have refused many. One time I was hired by a facility where demented and wondering patients did not have a guard bracelet. They would just walk out in droves. I was told it was the RN's responsibility to keep up with the escape artists. "can I leave now" and I never looked back.

  • May 2

    It angers me to no end when dumps like this take advantage of the caring, decent nature of good nurses. I say the same: GET OUT

  • Apr 27

    Lucky you, you don't have to learn a new charting system. That's an annoying hassle, not some big achievement. And, learning a new IV pump takes a few minutes, big deal.

    Just make it through orientation on your preceptor's term, learning the culture and flow of the unit. Develop relationships with the experienced nurses there, and find out who to turn to when you have questions in the future.

  • Apr 26

    I would love that situation. Better to have a progressive orientation than be thrown to the wolves and left to fend for yourself.

  • Apr 14

    Since he's a neighbor (as opposed to someone you're obligated to take care of), I guess if that statement and his overall demeanor bothered me that much, we just wouldn't associate. If you felt like you had to say something, maybe a, "Oh, what do you mean?" with a little head tilt would give him pause. He may very well have meant nothing by it, though.

    When I'm taking care of patients who make inappropriate commentary or physical contact, I am very straightforward: "That's not acceptable." Our taking care of patients doesn't mean they're allowed to harass us or make us uncomfortable. That being said, I don't think the grand majority of patients "fantasize" about being given a sponge bath. Most, in my experience, are more frustrated and embarrassed with the lack of independence. I won't lie and say I've never had a patient act inappropriately toward me, but it's pretty rare, maybe monthly. I currently work on a psych floor, so your mileage may vary.

    If a patient is capable of moving his arms and hands at all, they can probably at least wash their own private areas, even if they are bedbound. I hand them a soapy washcloth and ask them to finish cleaning while I change the bathwater or some other task.

    I've never been in a situation where I've been asked to care for an acquaintance, but I would ask to trade assignments with another nurse. It's usually more comfortable for the patient, I feel like, although some people are genuinely happy to have someone they know take care of them.

  • Apr 5

    And just another thought-this strengths and weaknesses thing should have been done during an individual student assessment review. Openly stating that your lack of eye contact makes you 'unprepared' or telling another student 'she is the smartest student in the class' in front of all the other students is just plain unprofessional and awkward for the one receiving the comments, good or bad.


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