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Joined Feb 26, '10. Posts: 726 (60% Liked) Likes: 1,634

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  • Nov 18

    Oh yes, I've had patients complain about me and ask to have another nurse. Not often, but it's happened. I just counted myself lucky that I no longer had to deal with them. One complained because I got her IV in one stick, but her veins rolled and so I had to dig a bit. Her complaint literally said, "Nurse should have stopped my veins from rolling." My response to my manager was, "Tell me how to do it, and I will." Stupid manager admitted that I couldn't but said I should have smiled more.

    I have to confess that complaints bothered me more when we got a manager who insisted on entertaining all complaints, no matter how wild, unsubstantiated, or ridiculous. I didn't mind when old manager would call me in, roll her eyes, and say, "Consider yourself talked to, go and sin no more, yada yada." (literally her spiel for stupid complaints). New stupid manager would want to have a long discussion on why you didn't use Jedi mind tricks to control rolling veins, how you could be nicer to idiots, how we should value each and every customer (the very term is gag-worthy).

    Did you act appropriately as a nurse? Did you treat your patient with respect? Can you sleep at night with clear conscience after caring for this patient? If you answered yes to these questions, then I really wouldn't sweat it.

  • Oct 14

    Quote from SaoirseRN
    We aren't mind readers, though. If you want to shut your eyes to help that's fine, but there's a call button there for a reason, and if you need pain meds, ask for them. You should know it's easier to control the pain before it gets bad, so ask. Don't blame the nurses if you didn't tell them you had that much pain.
    I wasn't given a call bell. I was in a recovery situation. I don't know if they didn't have them or I just wasn't given mine. My point was that sleep is not the opposite of pain, and that nurses never should, but often do, assume that just because a patient is asleep, they are pain free. And I've spent a lot of my career recovering surgery patients (usually c-sections and tubals) and assessment is key. I have no qualms about waking up a patient to assess for bleeding, vital signs, OR pain. It's not the same thing as waking up someone at 3 am to ask them if they'd like a sleeping pill.

  • Sep 29

    Quote from linzjane88
    As a side point I kind of want to get one of those strap on bellies. I swear it made patients nicer to me. Especially the little grumpy old people.
    Oh wow, I had totally the oppposite experience. I swear my belly made me a crap magnet. I had a rather large man go toe-to-toe with me and threaten to hurt me when I was 36 weeks. And then my manager forced me to kiss his bum, figuratively, so I was ready to murder someone by the time it was all over. Add to that all the "are you sure you're not having twins?" and "are you sure you're not due till then? You sure are big!" comments (and for the record, I gained 11 pounds during my pregnancy, but I'm barely 5 ft tall, so I had no where to grow but straight out) and my opinion of humanity in general took a big hit during pregnancy. And lets not forget all the pregnant patients who would express amazement that I was still working at 35, 36, and 37 weeks pregnant, insisting that they couldn't do it. Well, I didn't have a choice! I wasn't getting Medicaid and WIC vouchers, I had to work!

  • Aug 25

    Quote from linzjane88
    As a side point I kind of want to get one of those strap on bellies. I swear it made patients nicer to me. Especially the little grumpy old people.
    Oh wow, I had totally the oppposite experience. I swear my belly made me a crap magnet. I had a rather large man go toe-to-toe with me and threaten to hurt me when I was 36 weeks. And then my manager forced me to kiss his bum, figuratively, so I was ready to murder someone by the time it was all over. Add to that all the "are you sure you're not having twins?" and "are you sure you're not due till then? You sure are big!" comments (and for the record, I gained 11 pounds during my pregnancy, but I'm barely 5 ft tall, so I had no where to grow but straight out) and my opinion of humanity in general took a big hit during pregnancy. And lets not forget all the pregnant patients who would express amazement that I was still working at 35, 36, and 37 weeks pregnant, insisting that they couldn't do it. Well, I didn't have a choice! I wasn't getting Medicaid and WIC vouchers, I had to work!

  • Aug 25

    I worked L&D when I was pregnant, and it was a badge of honor among the L&D nurses to work up until the absolute last possible moment. In fact, several of the nurses I worked with came to work, finished a shift, clocked out and took a shower, and then got in a bed and were admitted in spontaneous labor. I was tired, I was miserable, and I was advanced maternal age. I finished my pattern on a Tuesday and then my water broke on Thursday. I was 38 0/7 when my water broke. The heavy lifting was tough. I dreaded the days I was assigned to do c-sections. So many of our patients were obese, and most of our patients had epidurals, so we had to move dead weight a lot.

  • Jun 22

    Quote from Chrishi
    The only complaint I know of was from a family member. I was in the middle of a long treatment on another patient. This lady wanted me to come listen to her husband's cough, despite the fact that I hadn't heard a cough for the first 7 hours of my shift. It took me probably 20 to 30 minutes to finish the treatment that I'd been doing, then I came to listen. No cough. I stood in his room for fifteen minutes (that I didn't have) just to hear his 'cough'. His lungs were clear on auscultation.

    The next day she complained to the administrator that she had to wait for 2 hours for the nurse to come listen to her husband and then the nurse 'didn't even do anything.'

    I think she wanted me to get an order for cough syrup or an antibiotic that he didn't need. Or maybe she just wanted me to act all excited. I don't know. Needless to say, I didn't get in trouble. But it's annoying when you're doing everything you can to help people & families have these unrealistic expectations of you.
    You're probably right about them wanting you to act excited. It makes families really angry sometimes when we don't respond in the way that they think we should. Like the pregnant patient that comes to L&D triage with no complaints of pain, leaking, or bleeding. Their only "complaint" is that they lost their mucus plug. I respond very calmly, and assure them that it's ok. Upon exam, I discover that her cervix is maybe 0.5 cm (if the examiner is generous), no contractions, and the baby looks beautiful on the monitor. Pt's mother has a come-apart. "But she lost her mucus plug!!!!" Omg, rawr, rawr, rawr, call the rapid response team! It didn't get any better when I calmly told her that I didn't have any to replace it with. Yeah, I should have held back, but come on! You can lose a mucus plug 2 weeks, 2 days, or 2 hours before labor starts, so big freaking deal. And NO! I do not want to see it (if I had a nickel for every time someone fished their mucus plug out of the toilet and brought it in a paper towel, ziplock bag, or baby food jar I wouldn't have to work. I'm happy to mitigate ignorance and educate, and I did attempt it in this situation, but the patient's mother wasn't accepting any knowledge. Her mucus plug came out, and therefore the nurse must....what? I never figured out what she wanted from me. I guess I was supposed to run around in circles in the room, throwing my hands in the air, screaming, "Lawd Jeebus, help us! She's done lost her mucus plug!" Maybe if I'd done that she would have taken it down a notch. The mother was very resistant to discharge, and I had to have the OB come in and speak to them. Said OB had been up for hours doing deliveries and had finally gotten a chance to lay down, so he was none too pleased and it showed. I'm sure she told everyone she came into contact with in the community that her daughter lost her mucus plug and we did nothing and didn't even care!

  • Feb 18

    What the young nurses should be worried about is the status of their personal malpractice insurance. You are much more likely to be sued for something that stems from a med error or understaffing than you are to have your license revoked. The BON doesn't worry me too much (not dealing or diverting! ) but trial attorneys worry me plenty. In our state the bar is set pretty high for even getting a med mal case into court, but who wants to deal with any part of a lawsuit, even if it's eventually dismissed?

  • Jan 3

    Quote from Jolie
    My experience with IV infusion of mag sulfate comes strictly from the OB setting (as a nurse and patient), so I can't offer any insight on office practices or standards of care.

    But I don't understand the use of IV mag sulfate for the treatment of a migraine in an ambulatory patient. The side effects of this drug (especially with rapid infusion) are horrific, and include intense dizziness, nausea, vomiting, weakness, flushing, tachypnea, tachycardia, etc., etc., etc. I can't imagine a migraine so bad that I would be willing to add these symptoms to the mix. Nor do I understand how you would then discharge this patient from the office without a lengthy recovery period, a ride home, and a caretaker.

    Aren't there plenty of other options for migraine treatment that are less invasive, and leave the patient in a more functional condition?

    I'll check back on this thread. This is very interesting to me

    Yes, for the "occasional" migraine patient, there are many other options. There is a subset of migraine patient, though, that require heavy duty, sometimes unusual meds. I'm one of those worst-of-the-worst chronic migraneurs. My background is L&D, so I was expecting bad side effects from mag, but honestly, compared to what I was going through with a days long migraine, the mag was NOTHING. I love mag. LOVE IT. I would have it on tap in my home if I could. It's a first line drug for my neurologist. It's cheap and it works when the triptans, NSAIDs, preventatives, and narcotics have failed. Why does it work for migraines? Probably some of the same reasons it prevents seizures in preeclampsia. It's also neuro-protective for fetuses.

    If the idea of mag amazes you, then the list of things I've tried over the years would probably leave you speechless. There is only 1 medications FDA approved for migraine prevention, Topomax. But the list of things that migraine specialists will try stretches past 200. I've tried Risperdal, Seroquel, Lamictal, DHE, methergine (yeah, methergine), and Botox just to name a few. And I don't have any mental health dx, so the Risperdal and Seroquel were solely for migraine prophylaxis. I've been given lidocaine, magnesium, steroids, ketamine, benadryl, and toradol in different IV sessions in attempts to break long cycles of migraines. If I walked into my neuro's office for my next visit and he told me that there was a new treatment from Asia involving IV water buffalo urine, I'd probably consent to it because I'm that desperate for relief.

    So, in summary, if the migraine patient can usually take something PO or just go to bed, and that's all it takes to get rid of their 3-times-a-year migraine, then mag may be a bit of overkill. But for the patients who are chronic and difficult to treat, mag is a very useful, basic step in treatment.



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