Bad experience as a patient

[Haarlem]

I'm a senior nursing student and I had a bad experience being a patient last year. I went for a septoplasty & graft placement for my nose. I was under general anesthesia, which I had never had before. When waking up in the PACU, my mind was the first thing that turned back on (my head was still extremely heavy and I couldn't open my eyes yet). I was shivering heavily and I noticed that I felt that my heart rate was slowing down. My mind being foggy, I tried to count it but I didn't have any watch or clock to my disposal.

Suddenly, my RR slowed down so much that I felt I couldn't breathe anymore. My eyes sprung open and I yelled "help, I can't breathe, help!!" all over the unit. I had never had a panic attack before but it felt as if I was going to stop breathing – it's very frightening.

(Days past this incident I realized that this is the general feeling many patients get when they have a cardiovascular event, or asthma/COPD patients).

A nurse standing about 10 feet away from my bed was looking at me with a blank expression. After a 5 sec or so, another nurse ran over to me and helped calm me down to breathe normally. I couldn't believe I freaked out because I'm normally not a neurotic or anxious person. The nurse who was looking at me and doing nothing earlier slowly walked over. She told me she was my nurse. I asked her why she didn't come to help me. She said that she wasn't obligated to help me, and she thought I wasn't in real danger. There wasn't a flicker of sympathy or caring in her attitude and facial expression. In my foggy state of mind, I was like "OK.." I didn't understand.

In the rest of my stay in the PACU she let me to walk back and forth by myself to the bathroom, in which I basically wobbled the entire time.

Later when I came home I became furious. In a very vulnerable moment, in which I had no critical thinking abilities being post-anesthesia, this nurse hurt my feelings personally and my trust pretty badly. I can't believe someone like that is employed by a high ranking hospital. I sent a complaint to the hospital, and they said she was a float nurse and they could not find out what her name was.

I try to take this experience to the hospital I precept in. Whenever I feel a bit annoyed with a patient, I think of this incidence, which I wish on no-one, and turn my thoughts around. Patients are in one of their most vulnerable states in the hospital and they at the very least deserve quality care and a genuine smile.

[jdub6]

Re:family visiting in PACU obviously none of us can know the policy at that hospital. Often families are allowed back when a patient reaches a certain stage of recovery and the time that takes can vary. Also they may not have known he was waiting until then. finally, in all acute care areas in which I have experience families/visitors may not be allowed when a patient is unstable or having emotional/psych issues-perhaps with your anxiety they had concerns and wanted you more awake (even though your husband could have helped calm you, sometimes visitors just feed the anxiety and become anxious themselves).

Having you walk to the bathroom is often a good thing-its good to walk as much/soon as possible and often necessary for you to be at baseline before leaving PACU. You may have looked more stable than you felt-did you tell anyone you felt "wobbly" or ask for assistance?

Finally, the moment one wakes from anesthesia is often scary and people can have a wide variety of emotional and physical issues. A float nurse often is not completely comfortable where they are especially in specialty areas like PACU. The nurse may have been anxious herself and focusing first on assessing you, watching the vital signs and trying to figure out what was going on and how to manage it. Being "distant" can mean someone isn't sure of themselves and is trying to just maintain safety and document right, and really isn't able to be supportive because they just don't have the experience to know what you need or what may be happening emotionally for you. It is very appropriate that another nurse, presumably a regular PACU nurse, stepped in to help as she recognized what was happening and knew how to handle it.

This experience in my opinion is a great example of why its not great to float nurses to areas they have not been oriented to. Perhaps you can ammend your complaint to focus not so much on the person but the system-the fact that your PACU nurse was a float who obviously wasn't comfortable or skilled in that environment. Or, maybe she was just a crap nurse. We can't know since we weren't there and don't have all the info. IMO its still not a bad thing for the hospital to get patient feedback to support what nurses have been saying all along-floating to areas where one has no orientation isn't good practice.

[jdub6]

I also did not know this. The person we spoke to just before leaving maybe have gotten it wrong, about when my hb was allowed in. My nurse probably called him in when it was time.

You guys have made me feel better about this experience. :)

FYI I don't think it was helpful in any way for that person to throw the nurse under the bus like that. saying that doesn't undo what's been done and therefore serves no purpose except to upset you. She may have been wrong and/or didn't know the circunstsnce/reason he wasn't called back earlier. Even if she was right that comment in my opinion was unprofessional.

And again, a float with minimal or no PACU experience may not have known it was her job to call your husband in, or may not have known the correct visitor policy, or thought she would be informed when he arrived, etc. Still could be a systems issue with floating.

ETA: again she could just be a crap nurse but I could see myself performing much the same way if thrown into PACU with no experience. I've made many similar blunders as a float because I had no idea what I was doing, what the culture and policies on that unit were and so on. I'm sorry you went through that anxiety (though its a normal reaction to anesthesia) but also feel sorry for the nurse.

[canoehead, BSN, RN]

If a patient is yelling, I know they are breathing very effectively, so I generally take a second to look for the "real" issue. That may explain the blank look. I'd definitely go over and give a bit of moral support, but she might have been in the middle of something.

I'd also hesitate about bringing in a second person when there's already a bit of drama at the bedside. Let the meds wear off and sanity return, then bring in the visitor. One way or another, anyone screaming "I can't breathe!" is not stable. A companion might help, or he might just panic himself, and if I don't know them, they stay out until things are under control.

[Ambersmom, BSN, RN]

I had a bad experience as a patient, As a nurse I have promised myself that never would I give someone the same (or lack of) treatment I experienced. Move forward, sometimes nurses teach us how to respond, and some nurses teach us how not to respond.

[Munch]

On the other hand, if she said, "I have no obligation to help you" then maybe she actually is the worst nurse ever. I have never once heard any nurse say that to a patient in my entire career.

This

Seriously..who says this to a patient that is in a panic? She really needs to get out of nursing and go take up basketweaving or something. I understand that if you can yell you can't breathe than the opposite is true and by not running over in a panicking frenzy might give some reassurance to the patient that they are okay. But seriously I'm not obligated to help..okay then you just stated you were my nurse..what exactly is your obligation? I wouldn't want that nurse caring for me or my loved ones..god forbid I coded and she failed to move quick enough simply because its not her obligation.

So sorry you had to go through that OP..that whole obligation statement really burned me up. Like I'm just baffled..who says that??!! As far as visiting in the PACU goes after a certain time period visitors are allowed to be at the bedside. After my surgery(one of my PACU nurses was a wench..and she happens work in the same place I do so she knew me, my other PACU nurse was fantastic she was on the ball with everything I needed) my mom and aunt came up after me being there for a few hours..I had a 5 hour crani and it took quite a while to get my pain under control.

I'm glad you are doing better and use this as a learning experience. I know every bad thing and good thing that happened to me medically I use as a learning experience and a chance to help relate to my patients better.

[FIDG333]

I'm a student nurse, but also had an experience similar over a decade ago. I went through a really rough time in my late teens, and ended up in the ER after an overdose (suicide attempt, not illegal drugs). They gave me a catheter, which eventually became very painful. I still remember the look on the ER nurses face when I rang my call bell to tell her. My room was right in front of the nurse station. She turned off my call bell and rolled her eyes. When I begged an admission person to tell her about my pain, the nurse refused to help. I laid in pain for hours. For years I had zero trust in medical professionals, but it does get better with time. What it did help was make me more compassionate.

There are so many medical professionals who do not take panic or anything mental seriously. But I know it's not all medical professionals. My instructors are vigilant about us being compassionate in all circumstances. I don't know what experience in that nurses life or day made her act like that, but it happened and all I can do is let it change me for the better.

I'm sorry it happened, but it does get easier. Hang in there.

[JKL33]

Quote from JKL33

On the other hand, if she said, "I have no obligation to help you" then maybe she actually is the worst nurse ever. I have never once heard any nurse say that to a patient in my entire career.

This

Seriously..who says this to a patient that is in a panic? She really needs to get out of nursing and go take up basketweaving or something. I understand that if you can yell you can't breathe than the opposite is true and by not running over in a panicking frenzy might give some reassurance to the patient that they are okay. But seriously I'm not obligated to help..okay then you just stated you were my nurse..what exactly is your obligation? I wouldn't want that nurse caring for me or my loved ones..god forbid I coded and she failed to move quick enough simply because its not her obligation.

So sorry you had to go through that OP..that whole obligation statement really burned me up. Like I'm just baffled..who says that??!!

My point was that I don't think the nurse said that at all. She may have said something to the effect that 'everything's okay'/'you don't need me to do anything' or even "I don't need to do anything" along the lines of a situation that Muno described.

But she did not stand from afar and say that she wasn't "obligated" with regard to the OPs general care.

[Susie2310]

When you experienced not being able to breathe in the PACU after undergoing general anesthesia and called for help, I would have expected your nurse to come to assess you right away. I presumed your heart rate, BP, respiratory rate, and oxygen saturation were being monitored.

In a PACU that I am familiar with family members are brought back to be with the patient once the patient is out of the procedure and in the PACU.

[Cowboyardee]

When you experienced not being able to breathe in the PACU after undergoing general anesthesia and called for help, I would have expected your nurse to come to assess you right away. I presumed your heart rate, BP, respiratory rate, and oxygen saturation were being monitored.

She said her nurse was 10 feet away staring at her silently. The silent staring bit likely WAS her nurse assessing her. The monitor is typically right there - you observe the vitals, the respiratory pattern, the apparent sedation level, etc, for a few seconds to determine if the patient is in actual respiratory distress or merely experiencing a rough awakening from the anesthesia. I can't account for the poor bedside manner or why her nurse let another nurse talk her patient back down, but surveying the situation for a few seconds before acting is perfectly decent practice.

[Susie2310]

She said her nurse was 10 feet away staring at her silently. The silent staring bit likely WAS her nurse assessing her. The monitor is typically right there - you observe the vitals, the respiratory pattern, the apparent sedation level, etc, for a few seconds to determine if the patient is in actual respiratory distress or merely experiencing a rough awakening from the anesthesia. I can't account for the poor bedside manner or why her nurse let another nurse talk her patient back down, but surveying the situation for a few seconds before acting is perfectly decent practice.

You and I understood the situation as described by the OP differently.

[Kooky Korky, BSN, RN]

I'm a senior nursing student and I had a bad experience being a patient last year. I went for a septoplasty & graft placement for my nose. I was under general anesthesia, which I had never had before. When waking up in the PACU, my mind was the first thing that turned back on (my head was still extremely heavy and I couldn't open my eyes yet). I was shivering heavily and I noticed that I felt that my heart rate was slowing down. My mind being foggy, I tried to count it but I didn't have any watch or clock to my disposal.

Suddenly, my RR slowed down so much that I felt I couldn't breathe anymore. My eyes sprung open and I yelled "help, I can't breathe, help!!" all over the unit. I had never had a panic attack before but it felt as if I was going to stop breathing – it's very frightening.

(Days past this incident I realized that this is the general feeling many patients get when they have a cardiovascular event, or asthma/COPD patients).

A nurse standing about 10 feet away from my bed was looking at me with a blank expression. After a 5 sec or so, another nurse ran over to me and helped calm me down to breathe normally. I couldn't believe I freaked out because I'm normally not a neurotic or anxious person. The nurse who was looking at me and doing nothing earlier slowly walked over. She told me she was my nurse. I asked her why she didn't come to help me. She said that she wasn't obligated to help me, and she thought I wasn't in real danger. There wasn't a flicker of sympathy or caring in her attitude and facial expression. In my foggy state of mind, I was like "OK.." I didn't understand.

In the rest of my stay in the PACU she let me walk back and forth by myself to the bathroom, in which I basically wobbled the entire time.

Later when I came home I became furious. In a very vulnerable moment, in which I had no critical thinking abilities being post-anesthesia, this nurse hurt my feelings personally and my trust pretty badly. I can't believe someone like that is employed by a high ranking hospital. I sent a complaint to the hospital, and they said she was a float nurse and they could not find out what her name was.

I try to take this experience to the hospital I precept in. Whenever I feel a bit annoyed with a patient, I think of this incidence, which I wish on no-one, and turn my thoughts around. Patients are in one of their most vulnerable states in the hospital and they at the very least deserve quality care and a genuine smile.

They can find out her name with a minimum of effort. It's all over the chart and in staffing records in the staffing office. It's on the assignment sheet/record of the Recovery Room for that day.

You can get a copy of your records and see her name if you want to. Don't tell the hospital why you want the record, just get it. Or sit in Med Rec and read it. If it's electronic, they can print it out.

If she was a float, she might have had little or no training in Recovery. Still, it sounds like she was dangerous and evil. She stated she had no obligation to help you? While you might have misunderstood because of the anesthesia meds that were still in your body, it's also possible that she did say that.

It wouldn't have hurt her to walk to the toilet with you, just to be supportive and make sure you didn't fall. I'm really sorry she was such a miserable excuse for a nurse. You don't have to be experienced Recovery to help keep a pt from falling or offer some human kindness.

If she did say what you say she did, not only is she cruel but she is wrong. She absolutely does have an obligation to take care of you if she is on the payroll and was assigned to you.

You need to get a lawyer to go to bat for you - if for no other reason than to write a letter to the CEO, Nursing Executive, and Board of Trustees detailing your experience and the incompetence, negligence, and cruelty of this nurse - and the stinking system that floats a nurse who's inexperienced (presumably) in a particular type of Nursing to work in that setting.

And maybe you do have grounds to sue her and the hospital.

[Kooky Korky, BSN, RN]

Quote from JKL33

On the other hand, if she said, "I have no obligation to help you" then maybe she actually is the worst nurse ever. I have never once heard any nurse say that to a patient in my entire career.

My point was that I don't think the nurse said that at all. She may have said something to the effect that 'everything's okay'/'you don't need me to do anything' or even "I don't need to do anything" along the lines of a situation that Muno described.

But she did not stand from afar and say that she wasn't "obligated" with regard to the OPs general care.

You were not there and do not know what she said.