I've been a nurse since 2012, I've worked at my hospital for just about 2 years. This week at work I can't seem to do anything right and it seems like every patient and/or their family members are going nuts.
I was assigned to take care of a post op R hip. I had helped my friend admit her the day before and we were setting up her PCA dilaudid pump and I was talking my friend and preceptee through setting it up. The patient asked if I could lower my voice as she had a migraine, I apologized for my voice and kept it low the rest of the time we were setting it up. By 3pm my friend who had admitted her asked to not have her from the 3-7 shift because she was so anxious and OCD and obsessive. I had her the next morning at 7am. Her BP was low at 86/50. I went in to see her when I was told her BP was low. She had her lights out and the door shut and when I opened the door I turned the side sink light on and she immediately asked me to turn it off as she was having a migraine. I obliged and turned the light off but also informed her that I needed to recheck her BP because it was slightly low. (She had been running low since PACU usually in the 90's/50-60's). She told me that the night nurse had told her that if her BP ran under 90's SBP that the MD should be notified. I told her after I recheck your pressure I will page him. Her BP on recheck was 106/62. I also removed the PCA pump key from her and explained that the dilaudid was probably making her BP low and could be contributing to her head ache and nausea. She was agreeable and I told her we could try some oxycodone instead. I asked if she needed any pain med at the moment and she said no. I left to page the MD and never heard back from him. I went back into the room and told her he had been paged and to ask if she needed anything else. She said no, just shut the door and keep the lights out which I did. She rang her bell and hour later or so to say she had just vomited (this happened the day before also). I went into check on her and checked her BP which was still good 102/54. She asked if I had heard back from the MD and I hadn't so I said I didn't hear from him yet but I can get you some zofran for the nausea. I left and got her AM meds and some zofran and came back. I placed the meds on the table still in their wrappers and she immediately asked me to go pull them again as she was scared of germs and the med wrappers had touched the table. I pulled her meds again and came back and gave her the zofran. I asked her about her pain and she said it was still ok. I also explained that sometimes low BP can cause N/V as well as having an empty stomach. I encouraged her to try some saltines if she wasn't still feeling sick in a little while. I asked her if I could turn the light on to do my assessment and she said yes. I turned the bedside light on and leaned on the rail of the bed to listen to her abd and she said this hurt her head and then asked to speak with the charge nurse and requested a new nurse. I was told she did not like the fact that I was not concerned about her BP and that I hadn't medicated her for nausea (which I did) and that I didn't page the doctor (which I did). I know not to take it personally and that my friend from the day before said she was nuts but it still sucks. Is there anything I should have done differently? I had already paged the MD once and he had not gotten back to me and her pressure had stabilized well. I am totally doubting myself and whether nursing is the right career and all that jazz. Thanks for any input.
