I'm a pretty nice person. When I'm abused/insulted by patients, whether I am in the wrong or not, I apologize and try to make everything better for them. I hate being disliked. I hate having unhappy patients. I want things to run smoothly during my shift.
But this crap really made me angry.
As nurses we put up with a lot of crap. And I can usually suck it up. But this patient made me want to SCREAM...
So it's the beginning of my night shift. I'm getting report on my five patients. Room 8 is Spanish-speaking only and he's in pain. Room 16 is fine but he started having cardiac issues yesterday so he's always worrying me no matter what. Room 1 is Spanish-speaking only and he is supposed to be discharged home... but we have a new EMR system and I can't figure out how to get his discharge instructions in Spanish (thank goodness for that interpreter phone...although it takes a long time to get a hold of someone). And then Room 10 is a new admission who just arrived from the PACU.
Okay. I can do this. I know who to see first and what steps I can take to get everything back under control. No one is unstable or critical or dying. I'm trying to get eyes on everyone and apologizing for the craziness of change of shift, assuring everyone I will get to them, assess them, get them all settled as soon as I possibly can.
Around 8 PM I walk into the doorway of Room 10, my new admission from the PACU who has had a total hip replacement, to apologize for my delay. The day nurse who had gotten vital signs on him upon his arrival had assured me he had no pain, he had an epidural, he was comfortable and he had no needs or issues.
I don't even set two feet in the doorway before I get my head bitten off by this man. He's not yelling but he's talking down to me, wiping the warm smile right off my face.
His complaint: He tells me he has not had an SCD (sequential compression device) on his legs for the past five hours. And with his type of surgery, he tells me, that he is at an extremely high risk for blood clots.
"Sir I am an orthopedic nurse...I am aware of that." I take care of joint replacement patients ALL THE TIME. I explain to him that I just came onto shift, I wasn't aware that he was without a SCD machine and please forgive me but I have four other sick patients that I have been taking care of.
What I want to say is... IT IS AN SCD MACHINE! A FREAKING SCD MACHINE! Do I think SCD machines are important for ortho joint replacement patients? Absolutely. Mechanical DVT-prophylaxis is important in addition to pharmacological prophylaxis... I've taken care of patients with PE's and DVT's before. It sucks.
But do you need to threaten to call Patient Advocacy because we haven't gotten a machine for you yet?!?! NO! I just met you! And frankly your SCD machine is the LAST THING ON MY MIND RIGHT ABOUT NOW, SIR. I'm more worried about looking at that epidural in your back delivering a high risk medication and making sure it's in in the right place and programmed with the right settings! AND based on the SCD sleeves on your legs...are you even certain you didn't have one on in the PACU?!
Are you freaking kidding me?!
I try to diffuse the situation but I'm so angry, he and his family can tell because they instantly feel bad that I've become the punching bag. I try my best to hide it because I've never raised my voice at a patient. But I was furious. I was NOT furious at the request. Getting an SCD machine is simple; I can order one and wait for the ortho tech to bring it...which my patient didn't want...or I can go to the dirty utility room and grab a used one, bleach it and bring it straight away. So I do the latter. Immediately. Because he perceived it as life-threatening. What made me furious was the way I had been approached about it, the way I had been spoken to and the way he had threatened me.
The best part is that after the whole SCD machine debacle (which took me ONE MINUTE to obtain for him)...after this patient's crusade against blood clots (turns out he was a physician)...I noticed that the orthopedic resident hadn't written the patient an order for coumadin, which we usually start on the day of surgery. So I spent the next 4-5 hours tracking down the doctor to put the order in the computer, talking to pharmacy about why they weren't processing the order (no INR lab result), calling the doctor again because I needed an order to draw an INR, and finally administering the medication to him around 2AM. There! HAPPY?!
While the patient did apologize for his behavior, I was still disgusted by the way I had been treated. Abuse of nurses really sucks. I empathize with patient's stress levels, I do...I know you're scared in the hospital... but that was just uncalled for. Goodness.
Okay, that's the end of my rant. Thank you for listening!
