SO mad...and not sure I should be.

[AngelfireRN, MSN, RN, APRN]

Please forgive the length...it's been a bad day.

I work in a clinic that dispenses controlled substances. As such, we have various and sundry very stringent rules in place so as to prescribe as safely and therapeutically as we possibly can.

One of those rules is: "If you know you are pregnant or think you may be pregnant, it is your responsibility to inform the clinic. Failure to do so will result in termination as a patient."

Back the first part of last month, we got a fax that a patient, in addition to being a 'guest' of another state, had had a positive hCg at the facility. In cases such as that, we turn care over to the OB/Gyn.

Said patient showed up today, acting as though nothing was amiss, and did not disclose her pregnant state until confronted with it. The conversation ran the gamut of her legal troubles, her 'stress' and her need for her pills. I politely informed her of our policy (did not terminate her on the spot as I probably should have) and asked for the name of her OB/Gyn so that we could contact them to send records of her meds, etc.

That's when I'm pretty sure my blood pressure hit higher than it ever registered before, even counting my toxemia-plagued pregnancy.

"Oh, I don't have one. We're not going to continue with this. It's just not a good time. So, what do I do? I need my pills. Do I just have to bring you proof that it's done and I can have them?"

In a nutshell ( and yes, I'm being judgemental here), she didn't keep her legs together, and now she's just blithely going to terminate a pregnancy so she can get her candy. It's an inconvenience for her. Before you flame me, I consider myself pro-choice. In cases of rape, incest, extreme youth, maternal danger, or a known fetal condition that will result in little to no quality of life, I support the termination of a pregnancy. Not because one had no foresight to take precautions. And yes, we did ascertain that none of the above were a factor. She didn't care to announce it to the entire lobby, triage, and clinic in general.

I was so mad I was shaking. Maybe it's the miscarriage of my first pregnancy followed by a difficult and premature delivery of my son making my hormones run cattywompus, but I could have absolutely ripped her head off. I can't remember the last time I was that mad.

She then had the nerve to hang out in the lobby 'just to see if the doc comes in, so she can go ahead and see if I can have my pills'. The secretary finally had her leave.

My question...am I wrong (or hormonal)? I know ultimately it's her choice and her body, but it just cheeses me off to no end. All she was worried about was the pills! That's all!

Sorry for the rant. Full moon and a bad day. Thank you for reading, and I look forward to hearing your take.

[Anna Flaxis, BSN, RN]

I understand why you would be so angry. I guess my first thought is that if all she cares about are her pills, then it's probably for the best that she terminate.

[AngelfireRN, MSN, RN, APRN]

You're right, I know. I just can't get my head around it.

[CalicoKitty, BSN, RN]

I went with a friend to have her pregnancy terminated. I believe it was her first time. She was "old enough to know better". I think she was only with the guy once or a short period. While at the clinic, I overheard some other girls discussing how many times they've had abortions. I'm pro-choice, for sure. I really wish more planned parenthood/pregnancy prevention measures were available, and I'm glad I took them to heart in my childhood sex-ed classes (granted, I think I had a fear of HIV more than pregnancy). For people more interested than their pills than their pregnancy, I'm just glad she's not planning on keeping her baby. Enough kids are already born addicted to the stuff.

[Liddle Noodnik]

My question...am I wrong (or hormonal)? I know ultimately it's her choice and her body, but it just cheeses me off to no end. All she was worried about was the pills! That's all!

Sorry for the rant. Full moon and a bad day. Thank you for reading, and I look forward to hearing your take.

I guess next time you will have to be cut and dried about it, just terminate her and don't get "into it." altho I am sure terminating a patient will result in some emotional confrontation anyway!!!

It could be any number of reasons to get upset, all valid in my opinion. Sorry things have been so rough for you personally That does not help at all, and more than hormonally!

xo

[LiLoRN]

Sorry, have to play devil's advocate from someone who is 100% pro choice.

It's not your place to judge her. Whether you like it or not, people have abortions every day for all sorts of reasons. And the reality of it is, you don't know for a fact that the reason she's aborting is because she wants the pills. You suspect it (and it may be a good suspician) but you don't know about every little facet of this woman's life. It possibly could be deeper than that. That's just my thought. Sorry you had a bad day.

[BCgradnurse, MSN, RN, NP]

It's ok to be upset and have your feelings and opinions about the situation. You treated the patient appropriately and professionally, so there's no issues in that department. I think we're all faced with situations that run counter to our beliefs and values, and they can be very upsetting. It's good that you came here and vented.

[caliotter3]

Of course all she was worried about was her pills. She was drug seeking. People like that tend to irritate me too.

[sharpeimom]

of course you're not crazy, or out of line. while i am adamantly prochoice, i have become very

uncomfortable with women having many many abortions as their usual method of birth control. this

woman is controlled by her never ending quest for drugs... any drug... and is unable to think beyond

her next fix.

for women like you and i who have miscarried, then gone on to have difficult and/or unsuccessful

pregnancies, the seemingly cavalier attitude of women like your drug seeking patient, seems cold,

calculating, scheming, and just plain wrong.

but i have had to remind myself frequently that the very same hard-fought law that legalized safe

abortions, also protects the rights of women such as this, for whom a baby is no more than a temporary

inconvenience. i don't have to like it, agree with it, or approve of her lifestyle, but it is her legal right.

ethics are an entirely different matter.

unfortunately, stats say that people for whom the misuse of legal or illegal drugs becomes a way of

life, indiscriminate sex is part of the package too, and that's how babies are born to these moms.

doesn't mean you can't get bent out of shape or enforce the clinic's rules though.

[Simply Complicated]

I have a little bit of a different take, I don't think it's totally fair to just outright judge her. While I get frustrated with people who use abortion as a form of birth control, things are not always as they seem. Just because she seems very flippant and nonchalant about it on the surface, does not mean she is inside. You also don't know the circumstances behind her getting pregnant. Coming from working psych, I have learned things are not always as clear as they seem. Yes, she may just be a cold hearted, drug seeking addict who doesn't care. But you don't know that for sure, you also don't really know her history to know if there are things in her life that contributed to her getting to that point. After some of the horror stories I've seen and heard, sometimes it gives you a different perspective, even for those drug seeking, worthless seeming addicts.

There are always going to be people in the world who we don't agree with their decisions, especially in nursing. It sucks, but we can't control people, all we can do is do our job to the best of our ability.

[AngelfireRN, MSN, RN, APRN]

To those that say we don't know for sure...we do. She said it flat-out. It was an inconvenience and she didn't need an inconvenience, she needed her meds. Period.

[Andrews_RN]

Took the words right out of my mouth @simply complicated, I completely agree!

As someone who has also worked psych, it's true even if someone says something 'flat out' it doesn't mean that's what's going on underneath the surface. There is no way that you can know the circumstances around how this poor woman came to be pregnant or addicted for that matter. Without walking in her shoes there is no place to judge. Im truly sorry that you had a bad day, it happens to all of us and I feel that as a woman you are allowed to have a reaction to something by which you feel you have been personally affected. However, as hard as it is as a nurse I feel that you cannot take such an incident so personally. IMHO it is our job as nurses to show compassion to our patients and not judge them no matter how we may personally feel about their life choices.