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

Specialties NP

Published

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.

Specializes in Trauma, ER, ICU, CCU, PACU, GI, Cardiology, OR.

needless to say, i try not to judge in some cases however, when i don't agree with the views of my patients, i don't let my feelings show. therefore, i'm glad you held your composure and came here instead and let it all out, and for that i applaud you...aloha~

whose life?

"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. "

i'd agree with the indications, and add contraception failure to your list.

however, i'm thinking that if we take her at her word, perhaps a druggie without enough foresight to take precautions isn't a real good bet for motherhood, and termination is the best option for her.

good for recognizing where so much of your anger is coming from. it will get better... :hug:

Specializes in Home Care.

I feel for you OP.

After dealing with my oxycontin injecting son and his addicted baby's mama, I have zero patience or sympathy for drug abusers. Fortunately, she didn't abuse pills while pregnant. But they did end up losing custody of the child to the state eventually.

Specializes in LTC,Hospice/palliative care,acute care.

The fastest way to burn out is to personalize this type of patient.We have to learn to compartmentalize our own life experiences away from those of our patients and sometimes we need to look for employment in a different area as self- preservation.

We all have things we struggle with-you are venting here and that's always good.

Specializes in med-surg, psych, ER, school nurse-CRNP.
I feel for you OP.

After dealing with my oxycontin injecting son and his addicted baby's mama, I have zero patience or sympathy for drug abusers. Fortunately, she didn't abuse pills while pregnant. But they did end up losing custody of the child to the state eventually.

I'm so very sorry. Prayers for peace and calm going your way.

No one understands until they've been in a situation such as yours. I've had several miscarriages, and one healthy pregnancy. It makes me cringe knowing people can just so "easily" terminate their pregnancy. BUT, this is our job. We tolerate ALL kinds, and silently judge them in our heads... LOL. I know it really stinks, but what can you do? I'm sure your hormones did not help this any though either. I remember after my son was born it took absolutely NOTHING to make me angry/sad/crying/laughing...sometimes all at the same time.

She didn't care to announce it to the entire lobby, triage, and clinic in general.

Of course she did not care to announce it! You made a pregnant woman talk about her termination in the lobby? I don't care if she is a drug seeker or not, discussions like that should NOT be within earshot of other patients or staff.

Also, I don't think women that choose to terminate should be required to be solemn at all times. They made a choice. How they deal with that choice is really no ones business. They have to stay pregnant until their termination appointment. I don't think that time should be spent in a mandatory shame spiral.

Just my 2 cents...

Pro choice does not mean "pro choice as long as I agree with the circumstances." It is not black and white, we have to separate ourselves from other individuals choices. This can also include a 102 year old CHF patient being a full code because the family cannot let go, or the patient cannot let go. It is not our job to interject our own feelings into the conversation, although we can vent about it later. Her circumstances were obviously not ideal for a child. She was on pain medication and did not wish to stop-even for a pregnancy. I am happy that she realizes that she cannot CTT because she wishes to continue using medications. (or otherdrugs) Seeing a child born addicted to meds because "mom" was against abortion, yet okay with bringing a child into this world to painfully detox just does not make sense to me.

As a side note. I had an abortion at 20. I failed to use BC. I did have an abortion, zero regrets, so I am a lot more open minded to women seeking abortion for whatever reason. Be it failure to use BC, or their acknowledgment of choices which are not OK for pregnancy, I support these women.

She is unwilling to CTT in a healthy way, so an abortion is her best choice IF she will not stop using drugs which harm a developing fetus.

Hopefully my post does not offend.

Specializes in Oncology.

I am 100% pro-choice. Well, make that 150%. I feel a woman should be allowed to terminate a pregnancy for any reason, whatsoever, including inconvenience. It's HER life and HER body and that fetus doesn't think, see, feel pain, or have thoughts. Sorry. Am I saying she's not a crummy person otherwise? Well, I can't judge her based on what someone else says. But, we don't need more unwanted kids though, no more addicts, no more foster cases. It's her decision, let her live with it and let it go.

Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.
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.

Doesn't mean anything. Could be her way of coping with a difficult decision. Doesn't mean she is as flippant as she is playing it off, is my point.

Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.

I will just add, I also have a history of miscarriage, and infertility. I've spent a few years of my life in fertility treatments trying for a baby. Successfully, luckily, but I do still know the loss. Still doesn't change my opinion. I don't always agree with other people's decisions, especially those who use abortion as a form of BC. I've just learned that other people's decisions of that sort honestly have no significance in my life, them having or not having a baby doesn't directly affect my situation at all. Does it pull at my heart? Sure a little. But if I let everything I see or disagree with bother me working as a nurse, I'd have burned out a long long time ago. It's just not worth it.

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