A coworker made me so mad!

Nurses Relations

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How would love to hear some of the things coworkers have done at work that just make you mad and frustrated.

For example, the other day we had a lady who was clearly terrified of needles. Now we all have patience claim they're scared of needles. But this lady was a little different. She came into the ER clearly in pain and flat refuse to let the doctors draw any blood work, or start an IV.

She had abdominal pain but would not allow us to do anything that involves a needle. Try to figure out a diagnosis for abdominal pain without being able to do any kind of lab work or use any kind of IV contrast.

Now I'm not the first nurse involved in taking care of this patient. In fact, I actually asked to take over care for this patient because nobody else was getting anywhere. After sitting there and talking to her for 20 minutes I finally got her to agree to let me draw blood do doing finger sticks with micro tubes just like I would have a very small child. So I went to gather up the necessary supplies.

Now I am a new employee and was oriented to the ER. My preceptor took it upon himself to walk in and try to convince the lady to let him start an IV. She's already told for people know she would rather leave. She had even said she would rather go home and die then let someone stick her with a needle and she was crying when she said so.

When I got back she was signing the AMA paperwork and leaving and nothing I could do to stop her.

. I've been a nurse twice as long as he has I just happened to be new to the hospital. I think he was wrong and out of line.

What do you think?

Thanks for letting me vent. I really needed it.

Specializes in Oncology.

If she had agreed to fingerstick labs, I would have also tried to get her to agreed to an IV. Trying to draw the needed labs with fingersticks would mean WAY more sticks than one IV, where all labs would be drawn and then she'd also have IV access. Plus fingerstick labs you risk getting inaccurate labs from interstitial fluid mixing in. Venous samples are accurate.

So your plan: about 5 painful (fingersticks hurt) needle sticks, possibly inaccurate labs, no IV access.

Your coworker's plan: (hopefully) 1 stick, accurate labs, IV access.

This woman had her mind made up. I'm guessing when you got back there with all of your pipettes she'd be on her way out.

In this case the first order I would have requested was for topical lidocaine. Even a small amount SQ you can inject with an insulin needle under the skin above the vein.

i would've made a deal with her, let me start this IVAnd I'll get you a dr pepper :) I would have then told preceptor she agreed to let ME start it and I'll be back shortly. But she wants me to do it not you. Yes I would've been mad after spending that much time convincing the patient. He won't be your preceptor forever. Once you are on your own keep him away from your patients

Specializes in Oncology.
This patient was being immature and ridiculous. Why do you come to the ED, repeatedly, to refuse treatment? Even if you *had* gotten the finger stick blood work - eventually the treatment based off that is likely to involve an iV or a needle. Focus your energy elsewhere and stop being mad at someone who didn't do anything wrong.

When you have a phobia, it's really not that simple. It was probably a huge effort for her to even come to the ED and shows how desperate she was.

I'm wondering if EMLA cream was offered?

Specializes in Postpartum, Med Surg, Home Health.

OP yes I would be mad as well. I wouldn't dwell on it, but I would be mad at that moment. Are readers missing the point?? It's obvious OP became upset because she spent a very long time sitting and talking to this pt to get her to trust her and do some lab work etc, that kind of progress is not easy to make! She went to get her supplies and next thing she knows pt is leaving because someone else had come into the room and was trying to talk her into it. Come on people, your telling me that if you worked hard on something for 20 minutes, left for a few minutes and came back to total destruction of what you had built/worked on, you wouldn't be even a little bit mad? Let's get real and get off our high horses. We are all human.

I feel bad for that lady. Obviously her phobia of needles is so strong it interferes with her being able to receive care. She came to the ED for help obviously, but unfortunately her fear won over.

Specializes in Oncology.

I was wondering about EMLA cream, too. But no Dr. Peppers for an unworked up abdominal pain!

Phobias really aren't that simple as "either let us help you or don't bother coming." They can be completely crippling and it probably took her awhile to even work up to being able to come to the ED.

I was trying to figure out the best way to express my thoughts on this and, honestly, I think blondy2016h hit it right on the head. It seems to me that many who replied to the original poster have forgotten how powerful a hold phobias can have on a person. And while this patient might have very well understood that needle work would be beneficial, it wasn't the rational part of her brain making the decisions at that time.

I believe that if the "100% solution" (what would be the ideal scenario) isn't going to work, then try and see if the 80% solution will do the trick. Failing that, work your way down until your patient can agree with you. Yes, it is time consuming and might seem futile but I think it is worth it. I cannot imagine anyone staying on there side of the fence (so to speak) and demand that the patient meets them all the way there. Sometimes, I think you have to go out of your way a little bit. It's in the patient's best interest.

Dany

When you have a phobia, it's really not that simple. It was probably a huge effort for her to even come to the ED and shows how desperate she was.

I'm wondering if EMLA cream was offered?

Actually, it really kind of is that simple - in the sense that those issues are not going to be resolved with an ED visit. What were they going to do? Call psych? The finger stick labs would have been useless without the ability to act on them. If the phobia is truly as bad as is being implied, I highly doubt EMLA or intradermal lidocaine would make a difference.

Specializes in Transitional Nursing.

She obviously did want help, that's why she went to the ER. OP found a compromise to allow the staff to care for her while accommodating her phobia. I don't blame OP for being upset, someone needed help and didn't get it, she doesn't sound like she was very rational, no, but her fear of needles should make it so she doesn't get treatment?

She obviously did want help, that's why she went to the ER. OP found a compromise to allow the staff to care for her while accommodating her phobia. I don't blame OP for being upset, someone needed help and didn't get it, she doesn't sound like she was very rational, no, but her fear of needles should make it so she doesn't get treatment?

How are they going to treat an acute abdomen with no IV access and sketchy labs?

Specializes in Transitional Nursing.
How are they going to treat an acute abdomen with no IV access and sketchy labs?

Well, we'll never find out, will we?

One idea is that upon getting said sketchy labs back OP could have explained the seriousness of a WBC count through the roof and perhaps convinced her, perhaps the MD would have ordered something for anxiety, maybe she just needed to be reassured.

Well, we'll never find out, will we?

One idea is that upon getting said sketchy labs back OP could have explained the seriousness of a WBC count through the roof and perhaps convinced her, perhaps the MD would have ordered something for anxiety, maybe she just needed to be reassured.

I agree with this. First establish a report, build trust, and work from there. Time is your ally here. But above all, show compassionate care. Understanding phobias, and knowing how to deal with a really scared person is a valuable skill to have.

Dany

Specializes in pediatrics; PICU; NICU.

I thought this thread was going to be about something that's worth being upset about. For example, the night I got to work (many years ago) & had a 4 year old getting a transfusion. The 3-11 nurse had only been working there a few months but was an experienced nurse. At the time, we didn't do bedside report. I walked into the room after report to find the tubing disconnected & most of the unit of blood on the floor. The 3-11 nurse hadn't left yet so I went & got her & asked her to help me clean it up & do an incident report. Her response: "I gave report, I'm going home ".

Now that's something to get upset about.

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