A truly stupid day

[oldiebutgoodie, RN]

Just thought I'd share some of the stupid things I had to deal with yesterday!

I'm a wound care nurse. Patient number one has wound between toes, it has cultured out MRSA. However, pt will not allow the silver gel we ordered (which hits MRSA) because it "stings". Also won't allow gauze or anything else between toes. Also won't allow me to touch toes, in order to separate toes to look at wound.

Patient one then explains that he needs an antifungal cream. I explain that MRSA (and Pseudomonas, which also cultured out) is a bacteria. He doesn't care, he said that in the past he has had this, and an antifungal cured it. Fine. Whatever. I tell him I will call his doc to see what doc wants to do. BTW, the doc had discontinued our order, but said, "Continue wound care". How??? We can't touch the patient!!!!!

Doc, of course, never returns call, and office staff sends me all over telephone hell everytime I call them. I finally fax the doc, chart all the attempts to contact doc and patients refusals, and move on.

Patient number two's wife gets upset because I won't rip the dry gauze out of her husbands wound (toe amp site). Instead, I use some saline to moisten in order to minimize pain and not destroy any new tissue that might be growing (of course, there is no new tissue). She says that "Dr. Quack at St. Elsewhere says we have to rip it out to get out the dead tissue". She also says that Dr. Quack at St. Elsewhere has some crazy

orders to do wet to dry on one day and Silvadene on the other day. I explain that

wet to dry is old school. She gets upset, whips out her notebook (always a bad sign),

writes furiously, and tries to get Dr. Quack, the vascular surgeon, on the phone to discuss. Of course, Dr. Quack is not available. All I can think is, Why don't you go back to St. Elsewhere?

Patient number three is in the ICU. Despite her serious pnemonia, urosepsis, and

subsequent hypotension, the granddaughter is mostly concerned about a few wounds. There are about 8 people in the room, one who is in a wheelchair, about half of them deaf. Granddaughter also has a notebook. And a camera phone, which she used to photograph grandma's wounds. Another relative is holding the patient's hand, looking morose and sounding weepy. Grandma looks like she just wants to take a nap, or maybe shoot everybody in there who won't leave her alone. I put a wound vac on large hip wound, with granddaughter "helping".

Hope your day was better! At least I'm off today.

Cheers,

Oldiebutgoodie

[Altra, BSN, RN]

Here's to family who are *an important part of the patient's healing*. :stone

Enjoy your day off! :onbch:

[mpccrn, BSN, RN]

this too will pass....sorry you had a bad day. thank goodness for days off!

[Nursebarebari]

Hmm, what else is new with those annoying family members. Enjoy your day off and hopefully your next day at work would be pleasant.

[JBudd, MSN]

8 people in an ICU room? How on earth did they all fit in? Our ICU room's barely hold a nurse on each side and the patient's bed.

I have no problem at all with telling people to go wait in the WR until I am done with whatever procedure I need to do (although I work in the ER). It also gives me a chance to ask the patient in private if she wants anyone let back in, so that she doesn't have to be the "bad guy".

Sorry you had such a crappy day! {{{{{goodie}}}}}}}}

[MaryAnn_RN]

A relative today, copying the ICU chart drugs/amounts/rates etc into a notebook...what

I asked 'may I help you' and she said she is married to a professor in biochemistry and she is going to discuss her MIL with him. I said to her that is a violation of pts' privacy etc, please stop, what a face she pulled at me. I can't stand it when relatives say they are married to this that and the other 'important' person. For me the only important person is the one I am caring for that day.

Hmm, what else is new with those annoying family members. Enjoy your day off and hopefully your next day at work would be pleasant.

[Keepstanding, ASN, RN]

hey sweetie, fugetaboutit ! :chuckle

so sorry you had a bad day. hopefully they will be few and far between. now go and enjoy your day off. don't look back ! :loveya:

[pagandeva2000, LPN]

I work at a city hospital where the majority of the patients have no insurance. We fee scale self pay patients to pay as low as $20 and this includes most diagnostic tests (except MRIs-those are $150) and labs. One new patient comes to our clinic and due to alcoholism, diabetes and cardiovascular problems, he has a boatload of referrals. I did a great deal of patient teaching regarding alcholism, complications of diabetes, medication reconciliation, HTN, and the reasons for his referrals. He says to me "I come here for one thing and I have all of these referrals. How am I going to be compensated for having to come for all of these appointments? The least you can do is pay my carfare. " I almost passed out from frustration, but I explained to him that he can see the financial counselor for the fee scale AND, if he cannot afford to pay the $20 for each of those visits, he will STILL be seen. Also explained that car fare is paid by the hospital once he receives Medicaid, but I would refer him to a social worker in case this is a problem for him. He then says that he doesn't want 'nosey*****" in his business and told me to kiss his ***.

Yeah, he really made my day...

[Babs0512]

I had a hectic day yesterday. Thursdays is primarily ENT day. We had 18 kids starting at age 1 -18. The first patient was a big 9 y/o male with autism - not a good mix when coming out of anesthesia. He came out kicking and screaming. Were trying to keep him safe from himself, I'm holding him from behind as he's trying to get off the stretcher, he starts spitting blood at the other nurses, they are dotted with it. We called the parents into PACU in the hope they could help calm him, to no availe. He was sitting with mom and just suddenly thrusted himself upright and head butted me, OUCH! That was the first patient, it sort of when down hill from there.

The BMT's are usualy easy, we need to recover them 15 min, then they can go to ambulatory surgery unit. But the T&A, Sinus surgeries, thyroids, all have to stay longer. He does the T&A's and BMT's so fast, that we have kids pulling in every 15-30 min, all day. His last case was at 1730. Mind you, we came in at 0730. His 1730 case has to be one of the mose horrific surgeries I can think off. This gentleman had sleep apnea, so to "CORRECT" it, he not only works on the sinuses, but removes the soft pallet and the hyoid bone - it is a bloody mess and very painful for the patient. Worst of all, it doesn't always correct sleep apnea.

We also had a total lady partsl hysterectomy who came out crying and pleading, needing a PCA, two C-sections, an appy, and a Choley.

We work our tushy's off on Thursdays. We are "suppose" to have two nurses for every child, but we had 3 nurses most of the day, 4 part of the day. That's not enough when it sometimes takes 3 nurses to keep a child safe from themselves. We never get a lunch, so we eat at the desk, I know, break in regulations, but so is starving the staff.

Came home with the worst HA, but at least I have the long weekend off.

Happy Forth everyone

[kmoonshine, RN]

:smackingf

For patient #1: bring in a picture of a severe MRSA skin infection and ask him if he thought the "picture" of the infection would "sting" more than the "sting" he felt with the silver gel. If he says the gel would sting more than the large infection, let him know you'll be following up in a week to see if his growing infection does now indeed hurt less than when the gel was previously applied.

For patient #2: tell the wife that you moisten the dressing first because if you just "rip" it, pus and blood will squirt everywhere -and you didn't want to ruin her nice white sweater. Tell her the "ripping" action aerosolizes the strong odor, and the odor will become permanently embedded in her clothing.

For patient #3: assign jobs to each person ("sir: you tear the tape; ma'am: you hold the gauze; daughter: you guard the door; son: you hold these q-tips; grandaughter: plug in the machine when I say GO"). Make it seem like its a top-secret mission of most utter importance. Pretend you wouldn't have been able to get the job done had they not been there ("oh wow, what would I do if you ALL weren't here to help me?").

Sorry, couldn't help myself

[Simpleplan]

I hope I don't have many days like these. :lol_hitti

[Virgo_RN, BSN, RN]

I took care of a nurse the other day, and in order to remain anonymous I will not post details, just in case she participates here. Let me just say, she monopolized my time with petty requests and was not very nice at all. That was a day that I was glad to see come to an end.