postop-wants a private room so i can be his private nurse so we can do private things. he tells me hes rich as though thats going to persuade me. i have one hell of a time getting out of his room because he goes on and on and on. later he tells me he wants morphine because his roomie is taking it and he thinks it might be cool. he suddenly decides hes in pain and i need to find his doc. he falls asleep while i am running a dose of antibiotics iv and when he awakes and hears me in the room he thinks we have changed shifts and complains that the iv has been in his arm "all night"
pt 2 (the roomie)
24 years old. constantly in the hospital for etoh abuse aka "pancreatitis". he was so drunk in the er he fell off his chair and on his face. he was just released last week. hes back. i always get this guy. last admit they gave him a morphine PCA, this time its round the clock scheduled diladid iv q2 with a chaser of ativan. he instructs me on which port to administer them in so he can get the most effective buzz. i comply. its ordered for him, i give it. i dont care.
between the two of them i spend all night in this room.
pt3
in his 50's from italy. broken english. cant understand half of what he says. thinks we are out to get him. says he sat on the bedside commode for an hour and a half the night before because nobody would help him to bed. he can walk. he has been refusing his meds. he swears he got a dose of a steroid he didnt want. the nurse snuck in and injected it in his iv. it made him sick.
hes on a PCA pump but he says he is not getting any of his morphine because the tubing is not taped right. i try to explain that the infusion pump will beep to let us know if its blocked but he doesnt believe me. he tells me he doesnt want me to get in "trouble" and is looking at my id badge. i told him im not worried because i have not done anything wrong. i listen to him rant the same rant again and again. why are his nurses like that? because they are white. ok.
pt 4
she weighs no less than 300 pounds. she is up all night long. at first she is appropriate but that changes. she asks for morphine every two hours as ordered. she knows when its due. i give it to her until she starts losing her grip with reality.
she starts singing my name. she recites the poem "the night before christmas" and sings christmas carols. she sits on the edge of her bed with her gown off. in all her "glory". when she lays down her humoungous butt sticks out. she refuses to be covered.
i ask her if she is looped. she tells me no and falls asleep. i get the pulse ox and try to get her sat. she wont give me her finger. she wants me to beg. i finally get the sat and its 87. i start her on O2. she wont leave it on. "it itches my nose". i continually go in her room and make her keep it on. its now a game. i try to get another sat rate and we play the "no finger for you" game.
if i leave the room and she sees someone go by she sends them to get me. "i dont feel good" no i guess not. leave your oxygen on and you will feel better. "it itches my nose" off it goes.
we did this for hours. when i was going home she was sitting on the edge of the bed, hanging out all over and crying, begging me not to leave.
i had three other patients but i didnt get to see too much of them. unfortunately for them, they were normal.
i couldnt wait to get the hell out of there this morning...lol
i wish i could say this was an unusual assignment, but it wasnt.
"Crumping" or "crumped" is a term commonly used to describe a patient who just plain went bad (at least in my unit)..."He crumped and we had to intubate." So the Unit itself was crumping that night...
Good for you, you survived, the typical night shift. just the other night had one guy on hourly injections of morphine, he sets his watch to alarm every hour so he doesn't sleep through a dose, got a 15 year old who decides he is gonna sign himself out and punches the orderly in the nose, got 2 pshych pt's in the same room one with diarrhea that she thinks is a punishment that her roomate has inflicted on her and the other a schizo who swears she doesn't hear voices but can't stop talking to the wall, and thinks her call bell is God talking to her each time she rings, in the other room 2 little old ladies that think they have come to the hotel, and they will speak to whomever is in charge in the morning because they can not get their rest with the other pt.'s making noise and when they are quite the nurses keep waking them for IV antibiotics, vitals etc... How inconsiderate. Know where your coming from, glad you can laugh about it and give us all a laugh as well.:)
psych patients are the creepiest to me because their distortion is their reality and you are forced to step in that. when i am giving care to them i feel like im drifting somewhere in between.
but your patients sound like our general fare on the "med/surg" unit
We have had patients call the hospital operator. One night an elderly male patient choked on a pill. After he swallowed it he still had that lump in your throat feeling. He was talking fine, pink, warm, & dry. We just encourgaged him that things were okay. Well, he called the hospital operator and told her that he was choking on a pill and none of the nurses gave a"s*it." The operator called us and told about his phone call. The man had O2 sats in the 95 range. The doctor got a kick out of it.
I had a pt once poop in his empty water glass and proceeded to place the cup back on his lunch tray. Fortunately, one of the nurses caught it before it went down to the kitchen. We were impressed that the man didn't make a mess!
I still have trouble believing this but I was told about a young (20's) male patient, a new admission to our Med-Surg floor who puked, peed and pooped in his urinal, then handed the vile mess to his nurse! (I'm new here and I hope it's okay to use those words-- "vomited, urinated and defecated" just didn't seem as funny.) I just marvel at such terrific aim!
After going back and reading all the posts, I'm reminded that my recent mantra at work has been "On admission, all patients should be ordered a mandatory psych consult!" I cannot beLIEVE the "issues" we have to deal with with most patients anymore... YIKES!
I believe you. I have residents who think the nursing home is a hotel and they come and go at will. When they return and I have to be their nurse I think the same thing, "I always get this person" and usually it is someone who is very noncompliant to anything I want them to do.
What a night for you...maybe tonight will be better!?!
It wasn't a full moon, was it?
Jane Ann
When you are 80 years old and you no longer have your own place, and the only place you can call home is a nursing home, then I hope you come and go as you please and I hope that you do what you want. Life is short, and it sounds like you dont really care much about your residents. And yes, a nursing home should be like a hotel, people pay lots of money to live there, and they also pay your salary. Your attitude is kind of annoying, and I only hope that when you wrote this note, you were having a bad day...........Your residents could be your grandparents, parents or you!!!!!
eg-i really take exception to your above post. i think you are quick to judge someone you dont know based on an internet post. hardly seems fair.
secondly,
its a sad thing that people in their old age end up in nursing homes. but i think you might agree that there is a need. if the residents are well enough to come and go at will then i would think there is little need for them to be in a nursing home. i am in no way implying that the residents need be treated as inmates, but i am saying that you have to know that there HAS to be rules and regulations for the residents own safety.
please correct me if i am wrong but it seems to me you are saying because they pay big bucks to live there they should be permitted to do as they please. if this is your reasoning then why dont they just move into a hotel? room service, cleaning, come and go as they please, all the frills. they dont do this probably because they arent well enough.
there are so many issues with the elderly. i think it would be the hardest thing in the world to realize you have to give up EVERYTHING you have and everything you are because you cant care for yourself any longer. these people need a little extra special care, there is no question of that.
however, this makes caring for these people all the more difficult. i see nothing wrong with blowing off steam here. what i do see wrong is attacking someone you dont even know based on YOUR perception of their attitude.
lets not do this to each other. you are right, life is short.
My last night in th er was a doozy,not to mention all the usual stuff, but with 2 gsw head wounds,with a GCS no greater than 6. A closed head injury with a GCS of 8. Then I get in via the fire dept a pt that they wheeled over from the nursing home in his bed. because he weighed over 600 lbs and they felt that was easier then managing somehow to get him the ambulance. Thing is the nursing home is half a mile away.Would have loved to see them pushing him down the middle of the street.
I once had a COPD with oxygen by nasal canula who decides that quitting smoking was not in her immediate plan, even if she were in ICU. So, she lights up... and the unthinkable happends... 2nd degree burns of both nostrils!!!!
I think that I have taken care of ALL these people! They must hospital-hop!
To add: had a spanish only confused lady, very angry, walking into other people's rooms. Not only could I not understand what she was saying, she was trying to hit me. Got one of the aids who speaks spanish, and I was informed that she was looking for her husband who, having run off with the neighbor lady, was in one of these "cantinas" getting bombed! Had to call security.
Had a druggie in er...kept threatening to leave but had admitted to being suicidal so we can not let her go without psych eval. Go into her room, and she is not there! We search the entire er...no druggie! Found her in the cabinet under the sink in her room. "why are you in there?" answer: "wanted to see if I could fit":(
Had a family member (I'm a hospice rn!) (not me--her)walk into dad-in-laws room right after an unsuccessful ng attempt..screaming.."did you premedicate him for that! Can't you see he's in pain? For this kind of pain HE NEEDS MORPHINE!!!" The patient hadn't said one word to me in the last two hours about being in any pain. I got written up for having a "flippant attitude" Also got screamed at by the son (I want who ever's in charge in here RIGHT NOW!! ) Of course the patient just lays there, and lets them both rant. He reminded me of patients who call for every little thing, and then just as you are about to move the curtain to bring them whatever, you hear them on the phone to relatives saying "No one has been in here ALL DAY! (sob), I've tried to call and call and no one comes!" I was nine months pregnant , and got called into a room to retrieve a roll of mints that had been dropped and had disappeared under a patients bed.
and even worse is when the family member calls to complain about you not being in there ALL day. ever have a patient call the operator to get you into their room?
this galls me to no end.
i can take only so much of that crap. if i were you and they asked me to look under the bed for mints, id bend over, say "i dont see them" and leave.
Good for you, you survived, the typical night shift. just the other night had one guy on hourly injections of morphine, he sets his watch to alarm every hour so he doesn't sleep through a dose, got a 15 year old who decides he is gonna sign himself out and punches the orderly in the nose, got 2 pshych pt's in the same room one with diarrhea that she thinks is a punishment that her roomate has inflicted on her and the other a schizo who swears she doesn't hear voices but can't stop talking to the wall, and thinks her call bell is God talking to her each time she rings, in the other room 2 little old ladies that think they have come to the hotel, and they will speak to whomever is in charge in the morning because they can not get their rest with the other pt.'s making noise and when they are quite the nurses keep waking them for IV antibiotics, vitals etc... How inconsiderate. Know where your coming from, glad you can laugh about it and give us all a laugh as well.:)
Zee_RN, BSN, RN
951 Posts
"Crumping" or "crumped" is a term commonly used to describe a patient who just plain went bad (at least in my unit)..."He crumped and we had to intubate." So the Unit itself was crumping that night...