Any other cold hearted nurses out there?

[sweet~revenge]

Anybody else feel like you're just not as caring and compassionate as other nurses? I think of myself as a caring nurse and I try to do the best I can by my patients. I love it when I leave at the end of a shift and I feel like everything was done well and my patients were well taken care of. However, I've been in some situations where I don't seem to be as sensitive as some of my coworkers when dealing with patients.

For example, one day another nurse needed to place an ng tube on a very confused patient with a bowel obstruction who was not very cooperative. Knowing he was going to be resistant, she asked for help from me and the charge nurse. She premedicated him with iv valium, we went in and his nurse tried to do it the nice way with the patient's cooperation but of course he fought us. Then we finally did it the way I would have done it from the start, which of course involved 4 of us restraining this very strong combative confused man while one of us inserted the ng tube. By the time we hooked him up to suction, it was really obvious how much he needed it.

Afterwards, the charge nurse and the other nurses were all saying how much they hated having to do that and just basically talked about how bad they felt for doing that to him. A new nurse who was there and just wanted to observe was horrified and is probably traumatized for life. Meanwhile I didn't get it. We did what had to be done and the patient was better off for it. If anything, I felt a sense of satisfaction and accomplishment. Am I some sort of unfeeling freak of nature or what? This is just one example of this where I feel like the odd woman out. Does anybody else have this problem?

[martymoose, BSN, RN]

Well, if someone is hypotensive or respirations are too low, by all means hold the pain med. But it's not okay to hold an ordered PRN medication because you feel the pt "doesn't need it". That is not a nurse's call to make. If you're going to refuse to give an ordered PRN medication, you'd better have solid, objective data backing it up. If a medication is ordered and the pt can clearly tolerate it, why even waste your time and energy resisting it?

Oh, I always give it, no problem.I just monitor them more closely, that's all.

And I figure, they will go home eventually.

[J.R.theR.N2b]

i was not aware that this was a vent thread for nurses and i humbly apologize for disrespcting nurses. my only real contact with nurses as a patient occured in 1995 when i underwent cardiac bypass surgery. every nurse i had during this hospitalization were indeed "angels of mercy", so i have no real reason for any feeling other than admiration for what nurses provide on a daily basis. so please accept my apology. as i indicated in my earlier post i have some very deep anxiety problems with some medical procedures that i know i could not without sedation. i cannot specify what type of sedation as the only requirement is that i be unaware of the procedure while it is occuring. my biggest issues are with restraint and being held down for any procedure i do not consent to. other procedures which i have anxiety problems are nasogastric tube insertion, foley catheter insertion, and intubation. i have underwent 3 cardiac caths and the only problems i encountered were with the bedrest afterward. i cannot lie still and not move my legs nor raise my head. i mentioned this to my cardiologist after the last cath and she told me to remind her if i ever need another and she will prescribe a sedative for me. i do not wish to be an uncooperative or combative patient, nor want to refuse any procedures recemmended by whatever physicians are treating me, but i am fully aware of what i can handle and that i must be sedated before some procedures can happen. so i guess the first step is to calmly and rationally inform my nurses of my problems so they, together with my doctors, can decide on a solution suitable to them and me. thank you again and please accept my apology. i will gladly answer any and all questions anyone may have either here or in a private message. again thank you all.

[Ruby Vee, BSN]

i was not aware that this was a vent thread for nurses and i humbly apologize for disrespcting nurseshospitalization were indeed "angels of mercy", so i have no real reason for any feeling other than admiration for what nurses provide on a daily basis. so please accept my apology. .

Apology accepted.

[CrunchRN, ADN, RN]

JR - it is great to let people know your special needs and they should be provided as much as safely possible. This was just the wrong thread for it. I thought your apology was very sincere and classy. Some day you will probably start your own thread like this :).

[monkeybug]

Just a question Monkeybug,, just curious? Do you work in pain management, or have you had pt's who are like the one described above ,especially for 8 hours a day?

I have had some of the patients as described. One can't help but group them together, and I as a chronic pain person, get so angry because these types of people ruin for others who have pain.

I don't think it's coincidence that some pts who are chronic"drug seekers" are totally mismanaged to the point that they are addicted, and yes, the doc gives them what they want, and we have to deal with the aftermath- low b/p's ,falling, decreased respirations, etc. Funny how a lot of these people always want phenergan with their 4 mg of IV dilaudid( and these are not post op or CA pts), and spend their whole time in the hospital as a zombie. Oh, but any other antiemetics will not do- it has to be phenergan- .and we all know what phenergan does....

And of course there's the other side of the coin, the doc who will not prescribe the narcs that the pt wants. Again we deal with the after math, which I'm sure I don't have to explain here.

After a few experiences of the above described over the years, yeah, sometimes one can get cold.

I have chronic pain. And I rarely ask for narcotics from doctors or nurses that don't know me extremely well, because of this attitude. If I go to the ER for a particularly bad episode, I ask for non-narcotic IVs. And in that, I've seen the "attitude" come out in full force. I've had a nurse say, "We were just talking about you at the desk, we know you aren't seeking!" Was this supposed to make me feel better? What it did was assure me that I should never ask for narcotics because I was basically told what would be thought of me if I did. And why ask for phenergan? Because if potentiates narcotics and makes them work better.

I think every nurse, no matter their area, deals with people at some point that we may suspect of seeking. I would rather medicate a seeker to their heart's content than risk having a patient in real pain go untreated (or made to feel guilty for asking for the medications they really need). Just to fulfill the curiosity, I worked for over a decade in Maternal Child. Lots of narcotic dispensing going on there, and plenty of encounters with people with drug issues.

[BrandonLPN, LPN]

Yes, giving a drug seeker the meds he desires is the lesser of two evils when the alternative is failing to medicate someone who needs it. I don't care how much experience you have, you don't always "know" when someone is faking it. I went to the ER for a full blown kidney stone attack. I was very stoic and was 100% alert and composed. My vitals were even WNL. But, trust me, I needed that morphine. Don't tell me someone in extreme pain will always show objective symptoms, cause this is just not true.

[Susie2310]

Somebody who is not competent may not be able to refuse and implied consent or consent from their POA would rule the day.

If 4 nurses pinned me down to keep me safe and provide quality care when I was temporarily unable to think clearly (anesthetized, delirious, or whatever) I would buy them all beers later.

Yes, I agree with your point about the need to keep the patient safe and provide quality care in situations where a patient is temporarily unable to think clearly (anesthetized, delirious, etc.).

Something to keep in mind though, and I am writing this generally and not directing it at you specifically, is that a patient's refusal of a procedure does not necessarily imply the patient is incompetent. Patients who are competent have the right to refuse care for any reason, and to provide care against their wishes is to commit battery.

[Susie2310]

i was not aware that this was a vent thread for nurses and i humbly apologize for disrespcting nurses. my only real contact with nurses as a patient occured in 1995 when i underwent cardiac bypass surgery. every nurse i had during this hospitalization were indeed "angels of mercy", so i have no real reason for any feeling other than admiration for what nurses provide on a daily basis. so please accept my apology. as i indicated in my earlier post i have some very deep anxiety problems with some medical procedures that i know i could not without sedation. i cannot specify what type of sedation as the only requirement is that i be unaware of the procedure while it is occuring. my biggest issues are with restraint and being held down for any procedure i do not consent to. other procedures which i have anxiety problems are nasogastric tube insertion, foley catheter insertion, and intubation. i have underwent 3 cardiac caths and the only problems i encountered were with the bedrest afterward. i cannot lie still and not move my legs nor raise my head. i mentioned this to my cardiologist after the last cath and she told me to remind her if i ever need another and she will prescribe a sedative for me. i do not wish to be an uncooperative or combative patient, nor want to refuse any procedures recemmended by whatever physicians are treating me, but i am fully aware of what i can handle and that i must be sedated before some procedures can happen. so i guess the first step is to calmly and rationally inform my nurses of my problems so they, together with my doctors, can decide on a solution suitable to them and me. thank you again and please accept my apology. i will gladly answer any and all questions anyone may have either here or in a private message. again thank you all.

J.R.theR.N2b, I do not believe you need to apologize for disrespecting nurses. I personally do not consider what you wrote disrespectful. allnurses is a public web site, and whilst it is a site for nurses it is also read by and contributed to by nursing students, future nursing students, unlicensed care givers, and the general public. I am an RN and I was happy to read your post. I felt you made perfectly valid points. I appreciate hearing the point of view of patients and family members.

[DroogieRN]

I've been a nurse three years, but I am 48, so I have life experience to add to many situations. I don't have trouble dropping a difficult NG that may cause discomfort immediately but ultimately is for the patient's benefit. Doesn't even make me blink. I do struggle sometimes with intervention after intervention on a septic 90-year-old full code patient, because I genuinely believe they are suffering and I feel like I am only adding to it, when I think treatment should be withdrawn and they should be allowed to pass peacefully. And I have to squelch down my disdain about the 45-year-old 4-day post-op belly who won't even reach for his water glass and moans for Dilaudid Q1H when I have a World War II vet in the next bed who is eager to walk and get up after his thoracotomy and has taken only Tylenol because, after all, "well, I figured it would hurt, but lying around isn't going to get me better." As nurses, we can feel, or not feel, whatever we want about patients. No one can say any feelings are "right" or "wrong.". What matters is how we care for them.

[Esme12, ASN, BSN, RN]

i was not aware that this was a vent thread for nurses and i humbly apologize for disrespcting nurses. my only real contact with nurses as a patient occured in 1995 when i underwent cardiac bypass surgery. every nurse i had during this hospitalization were indeed "angels of mercy", so i have no real reason for any feeling other than admiration for what nurses provide on a daily basis. so please accept my apology.

as i indicated in my earlier post i have some very deep anxiety problems with some medical procedures that i know i could not without sedation. i cannot specify what type of sedation as the only requirement is that i be unaware of the procedure while it is occuring. my biggest issues are with restraint and being held down for any procedure i do not consent to.

other procedures which i have anxiety problems are nasogastric tube insertion, foley catheter insertion, and intubation. i have underwent 3 cardiac caths and the only problems i encountered were with the bedrest afterward. i cannot lie still and not move my legs nor raise my head. i mentioned this to my cardiologist after the last cath and she told me to remind her if i ever need another and she will prescribe a sedative for me.

i do not wish to be an uncooperative or combative patient, nor want to refuse any procedures recemmended by whatever physicians are treating me, but i am fully aware of what i can handle and that i must be sedated before some procedures can happen.

so i guess the first step is to calmly and rationally inform my nurses of my problems so they, together with my doctors, can decide on a solution suitable to them and me. thank you again and please accept my apology. i will gladly answer any and all questions anyone may have either here or in a private message. again thank you all.

It is not a thread just for nurses only....all thread are open to members of AN to comment on and give their point of view. nurses view having to do procedure to patients that are unpleasant....but we realize that the benefit far out weighs the risk and discomfort. We get no pleasure out of hurting patients and yes some people have more issues than others in tolerating things.

You are very fortunate that your physician recognizes your needs and medicates accordingly. Nurses do not hold down patients down to perform procedure that patients do not consent for unless they are a danger to themselves or others.

I wish you the best.:)

[healthstar, BSN, RN]

The NG tube is the best thing that ever happened to him! With a bowel obstruction he would be nauseated and vomiting, throwing off the electrolytes - this is the worst feeling! Even the zofran, phenergan can't help! ! I have placed so many NG tubes due to an ileus and obstruction and I have enjoyed putting them in, I knew that my pt would feel so much better afterwards, except the irritation of the throat . I am not cold hearted at all! I care too much, I am very sensitive, any kind of story ( happy and sad) make me tear up----this is my weakness as well as my strength. I wish I didn't care way too much . I had a hard time separating work from home! I would think about my pts all the time! Especially the Codes!

[J.R.theR.N2b]

the following comments are for esme12 and anyone else kind enough to comment on my earlier post. last monday afternoon i had an appointment with my long time primary care physician and asked him if he might prescribe a tranquilizer for me to combat anxiety and restlessness interfering with sleep. he asked if anything was occuring that necessitated my need for this? i then reminded him of my anxiety concerning possible needs of medical procedures which i feared my problems would interfere with. procedures such as urinary catheterization, nasogastric tube insertion, and intubation. i also informed him of my inquiries on this forum and my asking about the possibility of being sedated to enable me to tolerate same, and my disappointment that the only answers provided me were that sedation was out the question for such minor procedures. he explained to me that the protocol used in carrying out of medical procedures are based on years of experimentation and research, which yield the safest ways of getting these things done. he advised me that what i needed to do when faced with the need of one of these procedures was to calmly and rationally explain to my nurse that i cannot tolerate this without being sedated, who would inform the ordering physician, who if he/she felt it necessary would discuss alternatives, if any, with the patient, but that the physician and only the physician could order the sedation requested. this is why the nurses on this forum do not talk about the possibilities of sedation for any procedure which it is not a routine part of. he did assure me that noone will ever force any procedure on me that i have specifically refused as long as i am competent and rational. he left me with his expert medical opinion that if a patient refuses insertion of an urinary catheter without prior sedation, as long as the physician feels the catheterization to be absolutely necessary that sedation would most likely be ordered. i again wish to thank all of you for allowing me to use this thread to explain my anxieties and promise not to intrude on this thread again.