Patient complaint - Did I mishandle this situation?

Nurses General Nursing

Updated:   Published

patient-complaint-did-i-mishandled-situation.jpg.2a35e9b186b19faf11f4a29aff98271f.jpg

So I got my first patient complaint. Without going into much detail, I had a patient who was on IV Morphine q 4 hours. Patient was reporting pain in middle of night. I administer medication to said pt. I check up on patient half an hour later and he is sleeping. 2 hours later, patient is reporting pain again. Patient has order for Tramadol q6 and I offer it to him. Patient states medication doesn't work for him but states they've been giving him Percocet q6h. I check the MAR again and the attending DC'd the order. I explain that to him that order was DC'd. Patient is upset about this but I tell him that I will reach out to Dr. I explain to Dr that patient states tramadol doesn't work for him and had been on Percocet q 6h. On call Dr states they are trying to wean him off the Percocet and told me to have him wait for the morphine. I check on patient again to explain the situation but patient is asleep again. I rounded on patient again when morphine dose was due but pt was still asleep and I didn't even know if he'd want it instead of Percocet so I decide to let him sleep. When patient woke up in morning, I offered morphine again to him but he refused, stating he didn't have pain and didn't want it. I apologized and told him they were trying to wean him off the Percocet, but he told me he was going to write a complaint about me and wants another nurse and refused care from me. I had to get oncoming nurse to administer his morning med and vitals since he refused to allow me to do it. I documented my interaction with the Dr and pt but can't stop feeling like I failed this pt.

1
Up Vote Up Vote ×

Please elaborate on how you think you failed this patient because I’m not seeing it.

40
Up Vote Up Vote ×
7 minutes ago, Wuzzie said:

Please elaborate on how you think you failed this patient because I’m not seeing it.

I feel like I maybe should have woken him up to administer the morphine? I read on here that sleeping is often a coping mechanism for pain. I'm a newer nurse and didn't realize this at the time... I assumed he was comfortable and didn't want to wake him up if I didn't know for sure that he would accept the morphine.

Up Vote Up Vote ×
Specializes in Rehab/Nurse Manager.

Let him write a complaint.  Nothing will come of it, other than hopefully you won't have to interact with him again.  Sounds like he was just upset because he didn't get what he wanted, when he wanted.  The only thing is when he refused the morphine, I might have kept quiet about the Percocet and only have addressed  it or let someone else address it if he spoke of it again.  You did nothing wrong, though.  Some patients are difficult to please

15
Up Vote Up Vote ×
Specializes in Rehab/Nurse Manager.
1 minute ago, lily8424 said:

I feel like I maybe should have woken him up to administer the morphine? I read on here that sleeping is often a coping mechanism for pain. I'm a newer nurse and didn't realize this at the time... I assumed he was comfortable and didn't want to wake him up if I didn't know for sure that he would accept the morphine.

Hard to say. That might have worked or you may have made him angry by waking him up.  I don't really see anything wrong with letting someone rest unless they specifically ask you to wake them up for all pain meds.  

12
Up Vote Up Vote ×
5 minutes ago, lily8424 said:

I feel like I maybe should have woken him up to administer the morphine? I read on here that sleeping is often a coping mechanism for pain. I'm a newer nurse and didn't realize this at the time... I assumed he was comfortable and didn't want to wake him up if I didn't know for sure that he would accept the morphine.

I would never have woken up a sleeping patient and I don’t think you did anything wrong by letting him sleep. He has no grounds for any complaint against you. However, his medical team should have informed him that they are changing his pain management regimen and why. 
 

The moral of the story is, you did nothing wrong, the patient is just blowing hot air, don’t lose any sleep over it. It’s a giant nothingburger. 

32
Up Vote Up Vote ×
12 minutes ago, SilverBells said:

Let him write a complaint.  Nothing will come of it, other than hopefully you won't have to interact with him again.  Sounds like he was just upset because he didn't get what he wanted, when he wanted.  The only thing is when he refused the morphine, I might have kept quiet about the Percocet and only have addressed  it or let someone else address it if he spoke of it again.  You did nothing wrong, though.  Some patients are difficult to please

Yes, that was probably my mistake...I wanted to be honest with him but that was the point when he refused all care from me. I apologized and assured him that he would be getting a different nurse tonight. I only worry that he was in pain for those four hours but every time I went in his room, he was sleeping. Patient was also alert and notified to use call bell if he started to experience pain. 

1
Up Vote Up Vote ×
Specializes in Trauma, Teaching.

So, when he was awake again he said no pain and refused the morphine?  It means he just wanted a percocet, not that he was in pain.

Yes sleep is an escape, but not a peaceful one.  If he was resting quietly, just chart that.  If they change the order without telling him, that's on them.  Next time just say "you need to discuss that with your doctor, the oncall MD wasn't willing to change the order".  Don't put yourself in the middle.

YOU DID NOTHING WRONG, and you certainly did not "fail" this patient.

 

22
Up Vote Up Vote ×
7 minutes ago, Wuzzie said:

I would never have woken up a sleeping patient and I don’t think you did anything wrong by letting him sleep. He has no grounds for any complaint against you. However, his medical team should have informed him that they are changing his pain management regimen and why. 
 

The moral of the story is, you did nothing wrong, the patient is just blowing hot air, don’t lose any sleep over it. It’s a giant nothingburger. 

Thank you for your comment. Last night made me feel like a terrible nurse and have been unable to sleep at all tonight over this... 

1
Up Vote Up Vote ×
Specializes in Trauma, Teaching.
1 minute ago, lily8424 said:

 Last night made me feel like a terrible nurse and have been unable to sleep at all tonight over this... 

There are nasty people everywhere, and you happened to get one as a patient.  Again, you are not a terrible nurse, you did the right thing, and if it hadn't been you it would simply have been a different nurse he was nasty to.  

9
Up Vote Up Vote ×
4 minutes ago, JBudd said:

There are nasty people everywhere, and you happened to get one as a patient.  Again, you are not a terrible nurse, you did the right thing, and if it hadn't been you it would simply have been a different nurse he was nasty to.  

Thank you for your comment. I feel a lot better about this situation. 

5
Up Vote Up Vote ×
Specializes in Rehab/Nurse Manager.
5 minutes ago, lily8424 said:

Yes, that was probably my mistake...I wanted to be honest with him but that was the point when he refused all care from me. I apologized and assured him that he would be getting a different nurse tonight. I only worry that he was in pain for those four hours but every time I went in his room, he was sleeping. Patient was also alert and notified to use call bell if he started to experience pain. 

Nah, I wouldn’t count it as a mistake.  You thought you were doing the right thing by offering him information.  I’ve just found that sometimes it works to not bring up previous issues if the patient doesn’t mention it and doesn’t appear agitated. Sometimes this approach works, other times not so much.  Like others have said, you did nothing wrong.  

4
Up Vote Up Vote ×
+ Add a Comment