I am both asking for advice and getting this off of my chest. I am an rn on a med surg floor. First, let me start off by saying I am a pretty good stick when it comes to iv's. I would say 90% of the time, I get an iv within 2 sticks- typically one though. That being said, no one is perfect.
Long story short, I had a patient getting 8 iv meds back to back. So I explained to the patient that he would benefit from having two iv's. Unfortunately, I did not get it on the first stick. This man went crazy.
He told me that I would not stick him again because I was clear that I havn't found a good vein. That, I just did not know what I was doing. He said "I don't know what kind of game you are trying to play but you have no idea how to do this and I want a nurse that does." .........I was literally speechless. I simply left the room.
Of course, I have replayed the situation over and over and each time I have a clever response that puts him in his place without getting me fired. But what would you have said/ done?
He then questioned my credentials each time I reentered the room which is just down right disrespectful. Any advice for next time? (Other than get the dang iv on the first sticky lol)
You have a bigger fish to fry with publically declaring needing to find a way to put a patient in his place. He may have been out of line but I think you are too- more so because you are the professional and care giver.
I disn't declare that I needed to find a way to put him in his place. I just asked what others would do in that situation. But thanks for your reply. I did ask another nurse to take over the iv, I didn't even try to stick him again. Ultimately, he refused a second iv, I documented that, and moved on.
Sir, regardless of what you may have concluded, I am very skilled at starting IVs... I've done it thousands of times. If you'd really like, I can try to find someone else to come take a look but the truth is that nobody here is any better at it than I am. It is your choice, though.
For these reasons xxx, yyy, and zzz, it would really be in your best interest to let us start another line so that we can give you the medications more rapidly but the choice is, of course, entirely yours. You are the boss and I'm simply doing the best I can to help you in as timely a fashion as possible.
I get that it hurts, I really do. I let medical students and nursing students practice on me precisely to help me remember just how unpleasant it can be. I promise you, I won't stick you unless I feel pretty strongly that I will get the. Unfortunately, it's not something I can guarantee.
How 'bout it?
Here's the thing, though... 8 meds that were "STAT." I'm guessing that they're all ordered STAT by default because I can't imagine a m/s level patient needing 8 meds that quickly... even the most unstable ED patients are very rarely that time critical. If they do need that then they probably need a triple-lumen CVC.
I presume some of those were IVP meds. If that was the case I would simply have stopped the piggybacks long enough to give the push meds and then prioritized the remainder.
Regarding the disrespect... I don't care much what the patient's think so long as I'm sure of my skills, my decisions, and my manners.
I disn't declare that I needed to find a way to put him in his place. I just asked what others would do in that situation. But thanks for your reply. I did ask another nurse to take over the iv, I didn't even try to stick him again. Ultimately, he refused a second iv, I documented that, and moved on.
Yes, you did. From your first post.
Quote
...Of course I have replayed the situation over and over and each time I have a clever response that puts him in his place without getting me fired...
Specializes in Psych, Addictions, SOL (Student of Life).
I think until you have been a patient (and I mean a patient)you don't really know just how scared and frustrated a patient can be. I was very sick for almost 2 years and ultimately had 18 inches of my l removed during the hospitalization for my surgery I had to have several IV starts and my veins all crapped out and for some unholy reason the doctor would not consider a PICC. I had multiple nurses from all over the hospital try. I managed to take it with a sense of humor though. I had husband bring a big box of Hershey bars and I let it be known that the nurse that got the stick would get a candy bar.
After all the things I've been through I seriously try not to let people rent space in my head - I don't stew over stuff like this because it's just not important.
Specializes in Flight Nursing, Emergency, Forensics, SANE, Trauma.
I tell my unruly patients from the get go-- I will fight for you, I will bend over backwards for you, I will do everything in my power to help you. What I expect is respect back when I give it to you. I don't want deference, that's not what this is about. Nursing is a partnership entered into by the nurse and patient.
Respect needs to flow both ways. But when my patients mistreat me or other staff members, I remind them of this partnership. Often in the ED we get overdoses, drunks, psychs, or patients who are non compliant with treatments and get sicker as a result.
I am nice as pie at work. I'm a multiple award winning nurse because of this. But I will not tolerate rudeness and disrespect to any team member trying to help.
I will break out the serious nurse voice when the patient becomes agitated and belligerent and inform them I am there to help them. I am not there to hurt them. I am not there to cater to them. I am there to help them heal and recover.
I don't know where this idea that it is ok to treat healthcare workers so badly comes from. But anymore I stopped tolerating it. I won't raise my voice or degrade a patient. But they will get the riot act read to them. "If you want my help, which you obviously do if you came in to the ED today, I strongly advise you reconsider your tone and choice of language with me. I will not tolerate being cursed at, threatened, or insulted. I will not hesitate to contact security. Now, if you want to stop this now, take a second to recollect yourself, I'd be very happy to move forward with caring for you"
You have a bigger fish to fry with publically declaring needing to find a way to put a patient in his place. He may have been out of line but I think you are too- more so because you are the professional and care giver.
If I remember her correctly she said she was only thinking about it, not actually doing it. I have done this many times, its human and professional that she didn't say it out loud.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Mrs.in2015 said:
Of course I have replayed the situation over and over and each time I have a clever response that puts him in his place without getting me fired. But what would you have said/ done? He then questioned my credentials each time I reentered the room which is just down right disrespectful. Any advice for next time? (Other than get the dang iv on the first sticky lol)
If he made the one remark, I would figure that a certain percentage of people are going to say things like that. Sometimes their outburst is about frustration with the hospital scene in it's entirety, and we're usually on the front lines when it boils over.
Since he escalated in the form of questioning your credentials every time you walked in the room it would be time to have a neutral party come and talk to him.
You have a bigger fish to fry with publically declaring needing to find a way to put a patient in his place. He may have been out of line but I think you are too- more so because you are the professional and care giver.
Personally, I don't understand what the problem is. I see a need to grow a thicker skin because if the OP got so upset over this what would they do if someone got REALLY disrespectful.
As for IV's, it's not pleasant being being stuck over and over again and maybe the patient thought that would happen after she missed the first try.
Some people here need to put themselves in the shoes of a sick and already stressed out patient and stop making it about themselves and their hurt feelings over some perceived slight from a patient.
When someone needs 8 IV meds back to back- I am thinking this person is on the more 'ill' end of the scale.
I am also thinking that this person is likely scared, wrung out physically and emotionally from getting to their current state.
They may even be a real tool in a healthy state.
My reaction to your post tanked at the words 'put him in his place without getting fired'.
I went straight to the thought of a medical professional demeaning or degrading or punishing the patient with words because they have been offended.
I get you were insulted by him by his words particularly with challenging your credentials and skills.
It may have been the better choice to have completely removed yourself from his care as soon as possible ( likely easier said than done).
I have had a family member be on the receiving end of 'being put in their place' verbally by a nurse. The family member was a tough cracker to deal with but they did have intense medical and mental issues but where a vulnerable adult none the less.
This is the internet, what you are saying can be heard different ways. That is what I heard.
I think until you have been a patient (and I mean a patient)you don't really know just how scared and frustrated a patient can be. I was very sick for almost 2 years and ultimately had 18 inches of my l removed during the hospitalization for my surgery I had to have several IV starts and my veins all crapped out and for some unholy reason the doctor would not consider a PICC. I had multiple nurses from all over the hospital try. I managed to take it with a sense of humor though. I had husband bring a big box of Hershey bars and I let it be known that the nurse that got the stick would get a candy bar.
After all the things I've been through I seriously try not to let people rent space in my head - I don't stew over stuff like this because it's just not important.
Hppy
I would have gotten that Hershey bar! Not because I'm so awesome, I just love chocolate (and rewarded challenges that much!)
Mrs.in2015
31 Posts
I disn't declare that I needed to find a way to put him in his place. I just asked what others would do in that situation. But thanks for your reply. I did ask another nurse to take over the iv, I didn't even try to stick him again. Ultimately, he refused a second iv, I documented that, and moved on.