First time fired by a patient

Published

Can someone help me out with this one also?

I've been a nurse since 2012, I've worked at my hospital for just about 2 years. This week at work I can't seem to do anything right and it seems like every patient and/or their family members are going nuts.

I was assigned to take care of a post op R hip. I had helped my friend admit her the day before and we were setting up her PCA dilaudid pump and I was talking my friend and preceptee through setting it up. The patient asked if I could lower my voice as she had a migraine, I apologized for my voice and kept it low the rest of the time we were setting it up. By 3pm my friend who had admitted her asked to not have her from the 3-7 shift because she was so anxious and OCD and obsessive. I had her the next morning at 7am. Her BP was low at 86/50. I went in to see her when I was told her BP was low. She had her lights out and the door shut and when I opened the door I turned the side sink light on and she immediately asked me to turn it off as she was having a migraine. I obliged and turned the light off but also informed her that I needed to recheck her BP because it was slightly low. (She had been running low since PACU usually in the 90's/50-60's). She told me that the night nurse had told her that if her BP ran under 90's SBP that the MD should be notified. I told her after I recheck your pressure I will page him. Her BP on recheck was 106/62. I also removed the PCA pump key from her and explained that the dilaudid was probably making her BP low and could be contributing to her head ache and nausea. She was agreeable and I told her we could try some oxycodone instead. I asked if she needed any pain med at the moment and she said no. I left to page the MD and never heard back from him. I went back into the room and told her he had been paged and to ask if she needed anything else. She said no, just shut the door and keep the lights out which I did. She rang her bell and hour later or so to say she had just vomited (this happened the day before also). I went into check on her and checked her BP which was still good 102/54. She asked if I had heard back from the MD and I hadn't so I said I didn't hear from him yet but I can get you some zofran for the nausea. I left and got her AM meds and some zofran and came back. I placed the meds on the table still in their wrappers and she immediately asked me to go pull them again as she was scared of germs and the med wrappers had touched the table. I pulled her meds again and came back and gave her the zofran. I asked her about her pain and she said it was still ok. I also explained that sometimes low BP can cause N/V as well as having an empty stomach. I encouraged her to try some saltines if she wasn't still feeling sick in a little while. I asked her if I could turn the light on to do my assessment and she said yes. I turned the bedside light on and leaned on the rail of the bed to listen to her abd and she said this hurt her head and then asked to speak with the charge nurse and requested a new nurse. I was told she did not like the fact that I was not concerned about her BP and that I hadn't medicated her for nausea (which I did) and that I didn't page the doctor (which I did). I know not to take it personally and that my friend from the day before said she was nuts but it still sucks. Is there anything I should have done differently? I had already paged the MD once and he had not gotten back to me and her pressure had stabilized well. I am totally doubting myself and whether nursing is the right career and all that jazz. Thanks for any input.

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Specializes in Complex pedi to LTC/SA & now a manager.

Be happy she fired you ? If your documentation reflects your assessments, follow up, PRN Zofran, offer of oxycodone and contacts to the physician perhaps just move on. That's what I would do. Your documentation will speak for itself as well as the medication logs.

Sometimes the best action is to walk away and not fret. You can't please everyone

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Specializes in Oncology; medical specialty website.

I'd consider it a blessing. She sounds like one of those patients that few if any nurses can manage on a day to day basis.

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Specializes in SICU, trauma, neuro.

Try not to think of yourself as fired, but as liberated. :yes:

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Specializes in Anesthesia, ICU, PCU.

Yeah I'd be relieved too. Patients like this make me hate my job.

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It's the people who act like that who end up with different nurses everyday - which only hurts their own care. Perhaps the MD could educate her that a systolic BP of over 100 is nothing to page the MD about. I hope your charge nurse backed you up a bit.

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Specializes in Critical Care.

I think most nurses have had this happen to them at least once or twice and usually it is a blessing because the patient was being unreasonable. Sometimes patients just don't like you for no apparent reason and you just have to accept it and let it go. We had a hot potato frequent flyer patient that was difficult to please and argumentative the nurse the night before didn't want the patient back so gave them to me and the patient became upset that I wouldn't cut his toenails and then the patient asked for a different nurse, I was happy to hand him back to the original nurse that had him the night before!

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Thanks guys! I just need to grow some thicker skin I think it just makes you feel like a pile of crap! She and I just weren't going to click and I think no matter what I did she would never have been happy.

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You did everything correctly, and went above and beyond--NOT MANY NURSES (I dunno, maybe it is just no nurse I know) would have actually returned all of the medications just to take them out again because of a germ phobia...

And you did give her zofran, as the documentation shows. And this whole "I have a migrane" thing...SERIOUSLY?!?!?!?! On a dilaudid PCA?! (I would have said that everything was an "allergy" to dilaudid just to add to her obsessions--I am kidding!!) But there's a lot of reasons one could have a headache, so perhaps a migrane med would have helped. But again, you did what you could.

I would be sure that if the MD doesn't call back in "X" amount of time, you ask what it is that you are to do from here. But the MD not calling back is not your fish to fry.

Count your blessings, and be ready to console yet another co-worker who will be fired by this patient tomorrow. Perhaps she should go home with home health--or a private duty nurse of her own choosing.

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Specializes in Med/Surg, Academics.

Agree with the others. As for the "med germs," I would have gathered them all up, charted for 5 minutes at the nurses station, and give the exact same meds again!

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Agree with the others. As for the "med germs," I would have gathered them all up, charted for 5 minutes at the nurses station, and give the exact same meds again!

Yep! Lol

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Specializes in Critical Care, Postpartum.

I had gotten fired once by a really needy patient who didn't care about the great care he was provided. I almost did back flips with joy knowing I wouldn't be his nurse the following day.

I agree your documentation will speak for you.

Sent from iPink's phone via allnurses app

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