Frustrated with neighbors

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My neighbors are really since people, and very helpful; They are sweet-hearts. However, since I became a nurse, there have been several occasions when they have asked me for medical advice. A few times, just typical stuff, like when are immunizations due for their kids, etc etc. Once when their son had cut his foot, cleaned and dressed it-and told them to follow up with their family docotor ASAP(which they did). But my big issue is this; i always feel like they expect me to come in and "fix" everything-maybe they have a lot of faith in me, I dunno. But one thing that I feel very bad about, is that I do what I can, but always, always always explain to them that I am a nurse; i can only do so much-assessment mostly, and always always always tell them to go to their doc/ED.

I am especially cautious because of this; the woman-40ish-has some pretty serious heart problems. She has a stenotic Aortic Valve, Mitral Valve prolapse with 70%(?) regurg, and has runs of Vtach (which she valsalva's to control). She is supposed to have surgery but is refusing it (lots of denial here)-she says that she'll have it when she's "sick". So, lastnight at midnight, there's a pounding on our door, and my dh answers it. Upstairs I hear "hear thing" and "blood pressure"-it's her husband, she's having problems. So I am up and over there-thinking that they did not call 911 because they don't want anothr ED bill this month. I get over there, she's in bed, covered with blankets. She tells me that she felt prefectly fine until she turned to her left side, and then she felt severe left sided pain, and her "heart beat racing thing" started, which she valsalva'd and stopped. She is waxy, c/o radiating back pain, numb fingers, chills, and nausea. Her B/p is 125/75 (she usually is about 90/60); her around 100; she has no audible s1, s2-just what sounds like ocean waves sloshing around. I try to explain that I don't really know her baseline, so I can't tell what, if anything, is abnormal. The whole time, I keep saying, I'm a nurse not a doctor, I really think that with your history of heart problems, that if you don't feel better soon, you should go to the ED-I can't really diagnose anything, I am not a doctor, but I will watch your kids for you if you decide to go. I don't know if I scared her or what, but they went to the ED. She had an abnormal EKG, but they only ran one set of enzymes, they did a CT scan, and by then she was vomitting repeatedly. No real outcome or diagnosis. They sent her home the next am with directions for her to follow up with her cardiologist.

But when I went to check on her the next day, I really felt like they were disappointed-not in a mean or even obvious way, it was subtle, more like a:stone "why did we ask you for help when you didn't really do anything like we hoped you would" kind of way. They weren't mean or anything, I just felt like they asked me to come over to try and AVOID going to the ED. I just feel bad, but if I had to do it over, I'd do the same thing. I just hate feeling like I disappointed these people, they are super-nice, and rooted me on the whole time I was in school. I really want to be helpful-but I know my limits, both scope of practice-wise and legally. Any hints?

(EDITED for spelling)

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My neighbors are really since people, and very helpful; They are sweet-hearts. However, since I became a nurse, there have been several occasions when they have asked me for medical advice. A few times, just typical stuff, like when are immunizations due for their kids, etc etc. Once when their son had cut his foot, cleaned and dressed it-and told them to follow up with their family docotor ASAP(which they did). But my big issue is this; i always feel like they expect me to come in and "fix" everything-maybe they have a lot of faith in me, I dunno. But one thing that I feel very bad about, is that I do what I can, but always, always always explain to them that I am a nurse; i can only do so much-assessment mostly, and always always always tell them to go to their doc/ED.

I am especially cautious because of this; the woman-40ish-has some pretty serious heart problems. She has a stenotic Aortic Valve, Mitral Valve prolapse with 70%(?) regurg, and has runs of Vtach (which she valsalva's to control). She is supposed to have surgery but is refusing it (lots of denial here)-she says that she'll have it when she's "sick". So, lastnight at midnight, there's a pounding on our door, and my dh answers it. Upstairs I hear "hear thing" and "blood pressure"-it's her husband, she's having problems. So I am up and over there-thinking that they did not call 911 because they don't want anothr ED bill this month. I get over there, she's in bed, covered with blankets. She tells me that she felt prefectly fine until she turned to her left side, and then she felt severe left sided pain, and her "heart beat racing thing" started, which she valsalva'd and stopped. She is waxy, c/o radiating back pain, numb fingers, chills, and nausea. Her B/p is 125/75 (she usually is about 90/60); her around 100; she has no audible s1, s2-just what sounds like ocean waves sloshing around. I try to explain that I don't really know her baseline, so I can't tell what, if anything, is abnormal. The whole time, I keep saying, I'm a nurse not a doctor, I really think that with your history of heart problems, that if you don't feel better soon, you should go to the ED-I can't really diagnose anything, I am not a doctor, but I will watch your kids for you if you decide to go. I don't know if I scared her or what, but they went to the ED. She had an abnormal EKG, but they only ran one set of enzymes, they did a CT scan, and by then she was vomitting repeatedly. No real outcome or diagnosis. They sent her home the next am with directions for her to follow up with her cardiologist.

But when I went to check on her the next day, I really felt like they were disappointed-not in a mean or even obvious way, it was subtle, more like a:stone "why did we ask you for help when you didn't really do anything like we hoped you would" kind of way. They weren't mean or anything, I just felt like they asked me to come over to try and AVOID going to the ED. I just feel bad, but if I had to do it over, I'd do the same thing. I just hate feeling like I disappointed these people, they are super-nice, and rooted me on the whole time I was in school. I really want to be helpful-but I know my limits, both scope of practice-wise and legally. Any hints?

(EDITED for spelling)

I learned my lesson with my neighbor lady. She was about 584 years old, COPD, and CHF. She would call me daily, ... "I can't breathe!" Daily I would run over there, give her an SVN tx and she was fine.

One day I wasn't home and she called. Left a message saying she couldn't breathe... She dialed 911. Paramedics knew her well. They would drive up to her home, honk their horn and that was my message to run my butt over there. Usually all she needed was an SVN tx. My fire station is *the* busiest in Phoenix. Phoenix is HUGE. They wanted me to sit and hold her hand because honestly, they couldn't.

Well, she called me c/o SOB. I wasn't home. She died.

Refer everyone such as this to ER and walk away. Literally, WALK AWAY.

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Specializes in Med/Surg, Ortho.

Dont be the hero. Simply put,, call 911 for them and get her the attention she needs that you cant give her. And tell them that.

If bills are a problem, there are plenty of places they can go for help if they need it.

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Specializes in Critical Care, Pediatrics, Geriatrics.

you certainly did more than what i would have done. When I first started nursing, I wanted to hear everyone's medical problems and what their docs were saying to sort of "test my knowledge." It was fun...never offered any medical advice mind you, but found my growing knowledge encouraging.

Now I get questions all the time from family members..."what do you think this could be, should i see a MD, is there anything OTC i can take for such and such..." It is annoying and does step on those legal/ethical boundaries.

For the most part, I think they ask because they admire my knowledge, they don't understand the difference in nursing and MD (legalities/scope of practice/depth of knowledge/roles), and sometimes they already have their mind made up anyway and are looking for reassurance...

This is probably what your neighbor wanted...in denial about dx and wanted your "second oppinion" hoping you would say she was fine so she could skip out on the next expensive MD/ER visit. You did fine. Perhaps, bring a "hope you feel better gift" and explain to her that you wish you could do more, but you are simply not allowed/trained/skilled (however you think she would tolerate best) to do so. Be nice but be firm. Draw that line.

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asoldierswife05 said:
you certainly did more than what I would have done. When I first started nursing, I wanted to hear everyone's medical problems and what their docs were saying to sort of "test my knowledge." It was fun...never offered any medical advice mind you, but found my growing knowledge encouraging.

Now I get questions all the time from family members..."what do you think this could be, should I see a MD, is there anything OTC I can take for such and such..." It is annoying and does step on those legal/ethical boundaries.

For the most part, I think they ask because they admire my knowledge, they don't understand the difference in nursing and MD (legalities/scope of practice/depth of knowledge/roles), and sometimes they already have their mind made up anyway and are looking for reassurance...

This is probably what your neighbor wanted...in denial about dx and wanted your "second oppinion" hoping you would say she was fine so she could skip out on the next expensive MD/ER visit. You did fine. Perhaps, bring a "hope you feel better gift" and explain to her that you wish you could do more, but you are simply not allowed/trained/skilled (however you think she would tolerate best) to do so. Be nice but be firm. Draw that line.

Actually, Marie (the REALLLLLLLLY old lady) didn't mind paying the bills. It was a hardship for her to leave her home to go to ER. On the few occasions she would go with paramedics to ER she would have them leave her house keys with me because she knew I'd be the one to pick her up when she was DCd from the hospital. Convenience.

But even when you know the treatment is as simple as an ordered SVN tx, when you aren't there to give it, they won't always admin themselves. I wasn't making clinical dxs, I was following MD orders, essentially. But she grew to depend on me and that is where my mistake was. She refused to dial 911 when I wasn't home and she died.

In all fairness to me, she was going to die. There was no way around it. I was only buying her time by following her MD orders. But she still died BECAUSE she couldn't reach me and wouldn't dial 911. She was waiting for me to get home.

It was just as much my fault because I didn't push her to do it herself. I assumed she would if she couldn't reach me. That was my bad.

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You need to explain to her that you are not qualified to assess her medical needs and that if she is symptomatic, she should call 911 or call her personal physician.

You need to be firm with her and her husband. You can only be a doormat for others, only if you allow it to happen.

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I really hate it when this happens. When people see me in my scrubs, whether they be nurses or just someone I happen to be chatting at in the grocery store, they just assume I'm a nurse (not yet) and that I should give free medical advice on the spot without knowing their medical history.

I'm just ranting here, forgive me, but this really does irk me to no end.:angryfire

I hate it when I'm dressed in uniform and although I don't mind helping out family members with questions I can answer, I hate it because it seems when I'm wearing scrubs in public people seem to expect free medical advice.

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I really hate it when this happens. When people see me in my scrubs, whether they be nurses or just someone I happen to be chatting at in the grocery store, they just assume I'm a nurse (not yet) and that I should give free medical advice on the spot without knowing their medical history.

I'm just ranting here, forgive me, but this really does irk me to no end.:angryfire

I hate it when I'm dressed in uniform and although I don't mind helping out family members with questions I can answer, I hate it because it seems when I'm wearing scrubs in public people seem to expect free medical advice.

Get used to it. I've had total strangers employed by my grocery store ask me about their abnormal periods. I'll stop there on the way home from work and I'm still in scrubs. They ask if I am a nurse and I stupidly respond, "yes."

When they ask you if you are a nurse, just say no... come up with ANY other medical profession such as an xray tech, MRI tech, housekeeping! ANYTHING other than a nurse.

I can't say it enough, CYA.

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I hate these situations. My mantra to those who ask for medical advice: "I'm not even a nurse, let alone a doctor." I'm a CNA and student and my grandma knows this, but she continues to wake me up on my days off asking me if the symptoms she's having is gout or something else. Drill into her head that you can't help her. If she's having symptoms she needs to go to the ER. I also have MVP and know how scary it can be BUT I know my baseline and when I pass that I'm heading to the ER. I can understand her denial, it's hard to accept heart probs at a young age (I'm only 25-18 when diagnosed) but if she has kids you'd think she would be thinking of them. As in, getting to the dr. ASAP and following up with her cardiologist. I would hate to see those kids without a mother.

Are you close enough to her that you could give her that push? Keep telling her that you're not a dr. Does she know the risks/benefits of the surgery? Are you able to speak to her husband about this?

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