Need advice

[redhead_RN]

Hi,

My name is Jessica, I usually pop in from time to time and read the forums, but have not really had anything to add until now. I have a situation at work that is troubling me, and I would love some insight from you guys!

We currently have an elderly hospice patient on our floor. Her family is the typical "pop in for 30 minutes to straighten the nurses up" kind of family. They do hire sitters to stay with her 24/7, which is a help to our staff. Our biggest obstacle (aside from the family's daily 5pm assault) is the family insistence that she be gotten up to the BSC for BM's (she does have a foley). This may not seem like a big deal, but she really can't tell when she has to go, which means we are getting her up 3-4 times a shift. This woman is also so weak, she can barely suck from a straw, so she is NO help. Completely lifting a 120lb woman 3-4 times a shift is murder on our staff.

Let me add that myself, and another nurse on our floor, is pregnant. Recently we both cared for her two days in a row, and with no tech to help us, put her on the bedpan against the family's wish. The daughter was livid and complained to the DON. Now, we have all been instructed to "NEVER" put her on the bedpan, and to get her up as many times as she demands.

So, my hands are tied. I have requested to no be assigned this patient, which I was told was not fair for the other nurses b/c we must "share" difficult patients. We do usually have techs on our floor, so I have to send the tech when she wants up. We have a great staff, and wonderful techs...they say they understand that I can not lift her. But I have begun to sense "displeasure" from them when I send them to the room.

I am simply at a loss, especially since this woman will be with us till her death. I know it isn't fair of me to put the task off on the techs, or other nurses when she is my patient, but I fear that doing it myself is a risk to my child. Anyone have any suggestions on better ways to handle this?

[leslie :-D]

you know, as a hospice nurse, my radar is going wild, envisioning this patient as soooo weak that she can barely suck from a straw.

IF that is genuinely the case, then TO HELL w/the family wishes.

IF she is that weakened, she shouldn't be getting oob at this point.

it certainly cannot be comfortable for this pt, when her body is screaming to be left alone.

let the poor pt be!!

just make sure she does not get constipated, which she will if she's on narcs and being immobile.

there is nothing wrong with a bedpan (which you can still sit the pt upright) but am sensing she would likely be better off with an attends.

she is no longer at a point where one should worry about preserving function or independence.

this woman is dying.

keep her comfortable, for crying out loud!!

it's a disgrace to be hauling her oob like this.

is hospice involved?

someone needs to have a talk with the family...

and the DON.

truly, i hope my 'visuals' are dead wrong.

this pt needs an advocate...

like, yesterday.

leslie

[pennyaline]

Wow! After reading some of the above, I'm even more grateful now for the supportive staff and nurse manager that I work with!! I'm 8 months pregnant and I work 12 hr night shifts on a surgical floor. There are currently 3 pregnant RN's on my unit (including myself) and we were all told by our nurse manager that she doesn't want us to do any heavy lifting or take infectious patients (c-diff, TB, etc). Our CNA's and the other nurses have been completely supportive. I'm probably going to get bashed (or kicked off this board) for saying this, but I have to wonder if some of the answers you got were because they were from nurses that cannot "use that excuse" as one is male and one has 30 years of experience and is probably beyond child-bearing years. In turn, there are several nurses on my unit who have had various medical problems and we have also helped them out when needed. It never occured to me that they were using their medical problems as an "excuse" to take it easy. I'm well aware that pregnancy does not mean that you get to sit back with your feet up, but just a little support and can go a long way.

Since you certainly know me so well as the "beyond child-bearing years" nurse who "cannot 'use that excuse,'" I am shaken to the core that you've failed to recognize my motherhood. I've worked through pregnancies, too. No, I'm not pregnant right now, it was 20-25 years ago, but hoo dang, honey! it sure was pregnant all the same! So your snarking assumptions aside ":twocents:" , I know how it works as well as you do.

In her original post, she complained that the techs were getting miffed over being called on to care for that patient all the time. I offered some suggestions for how they could cooperatively get patient care done as a team without any one developing hard feelings toward any other. That would constitute, in your own words "a little support and can go a long way." There is also the very real concern of the need for lifting restrictions. If she needs that, she should do that. Otherwise, there is little basis for exemption from caring for that patient.