First off, I was the code nurse which means I'm responsible for being present if a patient is going downhill or coding and facilitating the process. Which is something I don't mind...
However, this shift I started out with an ICU patient waiting on a bed who got moved 1.5 hours into the shift. No biggie. Also, had a DNR patient expire despite all allowed efforts. Again, dealt with it, did as expected. Also had a patient on the unit go into SVT and very nearly code. Once again, I did my job and helped in every way possible.
None of this was an issue, just giving you an idea of the kind of hectic shift it was...
Now, this one patient out of my four was an absolute nightmare. I've been told I have much more patience than some. I'm rarely phased at all by difficult patients. However this one took the proverbial cake. Except during each of the previous episodes mentioned, I was literally in this patient's room every 15 minutes.
Some of these were because I was called by the patient. A few were other nurses or the PCT calling me to the bedside. Literally over a dozen were because she set off the bed alarm and simply would not call for assistance. Though, they would call for everything else under the sun.
I tried in good faith to get this patient anything they wanted/needed within my scope. I was "rewarded" by the patient urinating in the bed multiple times, on the floor multiple times as well. I was "rewarded" with a million complaints and blatant lies and even fake seizures trying to seek more drugs...
I tried every single method available to explain everything. I gave 8 mg of ativan to them. I gave pain medication several times though they only allowed one dose of narcotic.
I literally did everything in my power and called up more patience than one nurse should ever have at her disposal. Yet, nothing I could do ever satisfied this person for more than 15 minutes at a time.
After 12 torturous hours, they requested to leave AMA and I called the MD to the bedside. I was practically giddy to sign the AMA form. I even gladly unhooked them and removed the IV infusing diltiazem with great joy.
After signing out, the patient tried to get the doctors or myself to arrange transportation. Which, as most of you know doesn't happen with an AMA. The patient even went so far as to ask for a bus pass. I desperately hid my relief as I explained the process to the patient.
Said patient continued to complain, come to the desk, and trash their room for the next 30 minutes. I happily went in, helped gather belongings and sent them on their way. I'd have even been glad to call security had they not vacated.
I didn't care one bit at the accusations of being "horrible" nurse or accused of stealing. I had never been more relieved in my life that I didn't have to pass this patient on to the next shift.
Anyone have similar experiences? Should I feel bad for feeling happy/relieved that they signed out AMA after torturing me for 12 hours?
"Against medical advice" form... it's a way for a patient to sign out of the hospital without being discharged and the hospital is not responsible for the outcome or possible readmission.
I commend you on the positive attitude toward this patient. I've said many times "There's a good reason nurses don't carry guns on the job because I would have used it!"
I've had patients like this (but not quite this bad!) and sometimes I think we're like battered women. Shouldn't be like this...
I would be surprised if there were a nurse in existence who hasn't experienced the feelings described by the OP at some point. Sounds like the OP did her best; sometimes nothing you do will be appreciated or good enough. If the OP actually resisted the urge to physically dance, I commend her.
I had a new patient at the very end of my shift threaten to leave AMA. She was transferred to my unit, claiming she didn't get meds (that were documented in the eMAR), threatening if I didn't give her what she wanted she would get her own out of her purse. We had to have security come up. We got it straightened out for a time and she didn't leave (but my shift ended thankfully). Since things started so rough between us my request not to have her as a patient again was honored- first time I asked to avoid a patient. Other nurses had issues with her drug seeking and all wished she would have signed out AMA.
Amethya
1,821 Posts
What's an AMA?