I need your advice/opinion desperately

[throwaway1]

I'm truly begging for advice. I am sick to my stomach. I can hardly sleep. I was tossing and turning into the early morning and had to call off work today. I had just gotten on shift yesterday and there was a patient I had taken care of before. She was on BiPap (which she usually ends up on) and was in the ER overnight on hold for the ICU since we didn't have beds. She was tearful from the moment I walked in the room. The doctor requested that we remove her BiPap for a few minutes for her to talk to family about where she would like to be transferred. Another senior nurse and I went in and removed her BiPap. Her O2 sat began dropping rapidly so we placed on on NC @ 5L and she came back up. She asked for a phone charger but we told her we didn't have one. I gave her a few minutes to talk on her phone. I relayed to the doctor which hospital she would like to go to. Then the requests started. She can be kind of demanding. She said that she has a headache and wants toradol since that normally works. I said no problem I'll let the doctor know. She said she wants to eat which I knew the doctor probably wouldn't allow but I said I'd ask. I told her the doctor says you can't eat but I got you another glass of water and let her have a few sips. He ordered magnesium on her so I drew the lab for that and hung her magnesium drip. I told her once the doctor ordered her pain med I would come back to give it to her and told her that it was time to put the bipap back on. I secured it and made sure that I asked her it wasn't too tight. She then states that she needs to use the restroom. I came back with her pain med. I told her that we should do a purewick since she is short of breath. She says I'm not short of breath. I want to get on a bedside commode. I said but your O2 sat dropped to 65% within 30 seconds when we took you off the BiPap. She did not need to be trying to transfer to a commode with the Bipap on. (We are also in the emergency room. It is ridiculous to think that staff should come transfer you with a bipap on to a bedside commode every time you have to go. I did not say this out loud. Just what I was thinking.) I ask if she's ever had a purewick before. She says well yeah. She says the ICU staff puts her on the bedside commode and I need to go desperately because you just gave me lasix. I say I will check with the doctor and walk out a bit frustrated and in a huff. She has had a purewick many times before. I ask the doctor and she says she will check with the ICU staff for consistency. (I normally try not to argue with the patient and just say it is up the doctor but I have been told to work on being more assertive per management. I don't want to keep immediately running to the doctor for answers I know so I tried to talk to her first.) They say, no we do not get patients up with Bipap on. I walk back in and she is hysterically crying yelling at me "I heard what you said" "You said "I'm not doing that." as you walked out the door" I don't deserve this. I want a new nurse. Get out." I tried to talk to her but she wouldn't let me. I don't even recall saying that but I guess it's possible. (Plus I don't really understand why even that phrase would be upsetting) In my four years as a nurse I've never been fired once. I am known as the overly soft and nice nurse. I know that I was more frustrated and less friendly than I normally would have been but I was still courteous. Nobody could believe that I was fired from a patient. I couldn't stop crying. I don't understand what happened. I am sick over this. I know I could have been more patient with her like I normally am, but it feels like if I am anything less than perfect, this is what I get? And when the doctor tried to explain she says the nurse was rude to me before that happened. I don't understand. I can't function like this. Please give me your opinion because I am baffled.

[AutumnApple]

I worked lung transplant for 3.5 years.  Before that, I was on a pulmonary floor that was so very tense.

 

You do know, any patient with breathing problems and especially those that have chronic pulmonary disease, tend to snap out on people and bite their heads off.  For the chronic patients, years of roids make them like that.  For the more acute ones, well........hold your breath and tell me if you're in the chippiest of moods after (just kidding, please don't do that).

 

Some of the most grand, Florence with a Lantern level nurses that I've met in my time.......have been fired and even put on another unit for a short time till the patient who has a problem with them is discharged.  That's just how things are in this field.

 

I'd be less concerned about the patients reaction and more concerned with yours.  Can't sleep, sick in the stomach.  Not saying you're over reacting but, this is the sort of thing that happens to nurse's.  Like I said, even to the best nurses.  If you end up having to call off every time a patient doesn't adore you...........

 

Find a way to vent, to destress and to help put things in perspective.  Make sure you have a circle of trusted (non gossipy) coworkers who you can rely on to give objective points of view on whatever is going on with you.  When something happens, if they don't seem concerned, neither should you be.  If they seem to be questioning your performance or bedside manner, then you know to "get hard" on yourself about it.

 

 

 

 

[MiCULove]

Aww man

[Grace p]

As long as you preserve the resident's (Patients )dignity and give respect. Do your job to the best of your ability. Never allow patient or staff to make you feel less than You are. We are nurses and the world is desperate for us. Don't take no nonsense, pack your bags and go get a job where they appreciate you. The longer nurses lay down for management and patients to walk over. They'll continue to walk over us. I loved being a nurse. I am truly grateful that I am retired. There were times I felt like I was abused by staff management and patients. But I know I did my best. Don't lose sleep just pray for them and forgive them and keep it moving.

[workinmomRN2012, BSN]

When a patient has asked for another nurse it's a blessing because the patient is usually a PITA. Now when this happens my first response is " thank God"! , someone else gets to deal with them.

[Grace p]

It's a blessing. Sometimes the feeling a mutual we nurses, not saints.