I need to vent right now or I will absolutely EXPLODE!!!!

Nurses General Nursing

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Specializes in Ortho, Oncology, Med/Surg, Critical Care.

I just went into my pt's room after being called in there by the lab tech who said the pt's bed was all wet and that I needed to check on him. I went in and saw that the pt had unscrewed the IV tubing from his peripheral IV and the fluids were running all over the bed. Now, normally, this would not cause me too much concern, I would just hook the fluids back up and change the sheets. HOWEVER, this patient had a chest x-ray that was positive for PE and he is now on a heparin drip to help resolve the issue. The fact that his heparin is dripping all over the bed and not into his veins does not help the matter. I hooked him back up and told him NOT to touch the IV or the pump. :nono::nono::nono:

I mentioned the pump b/c earlier this morning, I went in b/c his IV pump was beeping and I discovered that he had put both IV's on hold [the heparin and maintenance fluids] without telling me b/c he said he didn't want to wake me up. I told him we nurses don't sleep b/c we are working. Then he complained he didn't get to sleep b/c of the pump. I then explained to him that if he had called me in the first place, this would not have been an issue. I then proceeded to explain to him that he needs to keep his hand OFF of the IV pump or else he'd break it and we'd bill him a couple grand to replace it [iDk how much they cost, I just don't want him touching it].

Maybe it's just b/c I'm PMSing that this is making me so mad right now, but THIS IS REALLY MAKING ME MADDDDDDD!!!:banghead::banghead::banghead::banghead::banghead: :angryfire

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document, document, document......non compliance, etc.......are they passive/aggressively refusing rx? do they have a good understanding of the possible consequence?? sounds like a potential nightmare....document your butt off....and suggest the doc reexplain and or psych consult....good luck

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Specializes in Cardiac Telemetry, ED.

Do your pumps not have a lockout feature to prevent tampering?

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Specializes in NICU, Post-partum.

That is when I would have called the physician and had the physician handle it.

To me...that is the same thing as refusing medication.

He is putting not only himself at risk, but making everyone else responsible for babysitting him.

A physician here would have told him if he cut the pump off again, they would take that as a sign that the medication is being refused and discharge him on AMA.

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Specializes in Ortho, Oncology, Med/Surg, Critical Care.

I documented everything down to a T :typingand also let the oncoming nurse know what was going on. He knows full well what the heparin is for and why he is on it. IDk why he did it, but whatever.....I did what I could. I told the oncoming nurse to keep an extra eye on him and if he does it again to let the physician know. Also, when I gave report to the charge nurse, i also let her know what was going on so she could tell the next charge nurse and that way everyone is in the loop and knows what's going on.

But, as of now, I am at home relaxing with a drink. :cheers:

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Specializes in NICU, Post-partum.
I documented everything down to a T :typingand also let the oncoming nurse know what was going on. He knows full well what the heparin is for and why he is on it. IDk why he did it, but whatever.....I did what I could. I told the oncoming nurse to keep an extra eye on him and if he does it again to let the physician know. Also, when I gave report to the charge nurse, i also let her know what was going on so she could tell the next charge nurse and that way everyone is in the loop and knows what's going on.

But, as of now, I am at home relaxing with a drink. :cheers:

You need to let the physician know now.

Because the physician is assuming that the patient is getting the heparin over all of these hours....because there is a possibility that the physician may order the patient's status to be re-evaluated....the physician cannot address the issue if he doesn't know and if the patient runs into trouble....you won't be able to say, "We'll, he disconnected his IV....twice."

The physician will said, "Well, why didn't you tell me."

Then you'll be stuck.

His patient...his problem.

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Time for a restraint order

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Specializes in Utilization Management.

Or you could ask the patient if he's trying to commit suicide, because when he turns off the pump, he could die. Very quickly with a PE. Or slowly--as a veggie-person with a stroke.

Ask the doc to get a psych consult. That kind of noncompliance has to have mental issues, IMO.

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Does the IV pump have a lockout feature? I always use that when the patient is on heparin, cardiac meds, or TPN.

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Specializes in psych,maternity, ltc, clinic.

Does he have dementia or other kind of confusion? His comment that he "Dont want to wake you up" makes me wonder if he thought he was home.

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I hope you didn't connect the same tubing that had been rolling around open in his bed back to him, because then he could have a potential bloodstream infection in addition to the PE to contend with.

Use the lockout button on the back of the pump, ask the MD for mittens, and pull out the scare tactics on your patient.

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Specializes in ICU/Critical Care.

Don't you have a locking mechanism on your IV pumps?

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