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

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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

Specializes in CVICU.

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].

Is the patient confused or does he need a sitter or something?

I understand how annoyed you are. Things like this are extremely bothersome and time consuming to fix. Some people just don't get it, no matter how many times you tell them. Try explaining the importance of the heparin to him, maybe he doesn't understand what it's for. Sometimes I'm blunt with people like this and I will tell them that the options they have are to listen or face the possibility of DEATH. Sometimes the death option shapes them up, sometimes not :banghead:

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Is the pump beeping alot? That may be what the problem is. It might be driving him crazy and he is turning it off.

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Sounds like pt is not completely oriented. If there is no locking mechanism either turn the pump so he cannot reach the controls or put it far enough away so he cannot reach it. Second concern is heparin. Do you have a heparin protocol in your hospital? As much fluid as you seem to say was in his bed leads me to believe his ptt is far from therapeutic. Notify doctor. Our protocol would call for stat ptt and possible bolus dose of heparin to get the patient back to a therapeutic level. Protocol or not his ptt has to be evaluated so therapy can be adjusted.

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Specializes in Med/Surg, Home Health.

Does he have a type of dementia? It sounds like he was confused...because he thought you were sleeping. He possibly didnt completely understand what was going on? I would have locked the keypad on the pump and discussed his behavior with the MD.

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

Here's an update:

No, the pt is not confused and I did explain to him last night what the purpose of heparin is. I also did explain to him the "death factor". The MD was notified this morning, and he didn't really seem to be concerned. According to the day shift nurse, he's been fine all day. So, we'll see how the night goes tonight, b/c after this, I'm off for 2 days. :stone

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

No, that was another thing that caused me irritation was that I had to start a whole new IV set, prime it and everything which just added on to my list of things to do for the morning. :no:

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I see why you are frustrated, and while it sucked I'm not sure I would've called the physician about it. I mean if you felt the need to CYA I could understand but at our facility, we check their APTT pretty often and I would've just ordered a stat APTT and started from there. Plus, I've noticed that our sheets can wick fluid out to look like a gallon and a half when it was really just a cup of juice (meaning it might not have been that much heparin) Seems like he needs constant reminding. I would NOT assume he was confused at all, seriously, it seems like I get those kind of patients a lot. Totally with it but just not compliant for only God knows why. And they are endlessly frustrating, you have my sympathy.

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