Is a nurse in the ER joking to a patient like this appropriate?!?

[Laurenslovely]

I (a nursing student close to graduation) took my dad to the ER for chest pain last night. (He suffered a MI). He was immediately treated by a group of very pleasant doctors. The male nurse who was caring for my father quickly got too comfortable because my dad is a very calm and friendly patient. He rubbed me the wrong way when he quickly started advising my dad how he should eat, work out etc (as if my father was not already educated from this long standing condition and already taking very good care of his health to the best he could.) The male nurse then made a JOKE I did NOT think was funny: "I guess you were just born with bad genes!" my dad takes everything lightly and didn't get upset but I do NOT. Is this appropriate in the context of a joke from the "Nurse?" I seriously am developing ANGER towards this nurse today as my dad is still in the hospital. Should I let this go or report this? Also, he was sloppy when he inserted the IV and there was blood everywhere!!

[Laurenslovely]

But in all seriousness, sometimes joking - even if you don't think it funny - is good for a patient in an emergent situation and can help calm the atmosphere, even if but temporarily. If your father reacted and took it well, why bother complaining?

I believe joking does cool and calm situations. It is just my father so in this situation I can't take a joke. As for the IV, in nursing school they don't have us insert IV's so I do not know what is normal.

[Laurenslovely]

I'm sorry your dad is sick. I had 3 sick relatives while I was in school. I think it is great that the nurse educated your dad. I include all sorts of education information when taking care of patients in their care plans and discharge paperwork. Actually from my experience it is required especially for chronic diseases that the government says we have to educate patients about. As far as IV's I am messy so I always bring a couple towels when I start one. And I bring extra gauze or alcohol wipes to clean up the blood that is on the skin after I start an IV.

Awww... Thank you :) I know it really sucks-- double stress

They don't have us insert IV's in my program, so I wasn't sure what is normal for bleeding. I hope with practice we are able to learn and get better.

[Laurenslovely]

OP, I think you overreacted. It sounds like your Dad actually had a really good nurse. As far as IVs go, usually you can stem the flow of blood when you disconnect the catheter and reach to connect it with the IV tubing or with a hep lock, but sometimes you get a bleeder. It's still a small amount relatively speaking, and while not ideal, certainly not worthy of making a big stink over.

Hope your Dad is feeling better.

Thank you very much :) I know my emotions are out of whack and i may be overreacting to the situation, which is why I am asking advice rather than acting on anything. I'm not sure what is normal for bleeding from IV's. They don't have us insert IV's in my program.

[Horseshoe, BSN, RN]

I believe joking does cool and calm situations. It is just my father so in this situation I can't take a joke. As for the IV, in nursing school they don't have us insert IV's so I do not know what is normal.

Well, I wouldn't say it is "normal" to have "blood all over the place." I sometimes get a little blood, but never to that degree. But as others have pointed out, if he is on a blood thinner, he could have made it more difficult.

Sometimes when a situation is actually quite serious, I will act just a little more "casual" with the patient in order to make them feel less frightened. What you really don't want with a MI patient is even more anxiety-that only increases the demands on the heart at a time when the heart is vulnerable and unable to meet the demand. Perhaps this explains your nurse's bearing. He was trying to keep your Dad at ease, calm, etc., in order to increase the odds of a good outcome. Smart guy!

[Esme12, ASN, BSN, RN]

Thank you :) Yes, he was put on Lovenox, so that's where my concern stemmed from. I know I may be overly sensitive in this situation because it's my dad. I will def speak up if I am bothered next time. He does eat perfectly and exercises regularly, your assumptions are correct. It's a very frustrating situation.

I think you are angry....angry that your Dad is sick. Nurses get displaced anger from families ALL the time. We are the ones people feel "safe" with.......they have to be angry at something when faced with citations that can't control. I usually don't take it personally. As a manager if I got a complaint about this nurse....and I knew them I would i understand that the family was displacing their anger.

Your Dad eats perfectly and exercises regularly and he still had a MI....so it is bad genetics. I know you feel helpless right now and that's OK. Take this experience and use it to develop your own practice style. Nurses need to convince complete strangers to tell their most intimate secrets to a complete stranger and to trust them.....at their most vulnerable time. naked in a patient gown frightened and ill. It's a hard job.

Sometimes, no matter how hard you try, IV's bleed like crazy and make awful messes. I am the IV Queen and no mess is my middle name...but every now and the mess I make resembles a crime scene.

I am so sorry your Dad is not feeling well and is in the hospital. It is hard being the daughter and the nurse (even when you are a student). Remember this feeling and use it to help the families of your patients.....it will make you a better nurse.

:hug: I am sorry your Dad is sick. My prayers for his complete and rapid recovery.

:hug:For being a good daughter.

:paw:

[Been there,done that, ASN, RN]

I am so sorry your father has had a myocardial infarction. This is a life changing event .

You are an educated professional . This effects you on another level.

I agree with you, that was NOT the time to educate your dad .

He is having a HEART ATTACK!

Teaching should be done after the event.

You are angry ... and rightfully so.

This is the time to support the family and the patient.

As far as the messy IV start,, don't focus on that... concentrate on the big picture.

My prayers to you and your dad.

[Esme12, ASN, BSN, RN]

people wondering why so many nurses get burned out and hate nursing... you cant ever win, if your unpersonable your rude and robotic. if your personable and try and lighten a tough situation your unprofessional. Welcome to the wonderful world of nursing , enjoy :)

I think we need to remember that when the patients in our care have anxious family...it is our job to ease their anxieties. We, as the professionals, have the education and training to understand about human nature and that it isn't personal.

Sometimes what is perfectly clear to us...isn't to the families, who are frightened and looking at all that blood running everywhere. This young lady just reminds us of the families point of view and how misconceptions occur.

I think as the nurses we need to remember that it is not about us....it's about the patients, the families? Well they are just the necessary devil.

[GitanoRN, BSN, MSN, RN]

needless to say, this is not a situation that requires reporting the nurse in question. on the contrary, what this nurse was trying to do was to ease the anxiety level in the room. in addition, the education provided by this nurse was valuable and in relation to your father's dx. having said that, i can tell the level of your anxiety as i read your post, which is understandable and i feel for the both of you. however, keep in mind that we nurses can sense this from our patients, and we try to make the pt. feel more comfortable through education and at times in a joking manner to bring down the tension level. furthermore, when it comes to iv's no one can predict what can occur when we insert one, at least he didn't miss. wishing you the best and a speed recovery to your father as i send you both a hug :hug: from across the miles...aloha~

[Laurenslovely]

Sometimes, no matter how hard you try, IV's bleed like crazy and make awful messes. I am the IV Queen and no mess is my middle name...but every now and the mess I make resembles a crime scene.

I am so sorry your Dad is not feeling well and is in the hospital. It is hard being the daughter and the nurse (even when youare a student). Remember this feeling and use it to help the families of your patients.....it will make you a better nurse.

:hug: I am sorry your Dad is sick. My prayers for his complete and rapid recovery.

:hug:For being a good daughter.

:paw:

So sweet :~} I will def will use this experience to treat families well and keep them informed. I know its real life experience that makes you a good nurse. I feel better knowing the IV leakage was normal. I just wish I learned more hands on in nursing school.

Thank you very much :) Lauren

[Laurenslovely]

I think we need to remember that when the patients in our care have anxious family...it is our job to ease their anxieties. We, as the professionals, have the education and training to understand about human nature and that it isn't personal.

Sometimes what is perfectly clear to us...isn't to the families, who are frightened and looking at all that blood running everywhere. This young lady just reminds us of the families point of view and how misconceptions occur.

I think as the nurses we need to remember that it is not about us....it's about the patients, the families? Well they are just the necessary devil.

THANK YOU for seeing both sides!!! :)

[Meriwhen, ASN, BSN, MSN, RN]

I don't know if blood on the sheet and bed are "normal" after inserting a new IV.

If he's on any blood thinners, a little blood could be normal.

Also the amount of blood matters too: a few drops on the sheets from a IV that had a messy start but is otherwise patent and working well, that's fine. If the sheets look like an outtake from a horror movie...no, that's not normal :) Correction: that's not usual. May or may not be normal (is warfarin in the picture?).

It's hard when it's family on the other side on the bed rails.

I remember when I went to visit my family that my father ended up in the hospital. Mom called the doctor from home and found out that he was going to have a pacemaker implanted stat. I walked into the kitchen, having just woken up...she hangs up the phone, turns to me and starts barking, "Go make yourself a cup of coffee" before I say anything.

I knew that was my mom's way of trying to gain control over anything--in this case, me and my actions--in a situation where she felt totally out of control and helpless. I did explain this to her and she realized why she had done that...she admitted that she had no idea why she was taking it out on me.

Perhaps that is part of what is driving your anger towards this nurse: your feeling helpless and out of control about your dad's hospitalization. Having a sense of control over something, even something as small as our anger over a nurse or a daughter with a cup of coffee, is sometimes how we cope.

[Laurenslovely]

As far as the messy IV start,, don't focus on that... concentrate on the big picture.

My prayers to you and your dad.

Thank you :) Very true to focus on what's really important