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!!

[Esme12, ASN, BSN, RN]

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

:hug: It's ok....

:paw:

[Laurenslovely]

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~

Aww... Thank you :~} I wouldn't actually report him. I'm just wasn't sure correct procedure with IV's. I know it really does take intuition to be a nurse. He did make my dad relax a bit. :)

[Laurenslovely]

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

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.

Thank you. He was put on Lovenox. It's true. I do have anger I'm trying to displace on the nurse. :-/ but after reading the responses, I see he was actually doing a good job, so I'm just going to focus on my dad now. I wouldn't want to stress him with complaints anyway of a nurse. It's hard not having control, like you said with your mom, she sounds very similar to me.

[sauconyrunner]

I really do hope your Dad gets to feeling much better.

It is REALLY hard to be in your position, you know somethings, and at the same time, it's your Dad, so everything is suddenly very different.

My Dad got really sick after a colonoscopy- apparently there was a micro-perforation and he then got as you might imagine - really pretty sick. Well...he had complained to me about it, and I told him it was gas. So you can imagine how I felt as "the Nurse-daughter" when he ended up REALLY sick. It was really difficult, and I was all over the physician who performed the test etc...probably not my best moment in health care.

That said, you would have hated me as your Dad's nurse. I've often helped a man out of his shirt while telling him, "We want to get your shirt off right away, you know, we are the women your Mother warned your about." So far, all of the men have relaxed with that. (There are some who I don't use that line on, you get to know.). I try to use humor to help people to be a bit more comfortable. I also sometimes ask things like"How did you know your wife was the one?"- which helps a pt remember a different, and happier moment in life. Neither maybe seem appropriate on paper. But they tend to go over well and be theraputic for the right patient.

I've started a few Crime Scene IV's. It happens. It is sooooo embarassing when it does, but it is not something that will hurt your Dad unless he is also needing a pint or two already.

So yep, you overreacted. At the same time, you care a lot for your Dad...And I'll bet when you meet another Daughter, when you are the nurse that you will be entirely compassionate and have just the right approach to make her comfortable. Hang in there!

[babyNP., APRN]

We can be so irrational when it comes to our own loved ones. My DH has high blood pressure that was newly diagnosed, likely due to coming to the US from the UK and Americans having so much more salt in their diet...anyway, he's 25 and I'm getting readings in the 160s/100s and I'm freaking out and crying on the phone to my dad who is an ICU nurse, telling him all the time that I *know* it's not an emergency and that it's a problem but not a life/death problem, but I couldn't help the tears anyway.

This is exactly why it can be so hard when it's your loved one. Remind yourself of that if/when this happens again.

And I hope your Dad is doing better :)

[Cat_RN, ASN, BSN, RN]

Ha. We were all super-nurses once weren't we? Then we actually had to work the floor after graduation and got a reality check.

[jadelpn, LPN, EMT-B]

It is tough when a nurse starts educating our loved ones, and the daughter about to be a nurse thinks "HEYYYYY I could have TOLD you that!! Geeezzz Dad, this nurse is gonna think I am some goooood nursing student!!" (Been there)

Because of COURSE to keep mind off the IV stick, Dad has got to say something along the lines of "my daughter Lauren here is almost graduated nursing school!"(Been there, too)

Nurses are required to educate patients. Even if the patient is well aware of taking care of their conditions. The "bad gene" comment, though meant to lighten it up a little with all that "fried food is your enemy" talk preceeding, was taken as a joke by your Dad, so that is the important thing. (and I TOLD my DAD THAT tooo!!!! Grrrrr....sometimes stress makes us a little more defensive than usual). So remember this and be sure when you are a nurse and this scenario happens in your career you add "well, as I am sure that your daughter has told you......"

And make sure you educate yourself on Lovenox, especially if you are going to be giving him his injections at home.It is used quite a bit, and it will only serve you well in your career.

And try as I might, I sometimes do get a lot more blood than I would like to from an IV start. And with anything cardiac, the bigger gauge the better. Which then of course is like a hose. I would however, like to get the stick the first time, as opposed to multiple stickings. And in a really, really good vein. Sounds as if the nurse got it, one shot deal. And you might just be the nurse that loves to start IV's so get as much experiece as you can when you become licensed!! Best wishes to you and your family!

[RNKPCE]

I want to compliment the OP for asking for advice and actually listening to what people are saying instead of trying to change everyones mind to her way of thinking. This happens too often on the forum.

I second what the majority of people have said regarding using humor in nursing and of blood with IVs. My friend is going through nursing school and her preceptor told her not to stress over blood and that she rather see a good blood return than none and question whether the IV is in or not.

[PacoUSA, BSN, RN]

Sounds to me like your dad had a very good nurse!

[redhead_NURSE98!, ADN, BSN]

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.

Go to Youtube and look at the video called "bad stick," it might provide a little comic relief for you during this difficult time.

[Pets to People]

What the nurse did wrong is what many nurses do incorrectly when doing pt education, and that is to talk AT the pt instead of speaking WITH the pt. It took me years to get good at this (as in getting the optimal amount of education delivered and understood within the time I am given to spend with them), especially when we are so limited on time with our pt's, and we also have to factor in the environment, such as a busy ER, or pt about to go in to surgery, etc. When you talk at a pt and you simply repeat things they have heard over and over, it will just pass in one ear and out the other, as it obviously has been doing so far, or he wouldn't be in with an MI.

The nurse should not have TOLD the pt how to diet, the nurse should have ASKED how the pt dieted, was he sticking with it, what was preventing him from sticking with it, what did he understand of nutrition...and by the way there is major controversy over which types of diets are best, ph.d's and medical doctors cannot even agree, so it is up to the pt to decide what diet works best for him as a lifestyle change, not a diet to maintain only for a short period of time. If you sit there and talk AT him about a healthy diet, but he can't afford fruits and veggies, or he can't get to the store or whatever other issues may impede his progress, then you are wasting your time and his, and you are not helping him as is your intent.

Same goes for excercise...don't talk at him about how he needs to do cardio, get to the gym, workout at home, etc. What if he absolutely abhors cardio, talk to him about other options; what if he can't afford a gym membership or can't get a ride there? What if he can't work out at home because the wife and kids get in the way?

There are so many factors that affect/alter our pt education with each individual and we need to be able to adjust as needed, not simply deliver some memorized script...each pt is a unique individual who's life factors need to be involved in our discussions with them. Only then can we hope of actually helping a person make some significant changes.

And hey, atleast the nurse tried, there are many who simply don't care, feel that they don't make a difference anyhow or feel too busy to even try to deal with pt education.

[nursegirl75]

oh boy, another story about a nursing student who thinks they know what it takes to be a real nurse. This nurse actually did a great thing by educating your sick father, but heck let's report him for that.

I'm sorry if you think i'm being rude, but as you are just a nursing student and already being as overly-critical in your thinking, it will not get you very far in the nursing world. You need a wake-up call or you will be eating by your co-workers.