It still bothers me.

[chicookie]

I don't know why but it still does. I still feel like I did nothing wrong and it still makes me super mad. This happened about 2 months ago.(*warning* long post/ story ahead)

We had a patient transferred from another hospital because they didn't want to treat her due to her refusal of blood products. She has sepsis, is on the vent and is going into multi-organ system failure. I talk to the patients nurse and she tells me its been really hard to tell the family members anything, the daughter of the patient is very distressed. So I go in there and I start talking to the daughter who is hysterically crying. I tell her that we will do what we can here, she sounded a bit mistrusting of the doctors and nurses especially with what happened at the other hospital so I told her (which was the truth) that she had the very best doctors this hospital has to offer and the nurses here are great, I honestly couldn't pick a better team. Then I said your mom is in critical condition, but I think we should be as optimistic as we can be and take it one day at a time but at the same time be ready for worst. I didn't say she is going to make it or she is going to die. I don't think I gave her any false hope at all. By then she has calmed down and was actually listening to the nurses. (I was in there for almost an hour and a half)

So I decide ok enough, I can leave now. We step outside as the nurse need to do stuff in the room and asked us to leave for a bit. I hugged the daughter and told her Remember baby steps, Ok? I am very optimistic of the care she is going to receive. I am sure that the doctors and nurses here will do everything they can for her. I will keep checking up on you as well. The daughter thanks me, and I am about to leave feeling good that I at least managed to calm her down. One of the doctors is sitting at the nurses station, stops me and says in a very angry reprimanding tone: You just set us up for failure. What you did guaranteed that the patient will not make it. She is in a very critical condition and she is going to die. The family will suffer more because of you.

The patients daughter is not even 3ft away from us, heard her clearly and starts to cry. I feel myself turn red, and I snapped and said: if I did something to offend you first off I'm sorry but next time you have something to say to me you make sure that the family members aren't right behind you. The doc turned around to see the daughter crying again and looks at me and says she didn't hear me. Refuses to look at me again. I go hug the daughter take her to the waiting room and calm her down again. I'm still super mad, so I tell my boss what happened in case this doctor says something. My coworker is good friends with this doctor and tells me oh well she was just having a bad day, she really is super nice. I told my coworker that is no excuse. You don't talk to me that way and second you don't reprimand ANYBODY in front of a patient or their family members. I've talked to a nurse and my parents about it because I was so upset, and everyone defends the doctor. My coworker says she called him but I am pretty sure he called her and he told me that yeah she was having a bad day, and that she was SURE the daughter didn't hear her. Also that she was going to call me to apologize. Surprise surprise she never called me and when I see her around she pretends I don't exist.

Fastforward 3 weeks: the patient walks out of the hospital. Goes home and is doing well. -____- She looks good dead.

I don't think I did anything wrong. I feel like I did though. Did I give the patients' family false hope? I don't think I did and I am sure I didn't set anyone up for failure. I just said that she was going to get the best care possible here. I even told the daughter to prepare for the worst. Should I have said something different? I had to deal with a similar situation recently and I found myself at a loss of what to say.

That concerns me more than that stuffy doctor. She can shove it. I just hate that she made me feel so unsure of myself. Any insight would be helpful. Even if its the doctor-was-right but as another warning those will make me . Thanks. :)

[nurseprnRN, BSN, RN]

first off, i think you did great work!! that was an excellent nursing assessment and intervention. can we hear an amen, sistahs and brothas!

i hear the folks who say that this physician probably knows she screwed up, is embarrassed about it, and has learned something from the events you describe, even if she is evidently finding it very difficult to show gratitude for the opportunity it presented. :) we've all been there, done that.

if you always had a good relationship, or at least a decent collegial one, with her before, let a little time pass and then some day when nobody is watching, ask her to join you for coffee. you could say (if this is true) that you have always appreciated her willingness and skill to care for the difficult patients you get, and you had previously enjoyed your collegial relationship with her. say that you want to clear the air with her, and ask gently if that would work for her. then shut up and listen to what she has to say. i can't imagine what it might be, but it could be that the patient reminded her of her own sister, or that she got stunningly bad news that morning about something else, or ... or who the heck knows. one of my favorite quotes is this: every heart has its secret sorrows, and oftentimes we call a man cold when he was only sad.

we can already tell you're a good nurse. treat her like a patient. assess. listen. reassure. contract for future behavior. make a good closing statement. no point to pressing for an apology, but you might get one, which you will accept with great grace, because you can afford it.

we all know it is not your responsibility to maintain relationships. she is a coworker, not a friend. but she is behaving like someone in some sort of pain and you are in a position of strength over this. you might both discover you have a wonderful professional collaboration in your collective future. or not. but why not give it a shot? let us know what happens.

[Whispera, MSN, RN]

Awesome post, Whowland! Bravo.

[ErinS, BSN, RN]

I think you did the right thing. I work in hospice, and while I encourage pt's to set realistic goals, I am always optimistic. Like you, I do not think that being optimistic has to focus on pulling through a medical problem- we can also be optimistic about the care a person will get, the comfort we can provide, and the joy we can have in how ever much time is left.

[MrWarmHearted]

I concur with Whowland. If you can't let it go/it still bothers you, you should talk to the doctor (NOT the "good friend of the doctor") and try to have a peaceful/working relationship with her. perhaps she misheard/or imagined that you said something else/gave false hope.

btw your job sounds pretty interesting especially in reference to the plethora of research supporting bloodless medicine