you know you are in for trouble when.....

You know when you are in for trouble when:

The first family member you meet apologizes in advance for the behavior of family members yet to come.....

Been there, done that.

When my mother-in-law was in hospital last year the eldest D-I-L never actually came to see her before she died, but spent alot of time on the phone telling the nurses & doctors how to do it right (she was a 'carer' and thus knew it all). In the meantime whenever the other two D-I-L's went to visit they had to preface any conversations with 'No, I'm not that daughter'.

When you walk into the unit for your shift, and all the halls are deserted except one--and in the middle of that hall is a knot of people consisting of the CEO of the hospital, the ADON, the Charge, a few nurses & techs, a couple of security guards, and a few people you don't know.

Or when you walk into the unit and both crash carts are at the front open...with absolutely not a soul in sight....

In my experience, the most reliable indicator of a potentially problematic new patient is that patient's allergy list. An extremely lengthy allergy list is almost always a sign that a "challenge" is on the way.

When the family member in the room says, "I used to be a nurse."

And, whats really bad... often they are lying about the "I used to be a nurse thing."

I am so discouraged today that I am still at home, dreading to go in. I am the DON at the nursing home and so my hours are flexible. I have just sat here and read each one of these posts, and laughed until I have cried. I have had patients like all of these! So now I feel better. I am going to go blow my nose, put my big girl panties on and act like I want to go to work. Thanks to all.

I made the mistake of complaining to my CN (in jest) that I never get the 19y.o. female admissions. So, the next admission was--you guessed it. But the very first order on my Kardex was: "Absolutely no narcotics."

It was a long night.

You know you're in trouble when you come in the door and hear someone yelling, "Code BROWN."

These were all great!

Report starts with:

-the family isn't all onboard with hospice

-the family says they will sue if morphine is given

-the DPOA wants to follow the patent's wishes, but the sister out west (who hasn't seen the patient in 10 years) wants to continue aggresive treatment. She is flying in tomarrow.

You know you're in trouble when:

1. "Narcan" is listed as an allergy. (I always tell them if I can't reverse it, I can't give a narcotic. This usually provokes screaming, swearing, and a fast AMA exit).
   
2. The first sentence in report is, "Unfortunately, this 103 yr old pt is NOT a DNR."
   
3. The second sentence is, "this is their 3rd trip out of the unit, they have been on a vent 3x this admission."
   
4. The offgoing nurse says, "I'm back tomorrow, but I do NOT want room X back."
   
5. There is a large note on the front of the chart: "Doc says pt can leave AMA at any time, don't call him" and there's an AMA form started on the front of the chart.
   
6. The ER calls up to ask for a bed and when the unit secretary hears the name, she starts banging her head on the desktop, moaning, "No, we had her last time...."
   
7. The pt is in the ER, requesting "her room" back -- and insisting we turn the dying 99 year old with the 10 family members out so she can have the room she likes because it's close to the stairs so she can go out and smoke.
   
8. ER calls for a room assignment, and says, "this one's going to be a handful. He bites."