Makes you sick?

[iNurseUK, RN]

We recently had a patient admitted for his first chemo for colorectal cancer. On admission he told us an anti-emetic he had had from a previous (unrelated) surgery years ago and not at our hospital had made him very ill.

Concerned we bent over backwards to find out what drug this actually was. His GP didn't know and neither could we get hold of any records of a surgery many years before.

In the end we concluded it was probably cyclizine and the chemo regime wasn't using that anyway but had more modern drugs consisting of aprepitant and ondansetron. These are routinely used for in chemo protocols known to be emeteogenic such as anything involving Cisplatin.

Well the patient kicked up a hell off a fuss. Refused the anti-emetics, threatened to take us to court if we killed him with our nasty drugs. Our on-call doctor finally persuaded him to take the anti=emetics and the patient sailed through chemo with no nausea issues at all. And this was Cisplatin. The most barf-inducing drug known to man.

So we discharged him then three weeks later he came back for his next chemo cycle. This time however his complaint was "Those tablets made me sick" this being the domperidone and ondansetron he had been sent home with , was supposed to take for five days post-chemo and had not taken at all.

OF COURSE it wasn't the Cisplatin. Now he is getting a lawyer because we gave him anti-emetics that made him sick!

I just lost the will to live.

[merlee]

Please do not lose your will to live!!! Like many others, he has lost control of his life, and is attempting to gain it back, no matter who he rolls over.

Where is the oncologist in all of this?

Best wishes!!

[iNurseUK, RN]

I was just joking! I know the anti-emetics were not the cause.

Don't take your meds after Cisplatin? Expect Barf City

[nurse2033, MSN, RN]

He can sue but it sounds like he has no case. I agree with merlee that his behavior is probably a response to his illness. Although when grouchy self centered people get sick they don't exactly behave better. Sounds like you did your best, which is all anyone could ask. Just part of the fun here in nursing.

[OCNRN63, RN]

You can't cure stupid.

[steelydanfan]

He's angry, FEELS like he has no control, and wants to blame everyone. Remember, anyone can sue anyone for anything, but they usually don't win.

Relax, and continue your great care.

[carolmaccas66, BSN, RN]

Yes had a patient like this just last night actually. Unhappy with the doctors and nurses, CONSTANTLY c/o every little ache & pain (he's a frequent flyer to the pscyh unit, known to many older nurses), has had a barrage of tests done to find out what is causing his pain, nothing. He was in Vietnam, has PTSD, I said he was angling to get stronger pain killers written up. We were all sick to death of him, his care gets paid for by the taxpayers, so I told him after his last whinge of the night to me, that as nurses we have done all we can for him and he has to be more aggressive in talking to his doctors re his care. I said we as nurses can't order bone scans, CT scans, bloods, etc we can only pass this on to the doctors. This guy must have had every test and scan done already known to man, I kid you not. He is very needy and the staff enable him in this aspect.

This guy can't sue for something so stupid. He was given life-saving treatment. If he doesn't have a record of his drugs (all the oncology patients I have cared for know their drugs in and out, they're very good), then you are not to blame for anything. Direct any complaints to the oncologist or his RMOs, registrars etc so this is not a nursing issue.

He is re-directing and projecting his anger and pain re his diagnosis towards the nursing and medical staff, not uncommon for oncology patients.

[nursejoed]

He's angry, FEELS like he has no control, and wants to blame everyone. Remember, anyone can sue anyone for anything, but they usually don't win.

Relax, and continue your great care.

************************************

Hopefully, the judge will make him pay the facilities' legal costs.

[ObtundedRN, BSN, RN]

Nobody forced him to take the meds. He had the right to refuse. He can make threats to sue, but an attorney probably wouldn't be willing to take the case.

[Horseshoe, BSN, RN]

We recently had a patient admitted for his first chemo for colorectal cancer. On admission he told us an anti-emetic he had had from a previous (unrelated) surgery years ago and not at our hospital had made him very ill.

Concerned we bent over backwards to find out what drug this actually was. His GP didn't know and neither could we get hold of any records of a surgery many years before.

In the end we concluded it was probably cyclizine and the chemo regime wasn't using that anyway but had more modern drugs consisting of aprepitant and ondansetron. These are routinely used for in chemo protocols known to be emeteogenic such as anything involving Cisplatin.

Well the patient kicked up a hell off a fuss. Refused the anti-emetics, threatened to take us to court if we killed him with our nasty drugs. Our on-call doctor finally persuaded him to take the anti=emetics and the patient sailed through chemo with no nausea issues at all. And this was Cisplatin. The most barf-inducing drug known to man.

So we discharged him then three weeks later he came back for his next chemo cycle. This time however his complaint was "Those tablets made me sick" this being the domperidone and ondansetron he had been sent home with , was supposed to take for five days post-chemo and had not taken at all.

OF COURSE it wasn't the Cisplatin. Now he is getting a lawyer because we gave him anti-emetics that made him sick!

I just lost the will to live.

If he means the tablets made him nauseated, good luck to him with a lawsuit. In nursing school, we used to laugh about our pharm books. You could almost always count on "nausea and vomiting" as a side effect of a medication.

I wouldn't sweat it.