In our 12 month program, we clock upwards of 2,000 hours of clinical time. We go through 3 levels at which point, we graduate. I graduate in August. (yay!). I'm currently in the 2nd level of my program, during which we spend 2 7 hour shifts per week in the clinical setting. This rotation is being spent on one of 3 med surg floors at a very large local hospital.
Wednesday, we had a patient who was being monitored for compartment syndrome while waiting for an ORIF. He was wearing an open cast splint on his LLE, and was experiencing pain d/t pressure on his heel. An order for lambs wool was pending, and in the meantime, the guy was in awful pain. He had already developed blisters on his shin at this point and Ortho had yet to be called for some reason that wasn't directly explained when the RN was asked about it.
This patient's nurse went to lunch, and as I was walking down the hall past his room, he called out to me. I went into his room and he was bent over at the waist attempting to pull his own toes up out of his cast. I asked him what was wrong and he said that he felt like his heel was on fire and he was trying to help himself w/out bothering anyone but the pain was quote "hell". I told him that I'd be right back and went to talk to my instructor. I explained the situation and asked what sort of relief I was allowed to provide at which point she told me to go talk to his nurse.
The nurse that was covering for his nurse while she was at lunch stared at me from behind the desk and the conversation went something like this:
me: Hi, I had a question about twenty se...
nurse: yes. 27. what do you want.
me: I was told that you're the nurse covering for his nurse and was wondering what we can..
nurse: he has an order for lambs wool
me: ok well it doesn't appear that his lambswool is here yet and..
nurse: I'm not his nurse. and I already know.
me: So would it be possible for you to..
nurse: no.
and then she stared at me from her chair until I left. She seriously interrupted me and refused to hear anything, or do anything at all for the patient.
I went back to the patient and the guy was crying. I told him that I'd be right back and I went and talked to my classmate that was assigned to him and she said that he was a very sweet, nice guy. Pretty young. No problems, doesn't complain. So we both went back in the room and he's begging us to do something to help him. His leg WAS able to be moved as the splint was open, but obviously you CAN'T DO THAT. We knew it, told him we're looking for a solution and went back to our instructor again.
Our instructor went to the nurse covering, told her something had to be done so the jerk got up, went to the patient's room, stood IN THE HALLWAY OUTSIDE THE DOOR and said "you've already had all of your PRN pain meds, we can't give you anymore" and went back to her seat.
SHE LIED. SHE LIED TO THE PATIENT. He had meds ordered for breakthrough pain and had had none, and had never gotten any of the morphine that had been ordered Q4H either. WHY? WHY WOULD SHE DO THIS?
She refused to call ortho. She refused to do anything but sit in her seat, ALL DAY. She would get up every few minutse or so, but did nothing. NOTHING. She wasn't the charge nurse, she had patients. And was ignoring her own patients as well.
The patient's shift nurse came back from lunch, at which point the lambswool finally showed up, and she shoved it down inside of his cast with spoons and was standing at his bed holding his toes up out of his cast to relieve the pressure. The regular RN wouldn't call ortho either...it seemed like this guy needed a window in his cast. Everytime myself, my instructor and the other student who was assigned to him asked why his MD wasn't called, no one would give us a straight answer.
This patient was assigned to me on Thursday, and I was ecstatic that I could directly care for him as my own patient. He still had tremendous pain, and ortho finally showed up at 0000 prior to our arrival at 0640 at which point necrosis was found on his leg, and 2 separate spots were excised.
I know nothing about anything, I'm just a student.
But this guy broke my heart. Why was he left like this for so long? What am I missing? Why did this happen? Is this what's SUPPOSED to happen?
The cover nurse that was sitting behind the desk from after report at 0630 to the moment we left the floor Wednesday afternoon did the same thing Thursday afternoon. She got up once to look at the printer, and as we were leaving she was complaining that she had yet to chart assessments on any of her patients and was going to use the student assessment as her own.
To let a man get to the point of tears, and then lie to him...
I just don't understand it.
I know no one can give me much insight as you haven't seen his chart, but in accordance w/what I have shared, I'd like a little insight if at all possible.
Thanks y'all!
TheCommuter, BSN, RN
102 Articles; 27,612 Posts
You cannot worry about anyone else's motivations for showing up to the workplace. You can, however, use this experience to teach yourself to become a more outwardly compassionate and honest nurse. If you see a questionable nurse, you can use him/her as an example of the type of worker you'd never want to emulate.