What's the most desperate thing you've ever done to advocate for your patient?

OK, this should be fun!

Mine happened this weekend. I had a colorectal surgery patient who, while stable was not looking especially good. The patient's abdomen was getting more distended, they were having more pain, etc.

The patient's family was pretty anxious and of course none of the colorectal team were available on the weekend; all requests had to go to the junior surgical resident who was a first year family medicine doctor on surgery rotation. She was helpful and very sweet but freely admitted to me that she was a bit out of her league so after doing her best to calm the family down she told me she'd page the senior resident who works closely with the colorectal team and have her assess the patient.

Of course the senior was busy and of course I'd already attempted to reassure the family by telling them that the senior resident was going to consult so I found myself in the uncomfortable situation of text paging the senior directly to beg her to come (a big no-no; they're big on the chain of command where I work.). In desperation I promised to buy her coffee for the next month if she came by and she reluctantly agreed.

Being a nurse of my word I bought her a Starbucks gift card which I gave to her when she finally showed up. She muttered an ungracious thank you and went to see the patient. No good deed goes unpunished; the family complained to me that the senior surgical resident was short with them and I got out a half hour late because of the time I wasted begging and finally bribing this doctor.

I want my twenty dollars back.

[Ruby Vee, BSN]

I was living and working in a popular vacation destination in CCU. I admitted a guy who had been on a cruise ship when he arrested. He'd had a massive MI, and got bystander CPR on the cruise ship before being airlifted to our hospital, comatose. His wife showed up shortly thereafter and over the next few days, two sons and their wives made their way to his bedside from their home in Calgary, BC, Canada, a few thousand miles away. The family was lovely -- spent their days at the bedside talking to the patient, telling stories about his grandchildren, telling him they loved him, etc. This went on for days while it was decided that prolonged downtime had contributed to irreversible brain damage. With much love, the family made him a DNAR. Only he didn't die. He just continued on a ventilator, a few vasoactive drips, etc. Finally, the family asked if we couldn't remove the drips and the ventilator and let him go in peace. It seemed like a kind, loving thing to do, but per our policy we had to have three different attending physicians sign off on that.

The CCU attending was one, the pulmonologist who managed the ventilator was another. They did the appropriate paperwork, but the third attending, the nephrologist was tied up in the hospital across town with an unstable ICU patient. The family was READY to let him go, and they were clearly exhausted. The only way to accomplish that was to get the paperwork from the nephrologist who couldn't leave his ICU patient across town. I assembled the paperwork and drove across town to the other hospital, having talked to the nephrologist on the phone and explained the situation. I sat with him in the other ICU while he filled out and signed the appropriate paperwork for my patient, and then drove back to my hospital. We withdrew care that afternoon. It was such a beautiful and peaceful death with the family at the bedside telling "Dad" how much they loved and would miss him.

[Crush]

I called another physician to get the order my patient needed. Second physician called my nurse manager to tell her what a great advocate I was and what lengths I had gone at 0200 to get what my patient needed. The first MD never apologized but later, he specifically asked it be me who was his father's nurse.

[ruby_jane, BSN, RN]

I want my twenty dollars back.

$20 you'll never get back. On the plus side...if she was going down the drain it would have been well-spent...

[MECO28, BSN, RN]

If I'm ever dying, please steal my dog and bring him to me. So sweet!

[Hygiene Queen]

Aww! Davy Do, you know there's something about those black and white cats. I call 'em "cow kitties". They have the neatest personalities! Mine acts more like a dog and he talks to me by chirping. He takes walks in the woods with me! Glad you saved the cat and you gave him a happy home while you could.

Sorry to get off topic but I LOVE cow kitties

[Guest1025459]

Davey Do said:

Okay. Since we're confessing, I once "stole" a patient's cat.

I was a community nurse for an Assertive Community Treatment team back in the late 90's. A patient I regularly visited diagnosed with paranoid schizophrenia who had a history of a closed head injury, was a convicted pedophile, received regular depo provera injections for chemical castration, and was a substance abuser was being readmitted into the state facility. The team knew it was to be a long hospital stay and I voiced my concerned for his cat. It was a great cat, smart and mischievous.

One of the other team members suggested that I go rescue the cat, stating, "You know he always leaves his apartment unlocked with the stove burners left on".

Sure enough, when I went to pick up the cat, the apartment was unlocked and the stove burners were on.

I loved that cat. He would stand on his hind legs as I drove my truck up my driveway, boxing with his front paws as if to say to my truck, "C'mon! I'll take you on!"

Even though I had him neutered, he'd still take on the Toms, and I had to take him to the Vet a time or two as a result of his injuries.

Sadly, like a shooting star, he didn't live to a ripe old age. I think took on something that bested him.

Oh well...

Aww! Looks like my tuxedo cat. I bet you can guess what his name is