Nurses cannot perform miracles

Have Nurse, ADN, RN · Apr 6, 2018

Definitely agree with the Facebook thing.
I am the type of person that likes to form relationships and wants to make sure my patients know I will do my best to take care of them for the 12 hours I was there. I guess it just had me so frustrated that I couldn't even begin to do that because she wouldn't let me get a word in edgewise. It is true like you said to let it roll of your back, which normally I can but she just got under my skin for some reason. I think she was a well-to-do person and had an unfortunate diagnosis, and it was almost like she felt entitled to be disease, pain, and nausea free immediately after her surgery.

It sounds like you were a target for some pent up emotions and caught off guard. Be careful of passing judgment, please.

On one hand, here you are trying your best to do what you do best. On the other, here is a person who is use to be in control and is no longer. It is frightening place to be and as hard as it is to accept, we have to allow them to have those feelings and work through them.

We don't have all of the answers, that's a given. But, we can try to make those hours that we have with them as calm and competent as we can.

One thing I have witnessed when dealing with a patient who is so upset and distressed, is to pull up a chair, even if it's only to gently let them know that you are here for them, have a group of patients that you will be caring for, and if their light is on, and you are not able to get in the room immediately, that the staff assigned to your group will come. If you can pop in about every two hours, just to let them see you, so they know that you really do mean what you say about wanting to meet their needs, it will help them settle down, and they won't be on the light as often either.

If this lady wouldn't allow you to get a word in edge-wise, I can't help wondering if her needs were well attended before you arrived.

One strategy too that helped me, was to ask my patient that I was meeting for the first time: "What is the one most important thing for you today that you would like to see: ie: pain really under control, being able to sit up at least 20 minutes, ambulate 100 feet, eat in the chair instead of the bed, speak with the doc?

They usually tell me and outside of the immediate, it's our main focus until it gets done. We have had very good reviews using that strategy.

Hope this helps.

wondern, ASN · Apr 6, 2018

Plus, did you ever try to get a good sleep in a hospital??? :wacky:

jaderook01, BSN, RN · Apr 7, 2018

Ah, yes. I frequently encounter people that think that all hospitals should be like St. Mungos in Harry Potter. Wave a magic wand and we're all good.

Ruby Vee, BSN · Apr 7, 2018

Thought about posting this on Facebook but didn't think it would be well received, so I thought maybe my fellow nurses could relate. Yesterday I entered a patient's room with high hopes of reviewing the care plan, working on pain and nausea control, and going over post op instructions from the surgeon but instead was met with one complaint and one snarky remark after another without me so much as being able to get a word in.
Eventually she apologized and I try to be understanding because I know nobody wants to have an illness and be in the hospital, but one thing she said stuck out to me. She said "I thought I came here so you guys could help me." That was before I had even gotten an assessment in, by the way. There is just this notion in America that anytime someone experiences pain, is diagnosed with a disease, or experience any type of discomfort the doctors and nurses will fix it. We are a death and disease denying culture. I wish healthcare wasn't advertised as a cure all but as a chance to have a better quality of life. Just had me feeling frustrated...

You're right to keep it off Facebook!

This attitude of having "NO PAIN" started in the 1990s or thereabouts when a whole generation of surgeons and anesthesiologists started telling patients that they won't have any pain after surgery because "The nurses will take care of that." And then the nurse gets to explain to the patient that the physician was mistaken, or exaggerated or lied or whatever because "If I give you enough medication to take away all your pain, you won't breathe." Funny how they'll believe a totally unrealistic thing the doctor said, but won't believe an absolutely realistic thing said by the nurse. This expectation of no pain is what I blame for the opioid crisis.

K9lover, ASN, RN · Apr 11, 2018

The idea everything can be fixed stems from various sources. High on my list is the AHA which corners the market on BLS/ACLS. I just renewed these and if a lay person were to take BLS they would come away thinking the AED can fix anything, the majority of non-medical folks believe that most people can be revived from VFib et al neurologically intact.

The vast majority, of course, are not revived at all let alone neurologically intact. Essentially the AHA receives a lot of donations based upon misinformation and don't even get me started on medical dramas.

Same with cancer society and any other org dependent upon donations. Seeking donations in and of itself is not a bad thing but these orgs really make it sound as if the outlook is rosier than it is. The AHA does not address failure at all in BLS and ACLS devotes @ a paragraph to poor outcomes. Little wonder the public thinks miracles can be done.

missmollie, ADN, BSN, RN · Apr 11, 2018

You shut that down immediately, and don't worry what the patient thinks. Often they apologize afterwards.

Had a patient like yours who wouldn't let me get a word in when he arrived on the floor. After one minute of him yelling at me, I told him he needed to stop right now.

Patient: blah blah blah...pain...blah blah blah...you people...blah blah blah ARGH ARGH ARGH

Me: Sir, you need to stop yelling right now.

Patient: silent because no one has ever told him to shut up

Me: I can't do anything, and I do mean anything until I have checked you out, looked at your chart, and I figure out what to do. I am your nurse, and I will take care of you, but you have to calm down.

Patient: blah blah blah, pain.

Me: I can't help you right now.

Patient: ....

Me: ....

Patient:...I'm sorry

Me: let me see what I can do, but I am going to do a full assessment before anything else.

Patient: okay. You do what you have to do. I'm usually not like this.

I have a special script for drug seekers. It goes like this:

Patient: 10 mg of oxy isn't enough!

Me: It seems the oxycodone isn't taking care of your pain.

Patient: Exactly! You get it!

Me: Absolutely. I will immediately get that order discontinued, and we'll start you on Advil with the Tylenol. I'm going to call your doctor now.

Patient: Wait, my pain isn't that bad. The oxycodone is working.

Me: Well, if that changes you let me know. Tylenol and Advil have been proven to work more effectively than narcotics, and I want to take care of you pain.

It's all about how you approach it, but remember that you are ultimately in control. Don't put up with it, and let them know you mean business.