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Discussion

Please give me some advice

I am a lpn working in a surgical unit, I experienced couple times of the following situation, pls give me advices what should I do;

We have post surgery pts every day, for examples, I had one lady who had low abdomen surgery on Tuesday, I did twice catheterization for her according to doctor's order, eventually doctor asked me to keep indewelling catheter in overnight, at the end of shift, she started to complain lower back pain, and she firmly think she got urine track infection(of course I don't think so), refused me offer her pain medication, kept asking me to page the doctor, no matter what it told her, she didn't listen, at this point, I was really tired out, I went to report to the charge nurse, not surprised, charge nurse was not happy, she think I can't handle the difficult patient;

Any one please give me some advice, how can I handle this kind of anxious pt? Thanks very much

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    • Featured Replies

    I think your charge nurse has a bad attitude. I would have offered her pain medication took a urine sample and told her to wait for results. If she refused pain medication that's her problem. Your real problem with charge nurse not being a team player and offering advice etc..

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    Are you still working on the same unit where you were having problems before with not being able to get the work done?

    Would it have helped if another nurse would have spoken with your patient? I'm not saying you're not competent at all but I know sometimes the patients where I work, if a nurse does not speak English very well, they don't necessarily trust what they are saying. I'm just throwing that out as a possibility.

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    • Expert

    I don't see where the patient was being particularly difficult. She is uncomfortable. You need to try to make her more comfortable (reposition, warm blanket etc). There are other things you can do besides pain meds.You could have called the doctor to let him know about the lower back pain.You could investigate why she is refusing pain meds and discuss that with her to find a solution.Why are you assuming there is no urinary tract infection? You can't assume.You need to learn to deal instead of expecting the CN to do it.

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    • Author

    Thanks for everyone's reply, for the warm blankets, I also think this one solution, but the patient clearly told me she wish to page the doctor, if I refused to let the CN page the doctor, I do believe this pt won't be happy, but CN think this isn't obviously something wrong (UTI should not happen right after surgery), most likely the pt was anxious, that's why CN refused to page doc;

    That night at 2200, I really exhausted with heavy workload, she is one of 4 pts I had, she was not the only pt I had, this is another issue, seriously I am tired of this kind of dillama, I decreased my work hour to the minimum; but I still have to work couple days every month to pay bills;

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    Everyone periodically feels tired and stressed from workload, no matter where we work. The patient care still needs to come first, and in this case, I'm not sure why you felt the need to involve the CN? Next time, I woud just figure out a way to complete the task, or ask a colleague for assistance in that case. The CN is usually busy with other duties.

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