Iker

My short and distracted responses were one worded, like "yes" or "no" or "I can't remember". But thank you for the response. I was going to try to be more organized so maybe I won't forget it next time. I made my own report sheet.

I am a new grad working the 3-11 on a med surg unit. A particular patient aspirated during a colonoscopy and had been having unstable vitals all shift. The doctor ordered hourly vitals for four hours. He ordered this around 2200. I was in the room getting the 2300 vitals. Ordinarily I wouldn't get these vitals, but since they were going to be hourly I wanted to get them so the tech had some time to get her other vitals before she had to be in there at midnight. The tech came in at 2300 while I was getting vitals, I told her she didn't have to worry about the 2300 vitals because I was getting them. She seemed put off by this and stayed outside the door and asked questions about how she's been voiding and if she had a bed alarm. Now this is where I realized I had been so focused on monitoring her vitals that I forgot to put a diaper on her and turn the bed alarm on The patient was lethargic, not jumping out of bed at all. Anyway, I turned the bed alarm on then and there. I was trying to count respirations while she was asking about the diaper, so I think my responses came off short and distracted. I leave the room and apologize to the tech if I came off as rude. She said "hmph!" and went into the other room. I later overheard her complaining to the nurse about having to get hourly vitals and about me because I forgot the diaper and bed alarm. I would have gladly helped clean her up if she had asked. My questions is this: Should I ignore this, or should I apologize to the tech and let her know that I will try to improve and if there's a problem she can come ask me. I will help her clean up a patient before I leave if I have to. I really didn't mean to leave extra work for her. We only had one tech for the last half of the shift and I forgot and I feel terrible about leaving her extra work

They were seen by doctors, who told them there is nothing more we can do for them. All orders were continued, except for anything IV related. The patient wanted everything related to the IV discontinued. Otherwise they just stayed an extra two nights. No tests or treatments or new orders. Managers didn't say much. They were made aware that a patient was appealing to Medicare.

Thank you all for the feedback :) I had two unruly patients that day and by the time this was going down I was pretty frazzled. Just wanted some constructive criticism. She later called switchboard and asked for the night hospitalists extension. She talked to him herself. She calls the nurses station, asked to speak to me, and told me to check my orders. He ordered some Tylenol for him. She called a couple more times telling me to check on her brother because he wouldn't answer his phone. He wouldn't answer his phone because he was sleeping. She wanted me to get him to call her back because she wanted to make sure "his pain was under control." Ugh I was over it by the end of my shift XD

1.) They did appeal to Medicare and they stayed an extra two nights, paying out of pocket. Medicare saw no reason to keep them there. He had a pretty minor problem, nothing critical. 2.) The patient took the medication, but the sister made it quite clear that they would be expecting more pain medicine. 3.) They gave no preference for pain medication. They said he's hurting and needs something for pain. I should have questioned further as to what kind of pain control they were expecting. 4.) As far as the doctors were concerned he was discharged. They saw no reason to keep him, so I think that's why they were being conservative with the oral pain medicine. 5.) The sister of the man made all of these requests. I told her I called the doctor and that's all he ordered. She insisted I give her the night hospitalists number (we are a small hospital, so we only have one night hospitalist) and give the phone to her. I was not comfortable doing that.

Ok, I had a difficult patient this week. It's my first week off orientation and I wanted yalls opinion on if I handled it adequately. The patient was suppose to be discharged, but he and his sister objected and refused to leave. The patient said he wanted nothing through his IV, pain or nausea meds included. The morning shift discontinued all IV meds. He later complained of pain. I called be Doctor, who gave an order for a one time dose of something for pain. The sister was not satisfied with this. Wanted me to call the doctor and get something routine. I told her I already called the doctor and he ordered what he thought adequate. She was mad, called the nursing supervisor, and they eventually got an order for something routine. Did I do everything I could have? Was there something I could have done differently?