I work in psych so I deal with this type of patient a lot. Bear in mind that she has a mental illness as well as a painful debilitating physical one. That combination is not usually going to make for an easy, pleasant patient. My advice would be to not take anything personally and try not to engage in power struggles. Do what you can within your ability and that's all you can do. Try to remain calm and not feed into the negativity. Remain matter of fact and let her know what her choices are and that that is all you can do.
merrick replied to babblingbrook's topic in Nurses
Have you tried PostPartum? That way you'd still get to teach parents, but wouldn't have as much stress. PP nursing is pretty low key, most of the time. Of course, you do get the occasional hemmorage and what not.
Have you looked into the process of becoming a certified lactation consultant? There are several pathways but the shortest and easiest is if you are already a nurse. You will probably have your nursing degree in less time than it will take to get certified as an IBCLC. You could look into being a breastfeeding peer counselor for the WIC program, if you have personal breastfeeding experience, that is. OR being a tech on an OB/PP floor.
I originally liked D for both, but I can see where B was correct. I would like it better if it was worded as checking patency instead of blood return though.
But your rationale for B is a little off. Doctors will many times order a broad spectrum antibiotic for patients while awaiting the results of a culture. They will then look at the culture and change to a different antibiotic if needed. The culture would definitely need to be collected before starteing the abx as they could skew the results of the culture.
It's possible you're not seeing the whole picture. Maybe they do visit, just not as often as he'd like. Or perhaps he just doesn't remember. My husband went to see his grandfather and he started crying and saying he hadn't seen him in years. My husband had been to see him just the month before (we don't live in the same city). Older people with dementia often seem completely with it when telling old stories. Their long term memories are usually still intact. It's the short term memories that are the problem.
I think you are right. I would not hold bp meds for a normal blood pressure. As you said, the meds are what are keeping it normal. Just go with your preceptor for now. You will be on your own soon and can do things your way.