annie.rn

Sorry for the delayed reply. My phone broke so I haven't been on here in a while. I am just today seeing this. I really appreciate you asking the GI doc you work with. I couldn't figure it out either. Glad to know I'm not the only one :-) Thanks so much!

I respectfully disagree with this. I worked home hospice and my immediate supervisor had very little clinical experience. (She had only worked at managing her husband's medical practice) It made it very difficult for the nurses under her because when we were in a patient's home trying to solve a clinical problem, she was almost useless. She was a lovely person but not very helpful for us nurses in the trenches.

Your post is so familiar. We have a few frequent fliers like that on my med/surg unit and they are oh so frustrating. I am amazed at how well you handled the situation while also having your own load of patients to care for. As someone else said, you will not lose your job. And if by some freak chance you did, I'd say "good riddance".

ThIs line is part of our hospital's scripting, too. I have trouble getting myself to say it much because most often I'm not sure if I WILL have the time (or I flat out don't) and I don't want to set myself up to disappoint the patient. I like to give the pt. a quick rundown of what's planned for the shift. Usually when I am passing my 9 o'clock meds. I tell them when vitals will be done, what time the rest of the shift's meds are scheduled, what prn meds they have available, if they have a.m. labs, etc. If they have a sleeping pill, I ask if they want it. I've had a lot of people thank me b/c it's their 3rd day w/ little sleep and they didn't know they could get a sleeping pill.

I'm not much of a public speaker myself and have never been Valedictorian. However, I wanted to say Congratulations!!! That is awesome!

Thank you for sharing your experiences with us. I would be very angry in these situations, too. I'm glad there are people out there like you. who can advocate for these kids.

Quote from Banterings:

My comment wasn't directed toward you at all. I hope you didn't think it was. It's obvious you care or you wouldn't have been asking for help :-)

Dementia is not funny. Of course, I don't know you, so I apologize in advance for my perceptions. The way you refer to the residents you work with is hateful. I understand that working LTC is super stressful but you still have to show compassion. These residents are not "crazies", as you put it, they have dementia. (Unless perhaps you work in geri psych but even then it is unkind to refer to patients as "crazies"). My mother had dementia. Thankfully, she never had to be in a nursing home but if she had been and I knew the workers thought of her the way you seem to think of your pt.s I would be devastated and so would she. Your residents are human beings that had rich, productive lives before living there and they deserve to be treated as such. I know you are venting. We are all allowed to do that. I just hope that what you said here is something you keep very well hidden when you are caring for your residents. I'm glad you were able to find another job that will hopefully be less frustrating for you.

Can I come eat at your house?

Very true. But this particular guy is super abusive as it is so it couldn't get much worse :-)

Quote feature isn't working right but this is from KatieMI:

Thanks for all the replies so far. I agree about not being able to change habits during a few days of hospitalization and I usually don't sweat the diet stuff too much but these two cases annoyed me b/c they were directly making themselves ill by what they were eating. It was infuriating to be in that guy's room pushing Dilaudid q3 and Phenergan q6 while he was simultaneously munching down on a burger and fries. And he was vomiting and having the foulest diarrhea. You could practically taste the poo smell in the air. Sorry, gross, but true. I tried to educate him on cause and effect but no go. After all his GI stuff settled down for the night he turned around and ordered SIX carne asada breakfast burritos for his bkfst. He wouldn't be able to order all that if the doc would put his foot down and have him on a renal/diabetic diet. He had no means to get food from the outside so the doctor changing his diet would have put an end to it. But the pt. was a squeaky wheel and we all know that they get the grease. In his case, lots of it :-)

You can't make up lies to convince people to do things. And I'm assuming it's a lie b/c I've never heard of such a deposit. In your first scenario: I hope the nurse was certified as a medical translator. Just b/c she speaks Korean, it doesn't mean she necessarily knows medical terms in Korean. We have many Spanish speaking nurses on our floor who's native language is English but they also speak fluent Spanish from living in a bilingual household. They struggle to translate medical terms b/c their nursing education was in English and they didn't learn medical terms in the Spanish they learned at home.

Knew a nurse who actually did that. Had "DNR" tattooed over his heart and had a personalized tag on his motorcycle that said "IM DNR".

Are patients allowed to order food from outside places and have it delivered to their rooms if they are on anything but a regular diet? Right now we have a morbidly obese pt. who is a raging diabetic. He's on a diabetic diet. He can not even move himself around in the bed independently. All of us have been stressing our backs lifting his legs, pannus, arms, etc. so that he can turn and reposition. Getting him to sitting position on the edge of the bed is a real back buster. Don't even get me started on the two hour long dressing changes. Just about every night he orders large amounts of food from the local fast food delivery places. I understand that food is an addiction and free will and all of that but he is not complying w/ his prescribed diet which is affecting his ability to heal. We had a another situation w/ a diabetic dialysis pt. who the doctors allowed to be on a regular diet. He needed to have his gallbladder taken out but refused. He would order burgers and fries and nibble on them all night while at the same time getting Phenergan q6hr and Dilaudid q3hr for his nausea and stomach pain. He'd refuse his Carafate, Reglan and Pepcid. And dialysis for days at a time. Both of these pt.s could be verbally abusive and demanding to the staff. It is so frustrating that the doctors don't put their foot down and tell them that they cannot have a regular diet. Why can't the docs discharge them for non-compliance? We are basically just boarding these folks b/c they refuse everything that will make them better. I've been a nurse for a long time and I know the answer...customer satisfaction. But it feels good to vent. I'm still curious about the ordering food from outside places, though. And, do you all see any docs that will stand up to these pt.s and not allow them things that are hindering their healing? Or will discharge them if they are refusing all tx. that will make them better?

This was hilarious! I would have had a blast creating that furry pt. When in the military, I worked with a lot of young, mostly male med techs. If pranking were an Olympic sport, they'd be on the gold medal team. Once, they got the gurney from the morgue. The gurney was a metal tray w/ a second metal tray suspended over the first by posts on each corner. The body would lay on the bottom tray and then the whole thing was covered w/ a fitted canvas. At change of shift they put the gurney in an empty room w/ one of the med techs on it. The oncoming techs were told that there was a deceased pt. ready to be transported to the morgue. They went in to do the transport and half way down the hall the "deceased" yells and starts banging on the upper tray. Needless to say, the two unsuspecting transporters nearly passed out from fear. After the initial shock, they all got a kick out of it. There was a Sgt. who was a great guy but regularly had really bad breath. We had big dry erase boards hanging above our med carts (this was back in the day before computers and COWS) where we'd write down all of the appts. that pts. had scheduled for the day. They wrote on the board "Sgt. 'Smith', Halitosis Clinic, 1000". They all got a good laugh. However, I hope Sgt. "Smith" wasn't crying inside. There was a pt.'s necrotic toe that fell off during a linen change. And the time one bet another $20 to eat a half eaten saltine off of the tray of a particularly unsanitary, mean pt. (This was not done w/in ear shot of the pt.) He tried but gagged as soon as he brought it near his mouth. I hope no one gets offended by these stories. I know they sound kind of irreverent, immature and disrespectful. However, they gave excellent care and kept the joking outside of the pt.'s rooms. It was the toughest nursing job I've ever had but also my favorite b/c of my co-workers. We needed humor to get by and to help us decompress so that we could give the great care that we did.

My sister's name begins with an L. One time after a rather interestingly shaped BM, her boyfriend brought her into the BR and showed it to her, saying "Look! I love you so much I pooped an 'L' for you!"

If you mean demented, yes. Dementia, no. He was sharp as a tack. Drove, played racquet ball three times a week and was probably more physically fit than I am. He had a need to control everything. Including when and how this sweet woman would die.

When working hospice I dealt with a very difficult husband. He was a retired high ranking military pilot and used to bossing people around and getting what he wanted. His wife had cancer but was no where close to dying. She could walk, talk, eat and drink w/o any difficulty. She was beginning to show signs of dementia, however, and he couldn't deal with the lack of control that goes along with that. One of his complaints was, "I was in the bathroom shaving and she came in and stood there asking when dinner was and it was 8 in the morning!" One day I go for my routine visit and I sit down at the table to get my paperwork out. He sits down across from me and slaps a piece of paper down on the table and with a look of fire in his eyes he starts pointing at it violently and yells at me, "I want to enact this Living Will and if you all won't do it, I will call my lawyer!" "It says right here that if she is diagnosed with a terminal illness she no longer wants food or fluids!" I tried to explain that this means artificial feeding and that his wife can still eat and drink without any difficulty and still regularly asks for food and water. He practically punched me. It was awful. Supervisors got involved rather quickly. It was a hairy situation. Prior to that I thought I was so lucky to be assigned to this adorable octogenarian couple. Looks can be deceiving!

Good for you! It's so nice to know that there are people like you taking care of some of the people who need conscientious caregivers the most.

Way to go! Kick back and enjoy your holidays so you'll be refreshed for your race to the finish line. Good luck :-)

This is wonderful!

Shittrus --- funniest mash up word I've heard in a long time! It will now be part of my vocabulary. Thank you :-)