I tried posting this earlier, but it got eaten somehow, so I'm trying again. Excuse me if the other post shows up from cyberspace, lol.
At any rate ... I am laughing now about the whole thing, but it wasn't so funny when the whole thing was taking place last night!
At 0300 this morning, I had a 14 yo present to L&D c/o pain rated 9/10 in her lower abd. She was laughing with her best friend and mother and demanding that I get her a tray because the was hungry. I told her that I couldn't feed her until I knew what was going on with her and she became very upset with me ... almost throwing a tantrum. I proceeded to place her on the monitor and start my assessment. 1cm, very thick, very posterior. She had some mild contractions that were irregular - 20 minutes apart at one point. Her UA came back clear. Since she was 39+ weeks. I waited an hour, checked her again - no change. So I called the MD. He gave orders for a hydrocodone and to send her home with labor precautions.
When I went into her room to D/C her, her mother blew up like a rocket! WHAT! WITH HER CONTRACTING AND HURTING LIKE THIS! (The pt was asleep when I came into the room.) The mother then proceeded to ask why in the H--- the Dr hadn't even bothered to check on her. HER Dr came in to check on HER when SHE was in labor!
I told the mother that, had her daughter BEEN in labor, which she wasn't, the Dr WOULD have been there at some point to check in on her.
Then the mother informed me that she wasn't comfortable at ALL with some NURSE assessing her child and judging whether or not to send her home and that she was NOT leaving until they saw he DR! (The mother was also a nurse - or so she said.)
I called the MD back and he told me to just leave her there until he made rounds this AM, but to tell her that this didn't mean that he would be keeping her.
Like I said, I am laughing now, but I was so angry last night that I had to call the PP nurse to sit at my station while I went outside to cool off! :angryfire
I allways wonder how these pt's will handle being parents. We have had several of these "I refuse to leave" pt's lately and for the most part the dr's are firm in treating the pain, letting them rest and then if no change and as long as baby looks fine they go home. I had one last week that was only 35 weeks and insisting that we induce her. Well needless to say no doc was going to induce a 35 weeker for no reason, so we gave her lots of pain meds and let her sleep through the night then sent her home. She and her boyfriend were irrate with the MD, and I think left with the intention of finding another MD.
We even had one pt induced for insomnia.....having a newborn baby should help the insomnia! Pepole just don't get it!!!!
I find this type of behavior is very common with the indigent population.
They don't pay for their care and make loud demands on everyone when they present.
Being a minor and pregnant,she automatically qualifies for medicaid. It would be nice if they were greatful we are takning care of them for free and are polite to us.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I have found this behavior crosses all socio-economic lines. We had a similar situation with a clearly well-to-do and fairly well-educated patient. She was just obstinate and difficult---and felt she should be "allowed" to have her baby at 33 weeks, since "her last one came at 32 weeks and did JUST FINE in the NICU". No amount of reasoning with her worked...she kept demanding we induce labor and "get it over with" (she was having mild preterm ctx).
She did eventually sign out AMA (refused further tx) and purportedly went to another hospital in another town. I was actually relieved, shamed to say. I felt badly for the next people having to deal with her. She was almost menacing....
It's not fair to say this is limited to the poor/indigent. I see plenty of self-entitled behavior among many people of all backgrounds. It's a societal ill that makes me want to scream.
I had almost the same dynamics today . . .only pregnant teen was 17. Mom and another daughter were there - causing all kinds of havoc. I was glad to see them discharged (34 weeker).
Angel, what is sad though is the fact that our hospital offers classes on infant CPR, breastfeeding, epidurals and the labor process and newborn care, but only a fraction of these mothers will agree to attend the classes.
Or even listen when these classes are being taught. I've dealt with teens working in crisis pg situations. When I worked in that capacity we would have teens come through to attend classses (after X number of classes they would be rewarded with diaper bags, etc). Often they would sit there, whisper to each other or send notes - not to listen what's being said. I wish that occasionally the teacher would say, "Listen up, there will be a test later. If you don't pass you don't get the points towards your free goodies!"
I find this type of behavior is very common with the indigent population.
They don't pay for their care and make loud demands on everyone when they present.
Being a minor and pregnant,she automatically qualifies for medicaid. It would be nice if they were greatful we are takning care of them for free and are polite to us.
Specializes in Happily semi-retired; excited for the whole whammy.
I find this type of behavior is very common with the indigent population.
They don't pay for their care and make loud demands on everyone when they present.
Being a minor and pregnant,she automatically qualifies for medicaid. It would be nice if they were greatful we are takning care of them for free and are polite to us.
You're not taking care of her for free, you are being paid by your hospital, and your hospital is being paid by Medicaid. While I find entitlement attitudes as distasteful as anyone else, I also find blanket statements such as 'this type of behavior is very common with the indigent population' even more distressing, because we aren't supposed to be judging the people for whom we care. I don't fault the OP for venting at this particular patient's attitude, but we start down a slippery slope when we start judging our patients on the basis of who pays for their care.
Kind of a shame- you know she thinks the "mean" nurse said she wasn't in labor but the doctor saved the day when he came in:angryfire when you were actually doing her a favor.
I would have to agree that the statements about socio-ecomnomic status are offensive. Growing up I had no health insurance so when I saw the doctor (very rarely) I am sure I was looked at the same way and didn't/don't have that kind of attitude (although I do have insurance now).
Besides, as the nurse you get paid whether the patient pays or not so it shouldn't matter :) Whether you get paid enough for what you do is a different thread.
I find this type of behavior is very common with the indigent population.
They don't pay for their care and make loud demands on everyone when they present.
Being a minor and pregnant,she automatically qualifies for medicaid. It would be nice if they were greatful we are takning care of them for free and are polite to us.
WOW! This generalization certainly confirms my decision to work in Community Health Nursing when I graduate. There are millions of un/underinsured people that are appreciative of 1-the "free" care they receive and 2-the fact that there are professional and compassionate care providers that don't stereotype them based on their socioeconomic status and other trivial factors.
:angryfire I hardly believe the woman is a nurse. If she was, why would she behave in this manner? She should know what procedures are to be followed. Even if L/D is not her area, she should realize that MD's don't always have to see the patient. I understand that she was upset, but if she wanted only a doctor's opinion, she should have stated so before you examined the girl. What a bunch of crap! She's probably a receptionist or janitor in a hospital, and believes that she's seen enough to call herself "nurse." Or maybe she has had first aid training. Oooooo, what qualifications! Things like this make me wonder how long I'll be employed by any one place. I'm pretty hot tempered, and while I don't exactly explode on people, I do tend to speak my mind, which usually is not what the angry jerk wants to hear. Oh well, anger management for all!!!
Pepole just don't get it!!!!
:nono:
Marie_LPN, RN, LPN, RN
12,126 Posts
Kinda makes you think, though, of that old saying that you have to have a license to drive a car, but not to have children.