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'm so sorry, Mercy, for what your father endured. Many times, it's the ones who need help the most who are the least likely to ask for it. That could be a topic all by itself.
Time to shift this thread back to the focus of the original post--the demanding behavior of some patients and their family members.
Here's a question. Do we give patients enough information about what to expect toward the end of a pregnancy? There will always be those who view themselves as the exception to any rule. "I'm not LIKE other people--pain hurts ME." But I think there are many more who simply aren't aware that those final weeks can include a fair amount of pain and several trips to the hospital.
We give patients parameters but I don't recall getting any "real life" info about what it all meant in practical terms. Granted, I had my kids many years ago, but now that my three oldest have had children, it doesn't seem that much has changed in this area.
Could it be that docs don't make this a high priority because they aren't around to see it?
I'd love to see patients get an information sheet at about 36 weeks that gives them the low down on what to expect. Things like, "You may have several weeks of contractions that do not lead to active labor. If you come in, you will be examined by an experience labor and delivery nurse who will assess your progress and inform your doctor. If you are not in active labor, you will be sent home where you can rest in the peace and privacy of your own familiar surroundings. If the contractions let up, you can then resume your normal activities. We're happy to have you come in to be examined, but please understand that it isn't beneficial for you to be admitted if you are not truly in labor."
I finally figured that out by my third child. And I was able to fill my daughters when it was their turn, but it would have been good to have someone spell things out up front. Then I think all four of us would have gone in with the understanding that we might not be staying and being sent home wouldn't have been such a shock and disappointment.
Of course, as I mentioned, there will always be people who raise a stink no matter what. But I can't help but feel there are lots of women who would benefit from a bit of a warning.
As you said, it really takes giving birth a few times to get the labor thing down pat. With my first birth I went to the hospital totally thinking that they were going to take away the pain and make it all better. I did not get an epidural because I was too far along, even though I was in the hospital for 8 hours before delivering. My second labor was very quick so this issue did not come up. It was not until my 3rd birth that I realized that pain management has to come from inside me.
Too bad "mom" wasn't so attentive BEFORE her teenager got pregnant!
I don't think it's fair to judge somebody a bad parent based on this. A young girl can be sexually promiscuous for a variety of psychological reasons, it's not necessarily just the result of poor parenting--although, I'm not denying that in many cases it is. Perhaps this child was sexually abused in the past, or maybe she suffers from depression...etc... and this is how she acts out. I'm not saying this is definitely the situation, or even the most likely explantion, but it is a possibility, so why not give mom the benefit of the doubt? It's a little simplistic to just blame a parent for all of their childrens' problems. I was a problem child. I know.
I want to post a comment to the person that said she too would expect a doctor to come and make a final decision about the patient. Obviously you are not a labor and delivery nurse. OB's do not come and assess their patients. they rely on the assessment skills of the nurse. there is no way they could come and assess EVERY single pregnant person that thinks they are in labor or thinks their water has broken etc. we, L&D nurses, are expected to go through extensive fetal monitoring classes, NRP classes, ACLS etc. Most experienced L&D nurses can read a fetal heart rate strip better than some of the OB's. there are also many L&D nurses I would let deliver my baby over some of the OB's I have worked with. It is unfortunate that so many nurses in other departments don't realize what we really do. I have had some actually say what a "cush" job the L&d nurses have, just sitting around waiting for babies to be born....HAH!!! Try doing it on one busy night when the ER is calling cause someone is delivering in the parking lot, when a baby's heart rate is decelling to 30, when a mother is bleeding, when another one is having a seizure, one is going natural and in transition etc. See how much of a cush job it is.
I've worked in the ER, ICU, Med surg, nursery, post partum and labor and delivery. L&D is the hardest yet most rewarding position I have ever had.
Too bad "mom" wasn't so attentive BEFORE her teenager got pregnant!
That is a not so nice comment about the mother. The fact that her daughter got pregnant has nothing to do with her concerns. I feel that the mother had her rights to be concerned. The nurse did her duty by informing the doctor of those concerns. Why the anger?
I don't think it's fair to judge somebody a bad parent based on this. A young girl can be sexually promiscuous for a variety of psychological reasons, it's not necessarily just the result of poor parenting--although, I'm not denying that in many cases it is. Perhaps this child was sexually abused in the past, or maybe she suffers from depression...etc... and this is how she acts out. I'm not saying this is definitely the situation, or even the most likely explantion, but it is a possibility, so why not give mom the benefit of the doubt? It's a little simplistic to just blame a parent for all of their childrens' problems. I was a problem child. I know.
I agree. I feel that the comment made was very judgemental; At least the mother was supportive and concerned. I would not have taken the mothers statement personally, she does not know your job. She just wanted a physician to assess her daughter.
It wasn't the fact that she wanted a physician to assess her daughter that bothered me. It was the they way she approached the entire situation. She was literally screaming at me that she refused to take her daughter home hurting like that (her daughter had completely stopped contracting and was sleeping! She woke her screaming at me.) Then later making the statement that she had "already taken the day off work". I did take the comment personally that she didn't want "some nurse" assessing her daughter, but later cooled down and even managed to find humor in the fact that she too was a nurse. I never passed judgement on her for being a concerned mother, only for momentarily thinking she was going to explode! lol
I think it's safe to say that people aren't against Medicaid, but they're against the abuse of it.
I had a pt who was 34 weeks pregnant with her forth kid (unmarried) she had a cold and was coughing. She was sent home with a neighbor after cxr,IV fluids, neb trts and abx. she had multiplecomplaints what will she do if she needs help as she does not have a phone. Only to return 2 hours later by ambulance saying she was too sick to stay at home she did not pick up abx or take meds she was given to take home (inhaler). She was placed in a room our doctor did nothing at all and let her sleep until the morning then sent her home with a cab voucher because the neighbor refused to pick her up. I hear she turned up 6 hrs later by ambulance with the same symptoms. Our doctors keep patients who return or come from another hospital even though they do nothing except take up valuable space.
We had one last week that insisted at 35 weeks to be induced and the phyisician did it! Unbelievable.
Then we had one come in from out of area who said she was 37 weeks and contracting and needed to have her repeat c/s done that night. Well, Doc got an US and baby was 32 weeks and under 5lbs. We were going to keep her over night and observe her. She signed out AMA. We got a call from one of the neighboring hospitals and the same Doc was o/c there and said she was there! He wanted us to call all the hospitals in the area and warn them she was "hospital shopping."
--too many complains hah......and very demanding...jst contnue serving patients and meeting their needs but avoid d relatives esp. the ones who r very demanding slash unpredictable...hehe:nono:
While I agree to an extent on being judgemental ( and what I'm about to say comes from the "human me" not the "nurse me" ) , medicaid comes from the 1/4 chunk that's missing out of my paycheck every two weeks. Techinically you could say we ARE paying for our earnings. The state ( at least in Florida) does not have a money tree at our capital. I've worked other areas in the nursing field and this does bother me. We allow some people ( and based not on judgement but pure birth log statistics at our hospital) come back yr after yr sometimes having 8-9 kids on our tax dollars. What bothers me as a nurse is that there are disabled people being denied or having to spend money to fight for assistance from the gov. These people CAN"T work. I have to ell them how sorry I am that we can't place them in a decent rehab facility, alf, ect. because they can't be accepted due to the fact that their still disputing to get gov aid and they have no personal income.Our senior citizens can't afford to pay for their meds and groceries so instead of starving they buy food and end up sick and hospitalized for a condition that , could they afford it, a pill could help them avoid. People who work all their life and contribute are told "too bad" when they need finacial assistance due to a disease or illness they COULDN"T prevent ( pregnancy is fairly preventable, and in Florida the health department will give you birth control free with no questions asked). It is a frustrating issue and I think that is commonly how it gets expressed by us. I don't think indigent people deserve less or no respect or to be treated differently, but nurse are human too and I can see the personal frustration side also.
Now that I'm probably perceived as a complete villian I have to say I'm also a person, wife, mother of 2. My family and family time is valuable to me also. It's discouraging to work long hard hours to miss out on my family and children not to mention a good chunk of pay for taxes because someone else can remain unemployed and have multiple children on the system we contribute to. MY kids deserve their mom also. I realize this may sound harsh but while I am compassionate to my patients, I don't subscribe to the whole nurse martyr mentality that alot of us nurses are guilted into feeling. I want to take care of my patients but my "other job" is to take care of my family. I have my own children to support also.
I totally agree with you. I am caring and compassionate for all of my patients without prejudice, but in the back of my mind I know and have seen hundreds of cases where people work the system because they just don't want to work. It really bothers me that when I am working 12-14 hour days away from my baby, they are home with theirs and are more than capable of supporting themselves. Yet here I am missing my girl and paying taxes so they can have another kid next year and the year after that and the year after that... when is it going to end?
I suppose you will have to count me in with the minority of posters here who are being flamed for their points of view. I, too think that a disproportionate number of people expecting entitlement in such situations are ones who are having their lifestyle supported by our tax dollars. Yes, the phenomenon of entitlement does cross socioeconomic lines, and at no point would I suggest that the poor have no right to quality care, but you can't deny resentment at the fact that certain individuals obviously don't appreciate the good thing they have. I agree that the system is far from ideal, but there are many places in the world where the poor are left to rot in the streets. Be thankful for the good care that you get and don't insult me as a professional...
As a side note, I would never let my personal or political points of view affect the quality of care that I give my patients. That is just plain wrong. But don't mistake my neutrality in the care I give my patients with an all-out tolerance of stupidity and opportunism. You have to EARN my respect.
...and very demanding...jst contnue serving patients and meeting their needs but avoid d relatives esp. the ones who r very demanding slash unpredictable...hehe:nono:
rn/writer, RN
9 Articles; 4,168 Posts
I'm so sorry, Mercy, for what your father endured. Many times, it's the ones who need help the most who are the least likely to ask for it. That could be a topic all by itself.
Time to shift this thread back to the focus of the original post--the demanding behavior of some patients and their family members.
Here's a question. Do we give patients enough information about what to expect toward the end of a pregnancy? There will always be those who view themselves as the exception to any rule. "I'm not LIKE other people--pain hurts ME." But I think there are many more who simply aren't aware that those final weeks can include a fair amount of pain and several trips to the hospital.
We give patients parameters but I don't recall getting any "real life" info about what it all meant in practical terms. Granted, I had my kids many years ago, but now that my three oldest have had children, it doesn't seem that much has changed in this area.
Could it be that docs don't make this a high priority because they aren't around to see it?
I'd love to see patients get an information sheet at about 36 weeks that gives them the low down on what to expect. Things like, "You may have several weeks of contractions that do not lead to active labor. If you come in, you will be examined by an experience labor and delivery nurse who will assess your progress and inform your doctor. If you are not in active labor, you will be sent home where you can rest in the peace and privacy of your own familiar surroundings. If the contractions let up, you can then resume your normal activities. We're happy to have you come in to be examined, but please understand that it isn't beneficial for you to be admitted if you are not truly in labor."
I finally figured that out by my third child. And I was able to fill my daughters when it was their turn, but it would have been good to have someone spell things out up front. Then I think all four of us would have gone in with the understanding that we might not be staying and being sent home wouldn't have been such a shock and disappointment.
Of course, as I mentioned, there will always be people who raise a stink no matter what. But I can't help but feel there are lots of women who would benefit from a bit of a warning.