Went into a patient's room today - the son(patient) is a pleasant man in his 40's with mental retardation. The MD's removed his epidural today and he still has a chest tube. I tell him, "Ask for your pain medication when you need it. If you don't need it, it would be better not to take it."
Right before this - Mom had told me she was going to go home at 10 pm. But after I said this, she became irate.....she said the following.
"New nurse's don't know anything. I have been a nurse for a long time. A nurse kills 2.5 patients in her career - that's a statistic. Nurse's don't have the corner on dealing with pain and doctors don't overperscribe what patients can have. I am glad that when I am old, I won't have to worry about being in a nursing home because you young nurses will take care of me to where I don't leave the hospital."
I really tried not to be baited by what she said. I commented that she had a dim view of her professions future, that I WILL give her son pain meds when he asks for them and needs them.
She demanded to know my last name, and when I asked why, she said, " I only take down the full names of people I don't think are going to give good care to my son. His father died 6 years ago and he's all I have left."
I was stunned that someone would have such a dun view of our profession! And after I was just trying to give the patient some options!
So I had the doctor talk to her and I wrote a note detailing all this and put it in the chart. The intern said that she said she was just tired andgrumpy and she knew she was out of line.
So There you have an older nurse's view of where our profession is going.
Have any of you ever seen research data to collaborate her claims that a nurse "kills 2.5 people in their career." ?
I think you have to take "Mom" with a grain of salt. She is in a bad way loosing her husband and now having to take care of a sick and mentally ill child. However! That being said, after a comment like that I would ask to see her nursing license, and if she really is a nurse, I would ask for a psyche eval for MOM!
Her son is obviously in a vulnerable position and people are not themselves.
I would have said, "Let me give you some privacy with your son" and left. If he needed meds, and you brought them in, and she refused them for her son, then that's all you can do.
I think what set her off is your comment "its better not to take it if you don't need it." It sounds as though you are worried that he will become addicted. I don't think you are, but I have personally spent a lot of time explaining to people that are in pain that it is ok to take pain meds and they are not going to become addicted in 3 days! Most older people are afraid of pain medication. I took care of a lady yesterday that was 1 day post op for valve replacement, her pulse was elevated and she was obviously in pain and even stated so, the first thing out of her mouth when I offerred her a pain pill was "No, I don't want to get addicted!" I have also seen people suffer because some nurses believed the patient shouldn't need or have all that pain medicine. I am sure that lady has too and was probably concerned that you would not anticipate when he might be in pain while she was gone. Remember, we treat the family too! I always assure my patient in front of family members that if they need anything or experience pain to call. This lets the family members know that you are watching out for their loved one. They just need reassurance.
The same thing happen to me recently (I am a new nurse as well). I had a older pt who had a very anxious family. Each time i walked in the room it seemed like they were about to go ballistic on me but after some talking they were calm and applicative but if i left the room for a while and then came back i'd have to go through the same song and dance with them. Its a crappy way to deal with stress but some times the nurse is there only focal point to get their frustration out. I just roll with the punches cause a majority don't mean to be that hostile to you.
You're shift will go much smoother if in the beginning you reassure the family that you care and have their best interest at heart. Once you earn their trust, they will relax.
I have never had anything like that happen to me and thank goodness. I don't know that I would have been able to hold my tongue as well as you did. You are right though, we should be building each other up, not tearing each other down. I remember what it was like to be a "newbie". I was unsure of myself and had some very hard patients. I am glad that I had a nurse to take me under her wing and help me out. GOD BLESS HER! As for that mom, she had no right to say those things to you but I would be willing to bet someone said that to her too. I hope you never have to deal with anyone like that again, but if you do, you already know how to handle yourself. Keep smiling. Kudos!!!
Specializes in Trauma acute surgery, surgical ICU, PACU.
I remember someone asking to talk to "the REAL nurse" when I was new.
I also looked very young (I was young, I was 22 but I've always looked younger than my age), and patients families were constantly asking how old I was.
Being new is just hard, and it's hard to get to that place where families trust you right off. Some families never do, they pick their nurses that they decide not to trust for the sake of it.
Went into a patient's room today - the son(patient) is a pleasant man in his 40's with mental retardation. The MD's removed his epidural today and he still has a chest tube. I tell him, "Ask for your pain medication when you need it. If you don't need it, it would be better not to take it."
Right before this - Mom had told me she was going to go home at 10 pm. But after I said this, she became irate.....she said the following.
"New nurse's don't know anything. I have been a nurse for a long time. A nurse kills 2.5 patients in her career - that's a statistic. Nurse's don't have the corner on dealing with pain and doctors don't overperscribe what patients can have. I am glad that when I am old, I won't have to worry about being in a nursing home because you young nurses will take care of me to where I don't leave the hospital."
I really tried not to be baited by what she said. I commented that she had a dim view of her professions future, that I WILL give her son pain meds when he asks for them and needs them.
She demanded to know my last name, and when I asked why, she said, " I only take down the full names of people I don't think are going to give good care to my son. His father died 6 years ago and he's all I have left."
I was stunned that someone would have such a dun view of our profession! And after I was just trying to give the patient some options!
So I had the doctor talk to her and I wrote a note detailing all this and put it in the chart. The intern said that she said she was just tired andgrumpy and she knew she was out of line.
So There you have an older nurse's view of where our profession is going.
Have any of you ever seen research data to collaborate her claims that a nurse "kills 2.5 people in their career." ?[/quot
Hi Dairy,
I wish you did not feel bad a all. Mom's words sound like a frustrated , angry, bitter , and tired parent who is just ready to throw in the towel. Imagine yourself at say 65-70 taking care of your 40 year old Mentally Retarded son? Thats 40 years of your life, which might have been bliss before! Do give yourself credit for your efforts, and pat yourself on the back every day for lasting this long .This might have been your first big critic and what she is saying is not all true.
Older nurses tend sometimes to be a lot like 'Mom' . She is from a different age. We do things different now.And, she was just being a mom- protective. You might have said though that, "taking your pain medications on time will decrease the chance of your pain getting out of control and difficult to manage" especially if he still has the chest tube in. Never had one but patients says it hurt ,and that they are uncomfortable.
I don't know where "mom" gets her statistics from unless you have "killed" someone then youshould feel bad. After ten (10) years I probably outdone my Quota:nuke: . All the best girl keep that torch burning:bow:
Went into a patient's room today - the son(patient) is a pleasant man in his 40's with mental retardation. The MD's removed his epidural today and he still has a chest tube. I tell him, "Ask for your pain medication when you need it. If you don't need it, it would be better not to take it."
Right before this - Mom had told me she was going to go home at 10 pm. But after I said this, she became irate.....she said the following.
"New nurse's don't know anything. I have been a nurse for a long time. A nurse kills 2.5 patients in her career - that's a statistic. Nurse's don't have the corner on dealing with pain and doctors don't overperscribe what patients can have. I am glad that when I am old, I won't have to worry about being in a nursing home because you young nurses will take care of me to where I don't leave the hospital."
I really tried not to be baited by what she said. I commented that she had a dim view of her professions future, that I WILL give her son pain meds when he asks for them and needs them.
She demanded to know my last name, and when I asked why, she said, " I only take down the full names of people I don't think are going to give good care to my son. His father died 6 years ago and he's all I have left."
I was stunned that someone would have such a dun view of our profession! And after I was just trying to give the patient some options!
So I had the doctor talk to her and I wrote a note detailing all this and put it in the chart. The intern said that she said she was just tired andgrumpy and she knew she was out of line.
So There you have an older nurse's view of where our profession is going.
Have any of you ever seen research data to collaborate her claims that a nurse "kills 2.5 people in their career." ?
OK I have quite a few reactions about what you describe.
First is dismay at what seems to be the loss of the ability of nurses to empathise.(Not just from what is missing from what you say but from the replies.) This woman has lost her husband, she has raised a MR child who is now an adult with a medical problem in the hospital. He must have something major going on if he has a chest tube. So, without considering that she is a nurse and has a very good idea of what can and does go wrong, I see a terrified mother. Whether our children are MR or "normal intelligence", whether they are 40 years or 40 months old, when they are in the hospital they are our "babies" and we will protect them while being scared that we will lose them. Did you have any idea of what might have gone wrong since he came into the hospital. Whether it had been smooth sailing the whole way or not she was stressed and likely working on little sleep which increases that stress.
Secondly, she was correct and in this case it is difficult to believe that you would have made the statement you did to a MR person. It would have been better to tell him that with his epidural control gone his pain will be controlled a bit differently. He is to call you at the first sign of discomfort. That is when you deal with whether it is too soon and when you assess how strong the pain is and work out how to deal with it. Does he understand pain the same way as you? There are varying thresholds for pain among people, that are affected by gender differences, age differences and cultural background. Telling anyone, especially someone who may not understand that he CAN call you if he feels he needs to and not when it might be what you consider pain, is not the best approach. Yes, you do not want him to become addicted, you do not want to risk his having problems getting off pain medications, but that is your job to work with himand the doctor to find a suitable level of relief. Consider if this patient was still MR but his mother was not a nurse but someone who left and told her son, now remember what the nurse said, don't go asking for medication just because it hurts a little. What happens then? Have you ever seen a patient rip out his IV and chest tube because he is in too much pain? I have, I worked in a war zone.
Third, yes, the mother was correct about stats. I do not know about the 2.5 specifically but at least 100,000 people die EVERY YEAR in the US from human error in health care settings. Yes, ladies and gents, we nurses and doctors kill more people every year than die from auto accidents, breast cancer and AIDS through medical mistakes that happen because of human error. We have allowed MRSA to grow from a relatively rare occurence to an out of control problem killing 50 people, 85% of whom acquired it in a hospital, everyday. And 1 in 10 patients (that's 2 million every year) will acquire a new infection while in the hospital. The rate in ICUs is 30%.
My advice to you if faced with this situation again is to: take a deep breath and look at the person in front of you. Ask yourself what s/he might be feeling. Rather than seeing an attacker or an enemy see the person inside who is scared and is attacking out of fear, not a desire to hurt you. Then honor that person's pain by recognizing them. Thank them for pointing out the error you made and rephrase your statement to say what would have been correct. In this specific case, I would have accepted that even with your 5 years experience, this nurse may have had more than you and after dealing with that situation ask for her insight and experience to help you help her son and your future patients. Not only have you honored tis woman's pain, fear, relationship to her son and experience but you have defused her anger because you have recognized that she is a person and she is scared.
leslie :-D
11,191 Posts
ha!!
watch out people...this is a trick question.
hahahahaha.
leslie