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." ?
We only come half way toward killing them then she comes to the rescue of the patient before we get to finish them off.
Seriously, people are not always rational when it comes to their own loved ones. We behave very irrationally.
Besides, if there were data to support this statement how would it change your practice? It would not because you already do the best you can and you already try to keep up on the latest new things in nursing.
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.
Hi.
You sound like an older nurse.You are not helping and obviously did not read what I wrote to the nurse. I choose not to take sides. Try a little Mentoring . It might help you see how others see. Care and foster those who are going to be around to care for us.
Specializes in Rehab/Short-term,retired military medic.
All I can say is that older nurses, or should I say, more experienced nurses should always remember where they came from and that they were ONCE new nurses too. It's a crying shame how the nursing profession eats their young. And I'm sorry. I don't care how tired, stressed ect. someone is. There is no excuse for rudeness towards someone who is trying to help. The sad part is that management is ALWAYS on the side of the patient. The nurse is almost always the one in the wrong. At my facility, this simple incident would have provoked a "discussion" with my department manager. It's a shame. And although she explained her actions to the intern, did she ever apologize to you and thank you for all you do?????? Probably not.
First of all careinc. your post was not up when I posted (maybe it came up while I was writing. Yes, I am an older nurse (57), been at it for 30 years in 7 states and 4 countries and all areas in the hospital, LTC and home health. As much as I want to support my fellow nurses I am frankly more concerned with pts. and I will not deny that I feel that nursing has come downhill in the past decade or so. Even at this site reading some of the comments that some think are witty sickens me. I know there re good nurses out there and I know that many nurses (like diarygirl) want to do better. I don't think it helps them or their pts. to sugar coat things. If you do a good job you should be told and when you don't you should be told. What was said to the pt. was not appropriate for him, his condition and it was not correct. What is wrong with saying that? If you learn to take criticism and learn from your mistakes, even when the lesson is hard, then you will become one of the trusted nurses.
There is no excuse for rudeness? That was not rudeness on the part of the mother that was pure fear. She heard a nurse who would be responsible for her son's life and care while she was gone tell him something that indicated that he might have to suffer unduly because of her inexperience. She had every right to come to that hospital and expect that she could leave him in good hands. I am not saying that this nurse or any other was bad because she phrased something wrong or could have shown a little more undertanding of the pt.'s limitations. I am saying that instead of taking exception and being hurt by the mother's reaction that she can learn from the incident. And just in case there is any question about whether I am in management-no way. I can't stand working around alphabet soup. Yes, I was an inexperienced nurse 30 years ago-I started as a school nurse, on my own with 150 kids in a boarding school for 2 years. When I went to the hospital it was the nurses who were experienced and who were trusted by the patients to whom I turned with questions and for advice. You'd be surprised how helpful someone can be when they are recognized for their experience rather than looked down upon because the new nurses think they are old fashioned. What pts. complain about these days is not that their nurse isn't current on the latest trends but that they are ignored or treated as if they are a bother. They have to worry about whether they are going to be the victim of a medical error and many of them, because many nurses are so ready to tell them how hard their work is, actually don't ask for what they need because they don't want to bother the nurse. That to me is a crying shame.
Specializes in geriatric & childrens psych, rehab, woun.
I have been a nurse for 28 years and the mom of a handicapped children for 21 and 17, and have been the care taker of a retarded relative since we started school together in 1965 my aunt held him back so he would go to school with his 4 cousins to protect him. That being said let me play the devils advocate, we all become ****** when our child is hospitalized, factor in the fact he is a child in an adults body, his mother is a forever parent, I do not know the childs cognative fuctioning but i do know that pain is subjective and he may be a pleaser and will not express his need for pain meds. she also came from a less accepting time, she had to fight for his education, services and she has to contenplate her own death and his future and with the death of her spouse it is amplified. she is not a witch who hates her field she is a frightened parent who is her childs only advocate. and yes she was educated in a diffrent era of nursing, whe is in her 60's most likely, back then the focus would have been atc pain meds. her stats are probably on the money. instead of alienating her learn from her start a conversation with you are an excellent advocate for your son or i think you have done a wonderful job with your son. I can tell you first hand it sucks to be the parent of autistic, with another rare genetic disease called laurence moon bardet biedl syndrome and having walked a mile in the shoes i thank God for that generation because they did not sit back and except the glorified babysitting of early special education programs. Rain man is fun to watch but stinks to live with. and he is 17 I have to face becoming his permant guardian, fight to get him an education and services, and know that the average wait time for a group home is 9 years bit daunting isn't it
2.5 patients? I've been a nurse now going on 21 years. Gee, I better get on the bandwagon. I haven't even started to meet my quota! Oh, the shame of it all...
You sound like an older nurse.You are not helping and obviously did not read what I wrote to the nurse. I choose not to take sides. Try a little Mentoring . It might help you see how others see. Care and foster those who are going to be around to care for us.
Love always:bow:
I accidentally clicked "thanks" on this comment and I wish I could undo it. I certainly do not think your response is helpful AT ALL. The poster took the time to write a thoughtful answer, if you do not agree that is fine but do not insult her and make a nasty comment about "older nurses." I recommend that you try to respect others regardless of age or experience and you will be much more successful and have less conflict in your life.
As a new nurse I have dealt with this from some of my own coworkers! Stand your ground and let them know that you are not stupid and that everyone has room for new knowledge! As for MOM, I would like to say "Oh yeah, how many did you kill off?" When really it is just better to ignore patient and family comments because nothing you say makes a difference to someone who is scared even if they know better!
While everyone has room for new knowledge, new nurses have room for a lot more than those with experience. That's what experience means. If what you say about the mom is how you truly feel I say have at it. Please don't ask advice from or listen to the nurses with more experience that just MIGHT be more concerned with their pts. safety than your ego. Please don't because your concern about YOUR feelings and YOUR importance will block out understanding that the more experienced nurse has seen too many patinets and nurses suffer because the person charged with repsonsibility for the pat.s care and well-being just didn't ask...for advice, for help, for anything. A new nurse who thinks she has more to teach than to learn is just as obnoxious as a new doctor who thinks his degree makes him/her better able to deal with a question than an nurse with years of experience. YES, we all can learn and frankly we "older" nurses welcome and want to learn what the new ideas and approaches are. We have full time jobs, families and years of CEU's behind us but that does not mean we know it all. But, when we know it and we tell you because we have just seen you demonstrate your ignorance of the fact or approach, we are doing so for one reason-to protect the patient. The fact that it can help you become a netter nurse is what's in it for you. And once again, read the stats-when we kill 100,000 people every year just in the US alone because we have made a preventable error then she and every other pt. who enters our facility has every right to be scared and protective.
I really can't accept the story that U.S. nurses "kill" 100K patients every year. If we did we would have Congressional committees, people watching us like hawks, more and more regulations and the doing away of med techs and LPNs. This would be a political "hot potato" that politicians would love in an election year. Maybe we should dress in black, instead of white. Sorry, if this is some sort of "study" like the "studies" I see all the time...more to score points and get grant money...I'll skip it. It is much easier to blame nurses than to blame others, with more power in the workplace.
Actually graysonret it is a true statistic and it has come to light after the incident with the Quaid twins. If you do a little research you will find the reasons that it is not as well known-they are much along the lines of what you suggest might be the reasons for the stats-it is money based but the truth is influenced by how much power those who would be hurt by them have. Having in one 2-week period conclusively documented 17 medication and treatment "errors" on the floor of one unit in a LTC, I have no problem believing them. When you see nurses who record VS they have not taken, have A&O pts. tell you they have not received medications that are charted as given, when you can look at a blister pack that is missing 3 pills when 7 are charted as having been given, chart that O2 filters have been cleaned within the last 8 hours when they have not even been removed from their slots, find orders written to cover known medication errors, it is not exceedingly difficult to conclude that there is a large problem. Remember,the very same congresspeople who might get some support from the constituents would lose much of the support (which ncidentally has more money backing it) from the big execs who run the hospital and for credit compnaies that own them. It's a crying shame but it's true. Sadly, the same attitude that affects the low voter turn out in elections (What difference does one person make?)coupled with the absurd idea that it is more important to "support" fellow co-workers simply because they are "nurses" than to report them is what keeps this from being more well known and proliferating. As I said in an earlier post with the same statistic. In 1981 we had 2 cases of MRSA in the hospital where I worked. MRSA is now in the geeral public and is almost epidemic. The reason is simple: infection control rules, like handwashing have not and are not observed as if each person's life depends on it. Now we lose 50 lives a day (19,000 in 2005) to this largely preventable condition. WE need to wake up. If we are going to allow our fellow "professionals" to cntinue endangering lives out of some misplaced sense of allegiance to them over the patient we are going to continue to have these problems and one day it will smack us in the face when we lose a family member or loved one.
Agnus
2,719 Posts
We only come half way toward killing them then she comes to the rescue of the patient before we get to finish them off.
Seriously, people are not always rational when it comes to their own loved ones. We behave very irrationally.
Besides, if there were data to support this statement how would it change your practice? It would not because you already do the best you can and you already try to keep up on the latest new things in nursing.