Sigh. Is this really how we are graded?

[eriksoln, BSN, RN]

So, yes, I had another one of those days where............things just kept going wrong. None of my meds were in place to be given at the right times............but I dealt with it. There were some errors made by the shift before me that required me to spend time sifting through the mess of "who ordered what" in order to make sure...........what was ordered was really.........well, what was ordered. I handled that fine, no hitch. Had a very needy pt. in the room next to my assigned patients who didn't feel her nurse was up to snuff in fetching her all the things she wanted and decided to recruit me as her Denny's waiter to fill in the gaps. I kept my professional face on despite having much more pressing things to attend to and made her happy. I had a very complicated D/C that needed to be completed by noon (the pt. scheduled herself for things to do starting at 2pm), and made sure it got done.........................only to have the room filled up MINUTES after that pt leaves............filled with a very heavy post-op pt. Said post-op pt. had a spouse who was very afraid for her and very concerned about her well being..................and needed a little bit of attention himself. I made sure he got it and that she was comfortable, all the while completing the mess of an admit that was half done by "same day" before she was rushed off to surgery (because the float nurse was at lunch). I haven't even mentioned the dressing change with the lady who could barely move and was in a lot of pain nor the older gentleman who wanted to talk about baseball all DAYANDNIGHT.................

I'm not tooting my horn or throwing the poor me's out there. Just saying.........the recipe for disaster was there, with a ingredients very fresh and oven warmed up ready to bake. But I handled it without getting attitude or letting care drop off (or so I thought).

It came to the end of the day. Family members are leaving, going home...........some thanking me on the way out. I'm all caught up.........charts are neat and tidy with all orders taken off correctly, meds passed, pt's comfortable, "I"s dotted and "T"s crossed etc etc......................so I feel pretty good. Don't even mind the fact I am working all weekend.

Then the daughter in law of my one problem pt. steps out into the hall to create a scene. Yes, she's a former nurse (of course) and oh..............this is just unforgivable. See, I gave her mother her Zosyn two hours late. How is she going to get any better with care like that? And to boot, I tried to give her mother heparin in her IV instead of SQ like it was ordered. Am I trying to kill her now?

OK. Back up the truck, lets look at the facts: Said mother (the pt) was just one of those "I am in control" types. She wasn't happy unless she was sure you understood this................and, well, I thought I had heeded to her this boundary as she desired it so. She commented to me as I took her antibiotics in that the night nurse had been very late with said antibiotic during the night. I looked at the documented time of administration............it was about an hour late. Pt. wanted this one I was giving held for an extra half hour...........so the were not too close. OK. You da boss.........gotcha. Came back and administered antibiotic half an hour later as directed........saw no reason not to do it this way if thats what made her happy.

Guess that request was not enough of flexing the muscles though. I took the next Q6 antibiotic in later on in the day and...........well, no way, she wasn't having it. Wasn't willing to take it until 10 pm (it is now quarter till four.............antibiotic due at 4). I went through why I didn't think skipping a dose would help her and all.......................talked her into letting me hang it at 6pm. OK, its late as heck but she got the dose and its sooo much better than 10pm.

Six o'clock rolls round..............I'm going in to give now VERY late Zosyn and guess who is there. The daughter in law. She is livid because her mother's antibiotic is late. Seems mommy changed her story on why she did not have it running already when daughter in law got there.............told her I was busy and she missed the dose, had not seen me all day. Then, to add logs to the fire, made up this story about me trying to put heparin in her IV................

She succeeded in getting the spotlight off herself and onto me. Daughter pranced around like she owned the place with this "Alice in Wonderland" Queen "off with their heads" attitude. I explained what had gone one, but of course she wasn't hearing it.

So, now I'm fired by one pt...........on an assignment I spent the day making everything right on. Yes, I'll be on a different assignment tomorrow, daughter in law does not trust me to care for her mother soooo.............

I'm sure I'll be in the manager's office defending myself come Monday.

So is this how we are graded? A day in which I have to work miracles just for simple care to be given and............one oddball makes the whole day an epic fail?

Shesh..................."Team Nurse Burnout 45, Team Eriksoln 10".

[mehitabela]

{{{eriksoln}}}

Wow, that must have been so exasperating! Sounds like you did what you were supposed to do with a game face on. I wouldn't worry about it. There is always that ONE patient or family member, isn't there, who takes pride in derailing our best days! Give yourself a pat on the back and put your feet up...I'm sure your manager knows all about those kinds of patients. Hope your weekend goes better.:)

[Asystole RN]

Being fired from a difficult patient is the ghost of Nightingale giving you a +1.

You did the best you could in a very difficult position, kudos to you. Look forward to the fact you will never have to deal with her again.

[new_worker]

That was the longest post i ever read. But they should remember that saying, "you never know what you had till its gone."

you did the best that you could, but unfortunately things happen that don't favor everyone. Best of luck.

[carolmaccas66, BSN, RN]

I enjoy your posts Erik but find them a bit long. Maybe keep it shorter next time?

Don't worry, everyone has bad days. Quietly take the daughter somewhere & explain how busy and caught up you are - tell her what you said on here, re tidying up after the last shift etc. No-one is perfect and you are not superman, though people - for some weird reason I've never figured out - expect nurses to be miraculously wonderful 24/7.

She is just another member of the public who does not appreciate any care that is given to them or their family.

[makes needs known]

I got a phone call from our DON this morning letting me know that I was receiving a deficiency because I did not put a 2nd pillow under a pts arm. She had 1 good pillow under her elbow fx, her arm and hand were elevated well. When a patient complains just lay your head on the chopping block.

[JBudd, MSN]

. Quietly take the daughter somewhere & explain how busy and caught up you are - tell her what you said on here, re tidying up after the last shift etc.

Sounds nice, but there are people who WILL NOT listen or hear anything you have to say. Mama said this happened and thats the end of it, there are no excuses and no explanations no matter how accurate/truthful/honest you are. Daughter will not go anywhere quietly nor listen to anything.

OP: when stuff like that happens, I write a quick note to my boss about what happened and why, so she hears my side of the story first and is prepared when the complaint comes in.

[nursel56]

It might help to remember that they have to live the rest of their lives inside of the misery they tried to share with you. You're not the #epic #fail. Should I skip the lecture about how they were probably just scared deep down inside and that if you had just therapeutically communicated better everything would've been fine? :chair:

[Isabelle49]

That is why I won't work in hospitals anymore. I would rather work for wallyworld!

[pedicurn, LPN, RN]

I enjoy your posts Erik but find them a bit long. Maybe keep it shorter next time?

Don't worry, everyone has bad days. Quietly take the daughter somewhere & explain how busy and caught up you are - tell her what you said on here, re tidying up after the last shift etc. No-one is perfect and you are not superman, though people - for some weird reason I've never figured out - expect nurses to be miraculously wonderful 24/7.

She is just another member of the public who does not appreciate any care that is given to them or their family.

Yeah but ... we can explain how busy we are etc etc in Australia and expect them to understand.

We are still allowed to (politely) tell our p'ts to behave

However the US seems to be a different kettle of fish. I'm sure the p'ts there don't even want to know the nurse has other p'ts or is having a particularly demanding day ..let that slip and the p't gives her/him a poor score and/or makes a complaint.

Then it could be all downhill from there.

[noahsmama]

Yes, that's definitely one of the things about bedside nursing that I do NOT miss -- you can do a million things right, and nobody cares, but do one thing wrong -- or not even wrong, but in a way that somebody somewhere doesn't like -- and you hear about it.

The only thing I would have done different than you -- and this is NOT meant as a criticism -- but I would not have agreed to hang the antibiotics 2 hours late just to make a pt happy. I would have explained that they had the right to refuse a medication, but that if she did, I would have to notify the doctor, who would most likely want to come and have a talk with her about it. I would also explain why it's so important for abx to be on time. Then, if she still refused, I would have documented it as such and notified the doctor.

But again, that's not a criticism -- sorry you had such an annoying ending to what sounds like an otherwise stellar shift.

[DedHedRN]

If the OP had documented the reasons family was refusing care as they were refusing it, wouldn't that help when it came time to talk to DON?