Something that has been bothering me

[Griffin123]

Hi folks! I'm a pre nursing student and don't pretend to know much of anything about nursing yet so I had a question I wanted to run by you all.

About a year ago my mother was hospitalized for a spontaneous pneumothorax. She had a tube in her chest and was on some pretty crazy pain meds. She appearently had some issues keeping food down. The RN taking care of her commented that if she can't continue to keep her food down and green shows up in her vomit there is a possibility that she would have to have her gall bladder removed.

I was a bit uncomfortable with the RN making this statement as it seemed to have the effect of worrying my mother (and the rest of us) a bit prematurely. When the staff had left the room I told my dad I didn't think the RN should be saying that because (again) I felt it was a bit premature. The RN walked in as I was saying this to my father and she decided to say it again in a louder tone (in a sort of "in your face" kind of way).

My mother is a very dainty lady and doesn't drink and doesn't like drugs in general. Under any other circumstances it would almost have been funny to see my mom so loopy. When she was given food she said, "Let me hurry up and eat this food so they don't remove my gall bladder." (again, she was dead serious and quite loopy from the meds)

In the end, there was nothing wrong with her gall bladder and they never had to touch it. Although I have no doubt that the RN might have been correct in her statement and that removing her gall bladder might somehow be a future possibility, I was a little aggrivated that she worried my poor mother for nothing (and also restated it in that "in your face" kind of way).

Is this sort of thing normal? Is this common for nurses to do? Or was I out of line for disagreeing that the statment should have even been made in the first place?

[CVmursenary]

yes; every nurse is a jackass, very normal.

[Scooby's mom]

Sorry this happen to you guys. I'm just a pre-nursing student, but I don't think the nurse has the authority to say this, unless the doctor mentioned it to you guys. I may be wrong, but it's sad to see nurses with this type of attitude-thank God not all of them are like this. Was this in NY?

[Griffin123]

It wasn't the doc, it was the RN. This happened in Alabama. But I would have been equally uncomfortable even if the doc had said it. There's a huge difference between saying, "We have to take your gallbladder out." and "We might have to take your gallbladder out". I'm OK with the former. If I were a medical professional (and I hope to be one day), I would be very very hesitant to use the latter for exactly the reasons stated above.

[Skip219, BSN, RN]

It is unfortuate that nurse misspoke to your family. Pain medications, specifically morphine can cause abnormal perstalisis of GI tract. This fact would explain vomiting bile like emesis. The nurse failed to base her statement on anything except observation(old school). Some nurses lack tact and people skills.

[CapeCodMermaid, RN]

When I was a little kid I fell and split my chin and bit my tongue hard enough to have to go to the ER. The charming nurse who "took care" of me told me if I didn't keep the gauze on my tongue, I would need stitches and "IT WILL HURT!!!"

When I was 9 I was hospitalized with pneumonia. I had recently had major surgery and every cough was agony. The nurse came in my room with a huge, long needle and told me if I didn't stop coughing, "they" were going to stick the needle in my chest and IT WILL HURT.

Last year in the hospital. ER nurse came in to start an IV. I have bad veins and she couldn't start it. She yelled at me for having bad veins! I called the supervisor.

The point----some nurses are just plain mean. Your mom's nurse had no business approaching her in the manner she did. Sounds like she's a bully.

[lovleeme]

CapeCodMermaid...that's just sad.

[Esme12, ASN, BSN, RN]

It is unfortunate that nurse misspoke to your family. Pain medications, specifically morphine can cause abnormal peristalsis of GI tract. This fact would explain vomiting bile like emesis. The nurse failed to base her statement on anything except observation(old school). Some nurses lack tact and people skills.

Since there was no mention of the nurses age or experience level you are failing as well to base your opinion in fact. But you are right...... some people in general, whatever the profession, lack skills on many levels.

Being an "old school" prepared nurse I think I can address this............

I have seen many professionals, nurses (RN/LPN), physicians, lab techs, rad techs, and nurses aides, open their mouths and utter nothing but unintelligent prattle that it makes you wonder if they were even schooled at all or possess an once of common sense.

There are bad cops, bad teachers, bad waiters and crazy scientists.......just as there are bad doctors and nurses. I have sat at the bedside of family members and heard people babble such unbelievable bull feces that, even after being in the medical profession, I remain amazed at the utter stupidity and unmitigated gall of some people. I am amazed they can get out of bed in the morning and brush their teeth and wipe their ......uhm....noses.

You are going to run into idiots wherever you go, they are everywhere. I am sorry your Mom had to experience this and take pride that you have an instinct that tells you something isn't right....a well honed bull meter.........it will serve you well in nursing.

Anyone vomiting and not eating you will throw up bile. Bile is produced whether or not you have any food to digest so if that is all you have in your stomach when you throw up....it will be green. Pain can cause nausea, pain meds can cause nausea, not eating enough can cause nausea. I am sorry this upset your mom and I'm glad she is better.

I wish I could apologize to every patient that the uninformed with big mouths have offended, frightened, or misinformed patients and their families.................

but you can't fix stupid.

[knittygrittyRN, MSN, RN]

It was wrong for her to say but (and I'm not saying that the nurse was right but look at it from this perspective) it is very emotionally draining to be caring for patients and we become accustomed to death and dying. It sounds like this nurse was worn out and wasn't really thinking about what she was saying. Keep this in mind when you start practicing that while we see certain things everyday patients and their families don't. Sometimes its easier emotionally to not think of patients as people (which is wrong because they are) but it allows people to cope. It still wasn't right but I think it provides some information about what nurses cope with everyday.

[AngelicDarkness]

I can't say what the nurse was thinking, or what was running threw her head at the time of that conversation, but personally I've had to tell patients in LTC that they will get pneumonia from laying in bed, and have sent one or two to hospital recently because of it. Sometimes we assume too much, and sometimes we are accurate, other times not so much.

I'm sorry for what your family went through, but again, we don't know what the nurse was thinking, what her day was like (not an excuse, but can be a cause and effect situation), or anything that was left out about your Mother's situation (2 sides to every story). My own bed side manner can be found lacking on a poor day, despite my smile, residents/patients at my facility that know me the best, will know something is off. They can't picture what, but they can tell something isn't quite right. (Although that gets my smile back on track:))

[Tweety, BSN, RN]

It was wrong of her to say that because just because a patient is vomiting bile doesn't mean they are having gall bladder issues.

However, most of us are educated and experienced individuals trained in assessment and for watching for the "what could happen next?" "what does this mean?" "why is this happening?".....and sometimes we can share this information with patients. We don't make medical diagnoses or prescribe treatment, but we are educated professionals.

I hate when nurses don't reassure patients, don't communicate, or give bad information or say "because the doctor ordered it". If it were me, I would have said something like "from my experience, some pain medications cause nausea and vomiting...I will notify the MD and administer what she/he orders, but for now just take it easy and take ice chips, or what liquids you can tolerate without forcing down food". My answer might have been different if they had abdominal surgery and they were extremely distended and without bowel sounds........or if she was vomiting with right upper quadrant pain..etc.

This nurse just was dumb.....shameful, but there are some out there.

[karrncen]

Very sorry to read that the nurse misspoke, but also conveyed incorrect information. As a number of members have stated, presence of bile is not unusual when there is no food present and the (likely) narcotic medications can cause abnormal persistalsis. Sad that a "professional" would choose scare tactics over facts and supportive care.