Terrible clinical day, nurses don't seem to care.

Nurses General Nursing

Published

I may get a lot of flack for this from the more experienced nurses, but I would like some help in understanding this situation.

Today, I walked by a patient's room in the hallway. Keep in mind she is not my particular patient today. She calls out to me in a frail voice for help, and sounds like she is in very bad shape. I go in to see her and she is crying, and very frail. She must have been in her 80s or even higher. She stated that she could not move her arms, and that she was desperate for some water. My first thought was that she might have been having acute MI or something similar because she couldn't move her arms, I really didn't know. I held her hands quickly and asked if she could feel my hands in hers. She said she could, but that she can't move her arms, and continued to cry and beg for water. She kept saying that she did not know where she was or why, and to please help her.

At this point, I noticed the restraints. She was strapped into her bed, this is why she couldn't move her arms. I was horrified. This is a med/surg floor, not a pysch ward. I asked one of the tele people what was going on and they stated 'it's just some crazy old woman, she's weird don't worry about her'. I asked her nurse and this was the same answer I got from her, again. She stated this woman had previously tried to pull out her IV and so they restrained her.

So...

Help me understand. They clearly had to get an order for these restraints. Why did they not choose a chemical restraint or sedative instead of strapping her into the bed? Why does no one care about this woman, writing her off as a crazy old lady; when she is, in reality, a frightened human being who was strapped into her bed in a strange place and scared to death. Not to mention thirsty, as she was apparently NPO and no one would explain to her why.

I went into the stairwell and cried for about 5 minutes. This is not why I wanted to go into nursing. I see things like this every day, but never this bad before. Restraints! They strapped this poor woman down and wouldn't explain anything to her. I spent some of the rest of the day talking to her and trying to help her relax even though all she wanted was to get out of bed and get some water.

It broke my heart. And if this is what nursing means, that eventually you become so burned out that a fellow human being suffering in one of the worst possible ways becomes just some 'crazy old lady', then I want no part of it.

Specializes in LTC.
You made a most excellent posts that explains it well. Thanks!

I guess I feel like being self-deprecating today. It only happens on days I manage to drop my car keys down an elevator shaft. :hdvwl:

Specializes in Gerontology.

I completely understand this situation, and I would hope I wouldn't be one of the upset students. However, from a student's perspective, can I just make one plea? You are completely right about what should have been done with this patient, but did someone explain to the students calmly why things were the way they were? I can't tell from your post, other than that they were told politely not to hold meds, but where they also politely and rationally told WHY? I think so many issues (including the one I brought up here) could be taken care of much better if just a few minutes are set aside to answer questions. Everyone was a student once, and remembers how frustrating it was to not be explained some very important things. It helps you become a better nurse, and the nurse herself can feel better about truly helping someone.

Yes - they were told. But because they had not seen this side of him, they did not believe us. And tried to hold the med again. This time, the nurse was watching and she gave it. And we never gave him to the batch of students again. Our unit had a good reputation for nursing students - we have been told several times that our nurses are very supportive of students and teach them alot. This batch just wasn't open to feedback - the instructors fault, not theirs. We requested that this instructor not be permitted back and we haven't seen her since.

Yes - they were told. But because they had not seen this side of him, they did not believe us. And tried to hold the med again. This time, the nurse was watching and she gave it. And we never gave him to the batch of students again. Our unit had a good reputation for nursing students - we have been told several times that our nurses are very supportive of students and teach them alot. This batch just wasn't open to feedback - the instructors fault, not theirs. We requested that this instructor not be permitted back and we haven't seen her since.

Well I think in this situation the problem is pretty clearly with the students. If they were explained why this patient needed that medication, and didn't listen, it reflects on their likely future behaviour as nurses. Too bad.

Yes, it would have been NICE if the nurse you talked to (the tech or whoever you talked to first seems to not have been taking care of the patient, or really known what was going on, so i'm disregarding them.) had said, "Oh that sweet dear... she just doesn't know what she's doing." Instead of saying "yeah, she's crazy, ignore her." It's easy to get frustrated. So... sorry the nurse wasn't super sweet and patient with you.

I've got to be honest, it's a little offensive to be talked down to this way. I have been very respectful here, and I was very respectful to the nurses in question. I am not, and have never asked for someone to be "super sweet" to me. I am simply asking for the professional courtesy and respect and compassion that is the industry standard in nearly every job in existence. I have been in experienced roles before, tutoring new people and I have been able to take the small amount of time required to treat other people with a basic amount of respect.

I'm just going to say that I find a little irony in consistently being told to stop making assumptions about the nurses behaviour, when some of you are making assumptions about me and what my problem with this situation has been.

Again, I'm very much grateful for the advice on restraints and what to do in the future, but the assumptions that I was a brat towards these "obviously overworked" nurses is simply that: an assumption.

Nursing education is crappy because it relies too much on overworked bedside nurses who aren't compensated (or who aren't compensated enough) for teaching students and orienting. They have too much to do already without worrying about what the students are getting into (or telling their instructors!). How much happier everyone would be if nurses who wanted to teach were given decreased pt. loads in order to do so safely and effectively. I'd love it!

Up until very recently I was super nice to the nursing students and their clinical instructor (because I graduated recently and said I'd never be one of those "nasty" floor nurses.) Then I realized I was getting all the students! The students were asking for me and the instructor was funneling them my way because I was doing my best to do some actual teaching and didn't complain. Unfortunately, I started becoming not so nice and friendly because I was burning out and finding I wasn't effectively managing my time. Patients are my priority...

I complained to the instructor recently because she have me three students to pass morning meds with. She looked at me and said, "Well, more hands to help, right." I felt like slapping her and just walked away. I was a wreck that day, morning med pass took me three times as long and I was late with two patients. I couldn't find my MARs all morning. And a med error occurred (wrong route, given PO, not IV as ordered), which I guess was my fault but I didn't report... It was just too much.

Specializes in Hospice.

This looks like it's fixin' to deteriorate into one of those endless threads about eating our young.

Me, I'm gonna have a lemonade and finish my vacation ... :onbch:

Specializes in LTC.

:lol:

This looks like it's fixin' to deteriorate into one of those endless threads about eating our young.

What have I said wrong?

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
I'm just going to say that I find a little irony in consistently being told to stop making assumptions about the nurses behaviour, when some of you are making assumptions about me and what my problem with this situation has been.

Sorry about that. Some of have been on all sides of this issue, we know the stress of having a confused patient who demonstrates they can be harmful to themselves while we also have four to seven more patients to care for. We know "what the books says" about handling these situations.

We know there are battle axe nurses whom are uncaring and tie up people without a thought to the human being underneath.

We know the sting of student nurses judgements on us, thinking we're lazy, we cut corners, we eat our young, we're uncaring and burned out.

At the same time while reading your posts, it's not fair to make assumptions about you and we should open our minds a bit to your experience and what you're saying. We haven't forgotten that we were students once as well. I think if you're consistently being told not to make assumptions you perhaps should open your mind a little bit and admit that perhaps you did.

You've also gotten some support. I think it's great that you're so compassionate and caring. Hold on to that.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
What have I said wrong?

Nothing it's a old joke for the oldtimers hear. Ignore it. LOL

At the same time while reading your posts, it's not fair to make assumptions about you and we should open our minds a bit to your experience and what you're saying. We haven't forgotten that we were students once as well. I think if you're consistently being told not to make assumptions you perhaps should open your mind a little bit and admit that perhaps you did.

I absolutely did make an assumption, and have definitely regretted it, and with the advice of the people here, gotten a better sense of perspective regarding restraints. I'm only saying that it bothers me that even after I have admitted to over reacting, that I'm still being talked down to (by some, not all), as though I need to be coddled or something like that. I've even said i'm not looking for sweet-talking, just professional courtesy and compassion.

Specializes in Med-Surg., Agency Nursing, LTC., MDS..

"Sometimes,.. it's just not worth chewing through those damn restraints ! " Just give me the Ativan !! :deadhorse lol :bugeyes:

Specializes in SICU, Peds CVICU.
Well I think in this situation the problem is pretty clearly with the students. If they were explained why this patient needed that medication, and didn't listen, it reflects on their likely future behaviour as nurses. Too bad.

I've got to be honest, it's a little offensive to be talked down to this way. I have been very respectful here, and I was very respectful to the nurses in question. I am not, and have never asked for someone to be "super sweet" to me. I am simply asking for the professional courtesy and respect and compassion that is the industry standard in nearly every job in existence. I have been in experienced roles before, tutoring new people and I have been able to take the small amount of time required to treat other people with a basic amount of respect.

I'm just going to say that I find a little irony in consistently being told to stop making assumptions about the nurses behaviour, when some of you are making assumptions about me and what my problem with this situation has been.

Again, I'm very much grateful for the advice on restraints and what to do in the future, but the assumptions that I was a brat towards these "obviously overworked" nurses is simply that: an assumption.

If I came across as "talking down" to you, I sincerely apologize. Not my intent, but I probably shouldn't have been posting right before going to work. However...

I didn't make assumptions, I used information you gave to respond to your questions. I hope that you can use some of the information I've given you. You did not come across as respectful towards the nurse in your retelling of your clinical day, nor were you respectful (in my opinion, of course) to some of the posters that encouraged you to think through why things might have happened the way they did. You have been respectful to the posters that gave you positive feedback.

I absolutely did make an assumption, and have definitely regretted it, and with the advice of the people here, gotten a better sense of perspective regarding restraints. I'm only saying that it bothers me that even after I have admitted to over reacting, that I'm still being talked down to (by some, not all), as though I need to be coddled or something like that. I've even said i'm not looking for sweet-talking, just professional courtesy and compassion.

If you're addressing specifically my post in this comment, I would like to say that in no way was I trying to coddle you. Quite the opposite, actually.

I look forward to your perspective on professional courtesy, and compassion (towards nursing students, I'm inferring?) when you've been a nurse for six months.

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