The day I thought would never end...........

[grinnurse, RN]

Yesterday was absolutely horrible. Went down hill the moment I got my patients from NOC shift. Had one patient that came in with CP r/o MI who was admitted to the floor with no telemetry, EKG changes, with an extensive cardiac history (no order written for tele btw). Checked her tropin level trying to figure out if the pt had an MI and had Troponin level of 1.79 (no call from lab). Charge nurse freaking out, Doc freaking out, me freaking out, and dau freaking out when they are informed that yes, the Mom did have a MI. Pt has cardiologist at a hospital in this area but Doc insists that she go to another making accusations that he didn't trust this Doc:angryfire Pt was really wanting to transfer to her Doc hospital. Took 5 hours to get her a room to the hospital where she wanted to go.

All the while, I have 2 TC pts with an aide who is usually great but for some reason now thinks she's a nurse (not downing the aides...........I love my aides and couldn't live with out them truly) who is demanding that I stop in the middle of getting pt #1 monitored correctly to turn the TCs. Have another patient that speaks very little english, much less understands what I am asking who has c/o stomache pain and no pain meds that are touching it.

And to top it off I have a pt who is trying to get to heaven with a family that is in denial ( she has an autoimmune disease called dermatomyocytisis) that she is dying. This patient is wanting to make herself a DNR and is in her right mind............weak but knows what she wants and the family will not hear of it. They think that she is going to get better and no way in heck that is happening. She refused meds and at my pts request asked only for comfort care. So, I told the charge nurse that was exactly what I was going to do for her on my shift, which she agreed. Ok..end of shift, hospitalist is consulted by primary Doc and sends her to ICU, intubates and puts in central line:o I understand why they had to send her b/c of the full code, but I was so saddened that she is having her wishes ignored. She was a nurse in her other life and was dealing realistically with the situation. The last words that I spoke to her was that of praying for her last night for a swift transition to heaven where she could be at peace. She squeezed my hand lightly and said in a very soft whisper, Thanks. I kissed her cheek and told her that she was loved by many, myself included and she closed her eyes to rest.

I couldn't sleep last night and today I find myself really down in the dumps and crying for her and totally exhausted mentally and physically. I know that if I call and try to find out her condition that I won't be able to get information and it will only frustrate me until I know.

Thanks for reading this. Sorry it got quite long, but I know you folks will have some words of wisdom for me in dealing with this situation.

[rnmummy]

Sounds like a day none of us would have wanted. You did all you could for each of you patients. Remember, you terminal patient could have taken care of the DNR at an earlier time but might have been uncertain herself about it. She needed support and you gave all you could but ultimately it was her decision all the way along. Family often has a strong influence on us even when they ought not.