I had this post-op humerus fracture pt. She was on 6mg of dilaudid PO and still complaining of pain. The surgeon came in, examined her, redressed the arm, etc etc. He said, "Discharge her."
She kept complaining of pain. I went in and said, (not my exact words)"Do you think that maybe you're really anxious? I can give you something to help you out...Seriously, it might be in your head." (I don't know, I guess it was my sixth nurse sense kicking in - I wanted to give her a xanax). She said, "No!!! I'm in pain and you're saying its in my head! That's crazy, this hurts! Can't you give me something through my IV???" I replied, "I'm sorry but no you don't have anything I can give to you that way." (that was the truth). How about a xanax to help you calm down a little?" She flat out refused.
So I called the surgeon. He said absolutely no pain medications through the IV. I didn't really disagree, this lady was post-op day number 4 (and on 6mg of dilaudid nonetheless). However, I got permission to loosen up the ace. I gave her an extra ice pack. I literally tried guided imagery, turning on oprah, everything I could think of. Everything was fine in the extremity btw. I implemented everything as soon as I knew I could. Her mom showed up, and I didn't hear from the patient for about 45 mins.
The phone rang at the nurse's station, the guy on the line said, "I need to speak with the nurse for Ms. Smith. If I don't get anywhere with them then I want to speak to the CHARGE NURSE." And he said it in a "I'm calling to kick ass and take names kind of way.
I said, "Well, I'm the nurse for Ms. Smith, how can I help you?" (ms. smith is a fake name btw)
He said, "This is Ms. Smith's Brother. My sister is in extreme pain right now. Isn't there anything you can give her to help relieve the pain???" (paraphrased)
Me-"No there isnt. I'm gonna be straight with you, man to man, all that stuff is in her head. She needs to calm down but she's refusing anxiety medication" (again, paraphrased, because we were both a lot more wordy than what I'm typing).
Him-"Listen, I'll call my sister and you'll be in there to give her something to calm her nerves down?"
Me-"Yes!"
So I went in twenty minutes later and the lady took a xanax (no doubt her brother told her to take the darn thing). An hour later she apologized to me. I told her it was fine, and I was just worried about her. She even asked if she could get a script for xanax. The surgeon's PA happened to be around and I got it for her.
A little while after that, she went home.
Moral of the story, I got a small pleasure from all of that. No matter how much work it was in the beginning. Just getting her out with what she needed was just a joy.
Now, is this a "little victories" or a "small pleasures" thread?
For "small pleasures" (in this case, literally), mine would have to be a fat, healthy baby you can play with a little bit with cares, vs. the fetoid that you have to spend every moment of your shift keeping alive (and pain-free, and minimizing further damage to lungs, eyes, and brain, etc).
The fun babies get boring quick, but can be a nice respite from the more clinically challenging sort.
One of my very favorite nights? I had a guy as a pt who'd just had a MI -- he'd been to the unit, was stabilized, and was back out with us. Well, his family comes to visit, and I walk in doing my, "Hi, I'm Nerd, and I'll be your nur---sir, are you okay?" The pt's son in law was sitting in a chair, pale as milk, sweating, having trouble breathing -- my "oh crap o meter" went off. We got him up to the ER, and turned out he was having a MI, but they managed to "stop" his MI medically via clot busters. He was in the unit for a couple of days, then came out to us, and was ultimately okay.
But the cool part? The next day, I go in to see my patient, the original guy with the MI. He took my hand, and said, "thank you for saving my baby girl's husband."
The other was a lady we had on the floor for almost 2 months, unresponsive, trying really REALLY hard to die. CVA, MI, PE...you name it she tried one of each. I'd always go in and talk to her like she was awake..."Gee, Ms. Smith, you're lucky you're resting, there's nothing on the TV worth seeing, it rained today, they had a sale on turkeys at Food Lion and one of my coworkers accidentally left the turkey in her trunk, and her car STANKS." That kind of thing.
I come back to work the weekend, and she's awake -- and not just awake, she's talking and A/O x3. I walked in to say hello, and she turned her head at the sound of my voice and said, "I remember your voice, you're Nerd. You talked to me like I was still here. You were my angel." I went back out in the hall and sniffled all over the place.
Lovely lady embroidered a sampler that said "God Grant me the serenity to accept the things I cannot change, courage to change the things I can and wisdom to know the difference" during her rehab stay and gave it to me on leaving.
She said it's because I was real sweet to her. It wasn't hard, she was a real sweetie too. :)
Had a lady recently with a relatively new trach having trouble communicating. Was hard to read her lips. I put my finger over the trach opening and she heard herself speak. Her next statement was, "you mean I can speak?" Poor soul. How traumatized she must have been with the trach and no one showed her how she could still speak.
southernbeegirl, BSN, RN
903 Posts
btw...this thread rocks!