Vent: Bad day

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Specializes in oncology, trauma, home health.

I had to take an admit today, 52 miles away from any of my other patients who were all 30 miles from my house.

I pulled up into cabin version of a mansion. The place was spectacular.

The caregiver is outside waiting for me. "Your going to hear two different stories in there" she says.

"He wants her to go to a nursing home and she doesn't need it, as soon as she heals she'll be fine."

I get there and this lady, 80 ish, has everything wrong with her you can imagine.Cancer, Liver failure, ESRD, dialysis 3x weekly, heart disease, bell's palsy, active shingles, new colostomy. She is oriented, but not alert. She's sleeping on and off in a chair. The husand was very nice. CG lives there (in mansion) 24 hrs a day. She sits down with pen and paper to "take notes" She wrote down every single word I said. What's a fistula? Her temp is 98?? That's high for her! "What's her regular temp?" I ask, she didn't know, she never takes it.

BP is high, but her HR was in the 130's. Inside I freak a bit. I call the doc, answering service says "He requests not to be bothered before 1030" Bother him anyway, I say. While waiting for doc to call I request to see medications, CG refused to let me see them, then allowed it but she had to hold the bottles. No cardiac meds to be found. Pt tells husband of pt "She's fine, she's fine" Doc calls (not her regular) and I have to give report with CG chiming in in the back..Oh wait, before doc called she wanted the phone to call her pharmacy friend and ask her opinion. God, I mean, Doc, calls, angry as I try to relay everything about a patient who I have known for 10 minutes. He was a jerk but said she needed to go to ER. Pt looks at CG who says "Sweety you have a fast heart because you are an angel, God doesn't want you to go to the hospital" So patient and husband decide not to go, even though I tried every way possible of convincing them.

Ok, Doc prescribes metoprolol and asks that someone recheck hr in 6 hrs. Who is ging to do that? I ask husband, he says he knows how and shows me. Then CG butts in "I don't show me" So I show her how to take a radial pulse, she says "Is that the top number or the bottom number?"

The whole event was a disaster, that woman is on death's door. I have the yucky vibe that the CG just wants her home so she can stay in the mansion on the lake.

That was my vent...

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Specializes in OR, ICU, Tele, Psych, LTC, Palliative.
I had to take an admit today, 52 miles away from any of my other patients who were all 30 miles from my house.

I pulled up into cabin version of a mansion. The place was spectacular.

The caregiver is outside waiting for me. "Your going to hear two different stories in there" she says.

"He wants her to go to a nursing home and she doesn't need it, as soon as she heals she'll be fine."

I get there and this lady, 80 ish, has everything wrong with her you can imagine.Cancer, Liver failure, ESRD, dialysis 3x weekly, heart disease, bell's palsy, active shingles, new colostomy. She is oriented, but not alert. She's sleeping on and off in a chair. The husand was very nice. CG lives there (in mansion) 24 hrs a day. She sits down with pen and paper to "take notes" She wrote down every single word I said. What's a fistula? Her temp is 98?? That's high for her! "What's her regular temp?" I ask, she didn't know, she never takes it.

BP is high, but her HR was in the 130's. Inside I freak a bit. I call the doc, answering service says "He requests not to be bothered before 1030" Bother him anyway, I say. While waiting for doc to call I request to see medications, CG refused to let me see them, then allowed it but she had to hold the bottles. No cardiac meds to be found. Pt tells husband of pt "She's fine, she's fine" Doc calls (not her regular) and I have to give report with CG chiming in in the back..Oh wait, before doc called she wanted the phone to call her pharmacy friend and ask her opinion. God, I mean, Doc, calls, angry as I try to relay everything about a patient who I have known for 10 minutes. He was a jerk but said she needed to go to ER. Pt looks at CG who says "Sweety you have a fast heart because you are an angel, God doesn't want you to go to the hospital" So patient and husband decide not to go, even though I tried every way possible of convincing them.

Ok, Doc prescribes metoprolol and asks that someone recheck hr in 6 hrs. Who is ging to do that? I ask husband, he says he knows how and shows me. Then CG butts in "I don't show me" So I show her how to take a radial pulse, she says "Is that the top number or the bottom number?"

The whole event was a disaster, that woman is on death's door. I have the yucky vibe that the CG just wants her home so she can stay in the mansion on the lake.

That was my vent...

Ya know, I tried to pick just a paragraph to quote in order to save space, but that whole situation was just too much! I couldn't pare it down anymore:eek:

What a horror story! Is she still with us? The CG sounds like a trip. And she knew nothing of how to take a pulse? How does one get a position as CG and not know how to take a pulse???

Sue

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Specializes in oncology, trauma, home health.
Ya know, I tried to pick just a paragraph to quote in order to save space, but that whole situation was just too much! I couldn't pare it down anymore:eek:

What a horror story! Is she still with us? The CG sounds like a trip. And she knew nothing of how to take a pulse? How does one get a position as CG and not know how to take a pulse???

Sue

Thanks for the response, Sue.

Sadly, but not suprisingly, the husband called me today to say that she "wasn't responding at all"

I said , "call 911" I could hear CG in the back, "She's ok, she's just asleep" I said to Husband "Time to stop listening to her and to listen to the nurse. I will call 911 for you."

I haven't heard anything yet.

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Specializes in OR, ICU, Tele, Psych, LTC, Palliative.

Uh, I think you're right about the CG not wanting to leave the little cabin in the woods! :rolleyes: The body could be days old and she'd still be saying the poor thing was just sleeping! OMG! Let us know what happens?

Sue

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Specializes in oncology, trauma, home health.
Uh, I think you're right about the CG not wanting to leave the little cabin in the woods! :rolleyes: The body could be days old and she'd still be saying the poor thing was just sleeping! OMG! Let us know what happens?

Sue

So very true...I'll let you know, but it can't be good.

I swear, in the hospital it's the families who can cause so many problems and in HH it's these caregivers. Of course most are awesome, but the ones like this start to make my skin crawl.

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