What’s the most desperate thing you’ve ever done to advocate for your patient?

Ok, this should be fun!

Mine happened this weekend. I had a colorectal surgery patient who, while stable was not looking especially good. The patient's abdomen was getting more distended, they were having more pain, etc.

The patient's family was pretty anxious and of course none of the colorectal team were available on the weekend; all requests had to go to the junior surgical resident who was a first year family medicine doctor on surgery rotation. She was helpful and very sweet but freely admitted to me that she was a bit out of her league so after doing her best to calm the family down she told me she'd page the senior resident who works closely with the colorectal team and have her assess the patient.

Of course the senior was busy and of course I'd already attempted to reassure the family by telling them that the senior resident was going to consult so I found myself in the uncomfortable situation of text paging the senior directly to beg her to come (a big no-no; they're big on the chain of command where I work.). In desperation I promised to buy her coffee for the next month if she came by and she reluctantly agreed.

Being a nurse of my word I bought her a Starbucks gift card which I gave to her when she finally showed up. She muttered an ungracious thank you and went to see the patient. No good deed goes unpunished; the family complained to me that the senior surgical resident was short with them and I got out a half hour late because of the time I wasted begging and finally bribing this doctor.

I want my twenty dollars back.

[brownbook]

Great story but what ended up happening with the patient?

[MECO28, BSN, RN]

When I left the patient was up and walking and seemed a bit better. But I'll probably never know the outcome since I'm a float nurse.

[ruby_jane, BSN, RN]

I want my twenty dollars back.

$20 you'll never get back. On the plus side...if she was going down the drain it would have been well-spent...

[Medic/Nurse, BSN, RN]

I "stole" a patient's dog.

Yep, you read that right. Took it. Right out of "it's" yard.

Then I carried that dog into the ER on a linen cart. Of course, it was there to visit with my patient (who was fighting sepsis & prolly going to die and wanted to see their dog). The patient had been placed in the nursing home & had not been able to see their dog since (several months earlier). It was important, vital even, for my patient to see that dog.

Emotional support matters.

This patient was in despair over the dog as much as in physical jeopardy. The patient had had few visitors at the NH and there had been no one in the ER in the time they had been held there (approx 6 hours - long bed waits).

My patient's son & DIL still lived in the house. The patient told me that the son refused to bring the dog to visit in the nursing home. Okay? My patient's old neighbor visited at the nursing home and had mentioned that the beloved dog was being kept outside most always. I was due a break, the ER doc covered me on my mission (I was going to see what I could find out, maybe talk to the son, but no one was home), so, I quickly "borrowed the dog" tossed it in my car & was back in no time.

Of course, I took the dog back after my shift ended. Never saw the patient's son. Prolly just as well.

If I cannot save your life, I will make your last wishes come true. Just ask.

:angel:

[MECO28, BSN, RN]

If I'm ever dying, please steal my dog and bring him to me. So sweet!

[3ringnursing, BSN]

That's lame. The senior was an ungracious ass.

I work from home, but I baked chocolate chip cookies and drove it to a clinic for a provider and team who agreed to see a pt that wasn't his whom had just showed up at the clinic hoping to be seen for hematuria and dysuria (she described it as passing flames and razor blades). The front desk made her call the telephone triage line, so I brokered a deal for her to get seen rather than turned away (just showing up at a clinic unexpected is highly frowned upon - like a 5 frowny face rating frowned upon).

About 18 years ago I had an ICU patient who was clearly dying, but the intern decided rather than just making this poor guy comfortable he would reinvent the wheel instead. This guy was so restless - he ordered 4 point restraints instead of medicating the poor man. The intern said he didn't want to sedate the patient. Yeah, like that would be a crime. I tried being reasonable with the intern but he wouldn't budge. I finally told him he was being an ass. The attending showed up several hours later: boom! A MSO4 titration to comfort order. Thank God.

[3ringnursing, BSN]

I "stole" a patient's dog.

Yep, you read that right. Took it. Right out of "it's" yard.

Then I carried that dog into the ER on a linen cart. Of course, it was there to visit with my patient (who was fighting sepsis & prolly going to die and wanted to see their dog). The patient had been placed in the nursing home & had not been able to see their dog since (several months earlier). It was important, vital even, for my patient to see that dog.

Emotional support matters.

This patient was in despair over the dog as much as in physical jeopardy. The patient had had few visitors at the NH and there had been no one in the ER in the time they had been held there (approx 6 hours - long bed waits).

My patient's son & DIL still lived in the house. The patient told me that the son refused to bring the dog to visit in the nursing home. Okay? My patient's old neighbor visited at the nursing home and had mentioned that the beloved dog was being kept outside most always. I was due a break, the ER doc covered me on my mission (I was going to see what I could find out, maybe talk to the son, but no one was home), so, I quickly "borrowed the dog" tossed it in my car & was back in no time.

Of course, I took the dog back after my shift ended. Never saw the patient's son. Prolly just as well.

If I cannot save your life, I will make your last wishes come true. Just ask.

:angel:

You are amazing. I hope you win a huge lottery for that act of kindness.

[amoLucia]

I put my hand down on the pt's bedside phone and threatened the 2 junior docs that "I was going to call the police that they were ASSAULTING the resident if they pursued a GT" against pt's approval. It was a spur of the moment thing because I had no other possibilities.

I had just come on to my telemetry, step-down unit. The monitor was alarming and I saw a short run of V-Tach. Without putting my stuff down or removing my coat, I went to the pt's room. She had just transferred to our unit earlier and was now complaining of substernal chest pain and anxiety. VS were OK but she was nervous, like she KNEW there was something wrong.

Our protocol (way back then) was NTG and a lidocaine bolus with a lido drip. Done, done and done real quick. NTG WITH RELIEF noted.

I called the house residents who came up and examined her and decided they wanted to pass an NG tube. I understood the docs' rationale to r/o gastric disorder. But my EKG strip and NTG relief told me otherwise.

I had obtained the equip and the docs explained their intentions. But she ABSOLUTELY refused. BIG TIME REFUSAL!!! She was 54 y/o and fully alert & oriented. I tried explaining it to her also, but to no avail. And then I tried to call off the docs.

Then one of the docs stepped behind the head of the bed and made gestures like to hold her down/mummy her so the other doc could tube her.

That's when I put my hand down on her bedside phone to make a police call. And I told her if she wanted to press charges I was her witness!

Well, those 2 docs stormed off the unit. I called nsg supervisor. She was OK with everything. I never heard anything about it from the morning.

[dudette10, MSN, RN]

I refused an order outright. I approached the attending with the nurse manager in tow--the NM called the medical director on my behalf. Explained (argued) to the attending why it was an inappropriate order.

A few days later, the attending called me directly to let me know that the medical director had called him and explained the inappropriateness of the order. The attending thanked me.

[Davey Do]

I "stole" a patient's dog.

Okay. Since we're confessing, I once "stole" a patient's cat.

I was a community nurse for an Assertive Community Treatment team back in the late 90's. A patient I regularly visited diagnosed with paranoid schizophrenia who had a history of a closed head injury, was a convicted pedophile, received regular depo provera injections for chemical castration, and was a substance abuser was being readmitted into the state facility. The team knew it was to be a long hospital stay and I voiced my concerned for his cat. It was a great cat, smart and mischievous.

One of the other team members suggested that I go rescue the cat, stating, "You know he always leaves his apartment unlocked with the stove burners left on".

Sure enough, when I went to pick up the cat, the apartment was unlocked and the stove burners were on.

I loved that cat. He would stand on his hind legs as I drove my truck up my driveway, boxing with his front paws as if to say to my truck, "C'mon! I'll take you on!"

Even though I had him neutered, he'd still take on the Toms, and I had to take him to the Vet a time or two as a result of his injuries.

Here's a pic of me and him from the late 90's

Sadly, like a shooting star, he didn't live to a ripe old age. I think he took on something that bested him.

Oh well...

[Hygiene Queen]

Aww! Davy Do, you know there's something about those black and white cats. I call 'em "cow kitties". They have the neatest personalities! Mine acts more like a dog and he talks to me by chirping. He takes walks in the woods with me! Glad you saved the cat and you gave him a happy home while you could.

Sorry to get off topic but I LOVE cow kitties