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

Nurses Relations Nursing Q/A

Specializes in Float Pool-Med-Surg, Telemetry, IMCU.

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.

18 Answers

Specializes in Flight, ER, Transport, ICU/Critical Care.

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:

Great story but what ended up happening with the patient?

Specializes in Float Pool-Med-Surg, Telemetry, IMCU.

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.

Specializes in ICU; Telephone Triage Nurse.

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 ***. The attending showed up several hours later: boom! A MSO4 titration to comfort order. Thank God.

Specializes in ICU; Telephone Triage Nurse.
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.

Specializes in retired LTC.

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.

Specializes in Med/Surg, Academics.

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.

Specializes in Psych (25 years), Medical (15 years).
Medic/Nurse said:
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.

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...

Bless you!!!! From a retired RN and dog lover who has also smuggled a dog into a hospital for similar reasons! Before pet therapy dogs were allowed never mind someone's personal dog!

I once called the director of my unit at 2am to advocate for a patient, he was a sundowner hadn't slept at night for 15 years but family wanted to bring him home on the condition he sleep at night, So the docs decided to put him on a med for off label insomnia use, bad med we used to wean people off it, anyway as I was nights, when I gave report to days I asked they bring my concerns up to the docs, I mentioned the side effects, the just plain nastiness of this med, nothing happened, I was off for two days came back and my little guy was still up at night but when I looked in his eyes he was completely empty, just a zombie, not my happy little patient. So I thought about it and thought about it, it stewed and brewed in me until finally I had to make that phone call. I told the director what I had said at report, told the side effects, read the side effects, said my gut feeling was that if he stayed on this med it would kill him. Director promised to bring my concerns to the docs, I got message back they agreed it was a tough med but were keeping him on it. Two weeks later he died "unexpectedly". Director called me to tell me, I told her nothing would ever change my mind that that med killed him. still regret not being able to do more for him.

Specializes in PACU, ED.

I had an elderly woman in PACU who had undergone many hours of spine surgery. She was intubated and barely maintaining sats on T piece. When she would arouse she would silently scream in pain. A small dose of morphine would sedate her but also drop her respiration. A few times I had to bag her to blow off excess CO2.

I suggested we put her on a light proponlo drip and vent for the night. Anesthesia didn't want to put her in the unit and also didn't want to wait around.

He ordered 0.4 mg naloxone. I told him I would not give it, it was not appropriate. Then he told me to get it for him. I refused that too. I pointed to the Pyxis and said he could get it himself.

He did get and gave her the whole stinking vial of naloxone. Within a minute she was breathing deeply, extubated by him, and screaming in agony. I called a hospitalist who assessed and agreed to upgrade her to the unit. I called report and transferred her. Within 30 minutes she was reintubated, vented, and sedated.

Specializes in psych.

I had a pt who grabbed a shook another pt that had been calmly talking on the phone. This pt was scheduled to go to a small observation unit with only one nurse and a tech. I was worried that this pt would try to grab the nurse up there or worse. When the admitting doc told me that the pt was still going up I asked him if I could show him why he shouldn't send this pt up. He agreed that I could show him.

I proceded to grab and shake him the same way the pt had done to another pt. Everyone in the nurse's station stopped and gasped. When I let him go asked if he would reconsider sending them up. He did.

Since then every pt he wants to send to obs he jokingly asks me first now if it's ok!:yes: I never would have done that if I didn't get along with him in the first place. :shy:

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