What's the reason for a RN to be snippy to a new post op pt. ?

[momofqc]

OK. I don't want to fluff any feathers. I'm simply trying to get an opinion to experienced nurses and try to see this from the nurses point of view. I'm a nursing student so my POV is still very different from that of a seasoned Nurse and I understand this fact.

My mother had surgery today. She was scheduled to have a Hysterectomy and a Tummy Tuck. Her Hematocrit was too low (25) to do the tummy tuck so she just had the hysterectomy and will do a tummy tuck in roughly 6 weeks when she has healed and hopefully brought her iron back up. She has lost tons of weight and kept it off through diet and exercise alone. She quit smoking after 20+ years as well. Needless to say, this was a big day full of ups and downs for her and the whole family. (myself, dad, sister and brother)

Once she got to her room 2 hours post op she was doing as well as can be expected. She was of course in and out of it but pretty much knew what was going on. My dad, sister and I were there in the room. My sister had planned on spending the night with her and helping her with anything she needed. I was helping her with positioning, drinking fluids, answering any questions she or my dad had. My family has always believed that family involvement is very helpful to the nurses and we have always wanted to do as much as we could knowing that nurses are extremely busy and their time is precious. That all being said. My mother's nurse was less than enthusiastic that my mom would get talkative with her, my mom simply does this out of nervousness (esp with people she just met). I told the nurse I was a student and just about to graduate. I could make sure she did her incentive spirometer, kept and eye on her O2 sat, and let her know if we needed anything. Well, there were only 2 chairs in the room. We were all fine with one of us standing and being busy or just simply standing looking out the window during quiet times. My mother however was a typical mother and insisted that there was a third chair in the room. I asked the CNA, my sister also asked the CNA. We were told no problem and she would bring one back when she found one. Two hours pass and my sister and dad go to eat. When they come back my mom, once again in and out of a morphine nap, insisted there be a third chair. When the nurse came to the room my mom asked for a third chair very sweetly with a raspy dry voice. The nurse, in a not so nice tone said she'd try to find one. Moments later, she came back and said "Well here you go but just so you know now the room next to you has to be without a chair because of you. I hope you're happy".

Of course her tone didn't sit well with my mom, dad, or sister. I brushed it off and said she probably has a big workload and is tired. Then a couple hours later my mom was starting to have more pain that she thought she should. I know that the nurse needs to hear from the pt. herself the description of the pain so we called the nurse. Well, she was less than happy to have to discuss this with my mom and simply just said "well I gave you Toradol so any pain you have you just have to deal with"

To me, this is very uncompassionate care. I understand that nurses see a ton of different people, pt's as well as their families. But for my family, this wasn't a daily thing. This was a stressful and difficult day physically and emotionally. My mom and dad don't do this everyday, they paid a lot of money via insurance as well as out of pocket. Of course my mom was upset and didnt' feel comfortable with her nurse. I really wanted to go speak to the charge Nurse about it but I didn't, I left it alone.

Is my family wrong in feeling that this was very unprofessional as well as uncompassionate or as a nurse is everyone supposed to just bow down and be glad you even came to their room and answered the call?

[PostOpPrincess, BSN, RN]

I think it was very wrong to tell a patient to "deal" with pain. She is post-op and that needed addressing. THAT is your biggest problem. I validate your mom's feeling of insecurity with that nurse. Yikes--you did well holding yourself back, but as you progress in your career you might look at this experience and get angry.

As far as the chair is concerned....well....I can't say.....I wasn't in the nurses' shoes so I don't know what may have been going on at the time. Your mom was under the influence of anesthetics and drugs...it may not have been a priority to the nurse.

[tishirajan]

I'm not a nurse but have worked as an aide and to me this nurse sounded very rude. There are better ways to communicate with people and she evidently lacks that skill. Of course she could have been having a bad day but that's no excuse to be gruff with the pts.

You are right in feeling that this nurse was acting in an unprofessional manner. Telling a pt that they will just have to deal with the pain is wrong and could have been handled with a little more compassion. She could have at least found out if there was something else that your mother could have had to relieve her pain.

I'm sorry you and your family had a bad experience and I hope your mom gets to feeling better soon. I had a hysterectomy 2 years ago and it was one of the best things I've ever had done. Goodbye kotex!

[momofqc]

I think it was very wrong to tell a patient to "deal" with pain. She is post-op and that needed addressing. THAT is your biggest problem. I validate your mom's feeling of insecurity with that nurse. Yikes--you did well holding yourself back, but as you progress in your career you might look at this experience and get angry.

As far as the chair is concerned....well....I can't say.....I wasn't in the nurses' shoes so I don't know what may have been going on at the time. Your mom was under the influence of anesthetics and drugs...it may not have been a priority to the nurse.

I agree about the pain...I was really mad but at the same time I wasn't going to be there tonight so I just left it alone. Probably not the best I know, maybe I was intimidated. The whole chair incident didn't bother me I understand it wasn't a priority but she could have come across with a better tone and didn't have to be rude about it.

[leslie :-D]

as a student, i would like to inform you that while nurses who are compassionate, are ideal, it is not a requirement.

nurses at all times, should be professional, efficient and competent.

as for the chairs...

no, it was not priority and depending on how often you/family asked, perhaps it came across as a bit persistent?

i don't know...

but do know that sometimes, finding various items can be challenging at best.

however, the nurse saying "i hope you're happy" was inappropriate.

re the pain...i'm not understanding.

it sounds like mom was on a mso4 gtt and had prn toradol?

is that right?

how recently had she gotten the toradol before complaining about the pain?

the way you describe it, it sounds like she only complained of pain once...is that right?

is that the only time she had seen this nurse in regards to her pain?

it would also be interesting to hear what the nurse had to say.

but, it is perfectly reasonable to ask and relay your concerns to the doc re pain mgmt...

bottom line is regardless of the situation, we are always expected to respond professionally.

hope mom feels better.

leslie

[pawsomepooch47]

Pain control problems should be addressed immediately unless the pt has a low BP, RR or o2 sat. Is she on a Morphine PCA as well as Toradol?

The chair thing...let it go. That's pretty minor.

It can be frustrating to deal with patients that are very talkative. First of all, I can't get a word in edgewise to teach anything, and 2nd I am under the gun to get my work done and get out on time because the hospital doesn't want any overtime. And 3rd my patient down the hall could be dying and need me more!

I am not condoning this nurses behavior. I have been on the other side and have seen alot of different behavior. Some very good and some very poor. You will see after you become a nurse that it is very difficult to be loveable all the time---especially if your own personal world is crumbling.

[Batman24]

She's post-op and pain complaints need to be assessed and addressed. This needs to be followed up with her doctor. If she is still having pain tell her not to be afraid to mention it again to the nurse and not to be intimidated.

[BrnEyedGirl, BSN, MSN, RN, APRN]

There is no reason to be rude,....I can understand the nurse that gets "firm" with overly demanding or belligerent family/pts,.....but it doesn't sound like this was the case. Nurses are people too,..some of us are short, some tall, some heavy some thin. Some of us are loud and talkative, others quiet and shy. Some people are just rude and short tempered. They are rude at the bank, at the grocery store and probably often yell at their kids. Nurses are people, and some people are just rude!

Don't waste a lot of time fretting over this. Maybe you will remember this nurse and how she made you feel some morning after a 13hr shift, when you're tired and behind and someone asks for an extra chair. In her own twisted way this rude nurse taught you something!

Hope your Mom is doing well,..I'm sending happy thoughts!

[LEN-RN]

I would request another nurse. You have that right. She was rude. Your mom needs compassion. And your mom should not be in pain.

Please don't take this wrong, but usually during report, when family members campout, the oncoming staff is made aware by the offgoing. It doesn't sound like you were demanding, but some families are. They want ice, cups, food, pen and paper, extra pillows, pizza menus, towels, straws.. And track down the nurse when the patient has the slightest itch, or to ask questions that were already answered when the first set of family members was in.. So staff generally tries to avoid that room. The patient still gets cared for, but not as much. Because when a nurse comes into the room, there is just not one person to answer to , but a whole tribe. That watches every move. . And its not the patient's fault. the patient is usually sweet and quiet! You will learn this when you start working.

But still no excuse for her rudeness.

[Scrubby]

As nurses we have to deal with some pretty obnoxious family members. I guess some nurses become a bit jaded an over time become quite resentful to all family members...

But the comment made about the chair was so petty an inappropriate. And to tell someone in pain to 'just deal with it' lacks compassion and is very unethical.

Perhaps you may want to have a word with the nurse manager on this unit on this nurses behaviour.

[canoehead, BSN, RN]

I think any complaint of pain needs to be dealt with, and "just deal with it" is an inappropriate response. If there was a reason your mom couldn't have more meds they should have explained it to you. Possibly they wanted her to become more alert and mobile- but she could have told you that.

The chair thing...well you sound perfectly reasonable in your post.

Speaking of other people, not you, if we have more than 2 people in a room then the chair needs to come from another room, leaving the other patient with less, and causing fristion with that family. Usually we can accommodate everyone, but people can get huffy. I have also gotten the urge to drink when settling a sick post op patient and being asked for an extra chair 3-4 times in 30 minutes. There are urgent things to do both inside and outside the room, phone calls, charting, pain control, vitals, and the chair is on my list but I'm prioritizing life and health above comfort. I swear, sometimes I just nearly blow a gasket over that and warm blanket requests. I work the ER and we'll need the patient naked or nearly so to do all the immediate testing, so a warm blanket doesn't do much good, and families keep covering the patient up (!@#$!). If everyone sits down and gets comfy they are SOOO in the way, especially if there's more than one person.

Anyway, thanks for listening to my rant. A request for another chair is not unreasonable, but many requests when the nurse is trying to complete post op care may not be received as well as you'd like.

[*LadyJane*]

You know, you should really report the details of this care to the hospital. No patient should have to be subjected to this kind of treatment. Not only is it really uncaring, but it's not therapeutic to the patient and is unprofessional. Please do report this, and spare lots of other patients in the future.

Jane:nurse: