Which patients are you most scared to take care of?

[SilverBells]

Although a variety of patients have brought forth challenges during my time of a nurse, lately I've been finding myself getting very stressed out caring for patients with GI issues.  I've had three patients in the past year with bowel obstructions/bowel perforations who decline no matter what I do.  I've sent them all repeatedly into the hospital.  They've all required surgical intervention.  This really causes me distress, so much to the point that I can no longer sleep at night if a patient hasn't had a bowel movement.  I'm always worried about doing the wrong thing.

Anyone else experience similar things with any patients? Who are you scared of taking care of? 

[speedynurse, ADN, BSN, RN, EMT-P]

In all honesty - after working on the ER, I don’t think a whole lot scares me in my current job. I had critically ill patients in the ER, psych patients, PICU patients, etc. Pre and post op is generally a breeze. I do agree with others though that you will have to find a way to leave work at home. It’s going to continue to influence you in a negative way if you can’t.

[gere7404, BSN, RN]

Really young kiddos with FUO 

hate cathing them and doing LPs, 99% of the time all labs come back normal and the md and I just tortured this poor kid and traumatized their over protective new parents 

[LibraNurse27, BSN, RN]

Covid pts scared me because of how they could decline so suddenly and rapidly. Almost like pediatric respiratory pts where they compensate so well until suddenly they can't and crash. So many crash intubations/ICU transfers. Sad to get to know pts walkie/talkie and then see them intubated, sometimes never getting off the vent or ending up bedbound/cognitive issues. Seeing vented pts or bedbound/cognitively impaired pts is always a little sad, but if you didn't know them at their baseline it's not as bad, at least my opinion. Getting to know them, their stories, about their families, then seeing them come back so damaged was scary. = (

[guest1163268]

On 4/22/2021 at 1:27 PM, JBMmom said:

I appreciate that you care for your patients, you need to find a balance in your life. Patients' bowel movements should not be impacting your sleep or quality of life. You are responsible for the things that you can control during the hours that you are at work. Do you provide medically appropriate care for the patients you are personally assigned to care for? If so, then you're all set. You are not personally responsible for all aspects of care just because people are admitted to the facility where you work. No one has that level of responsibility just because they became a nurse, even if you are in management. People with GI issues can have a complicated course of treatment and recovery no matter what happens. And dietary issues in a long term care situation are always challenging because they are trying to feed many people economically so the diets are rarely optimal, with many processed foods and scant fresh fruits and vegetables. With at least one of the patients you recently described it sounds like there were also some personality/psych issues related. I'm not a fan of neuro patients myself. Good luck.

Patients' bowel movements should not be IMPACTING your sleep or quality of life. 

Easy for you to say ???????????

[Davey Do]

On 4/21/2021 at 10:48 PM, SilverBells said:

 I can no longer sleep at night if a patient hasn't had a bowel movement. 

 

13 minutes ago, Curious1997 said:

Patients' bowel movements should not be IMPACTING your sleep or quality of life. 

Oh, only if everyone could put their posts and replies in a cartoon bubble.

 

[guest1163268]

20 minutes ago, Davey Do said:

 

Oh, only if everyone could put their posts and replies in a cartoon bubble.

 

Putting a bowel movement in a bubble doesn't seem hygienic or practical ??????

[Davey Do]

35 minutes ago, Curious1997 said:

??????

[guest1163268]

58 minutes ago, Davey Do said:

Looks like you are on the throne having a grand old time Davey ???????

[SilverBells, BSN]

On 4/23/2021 at 2:00 PM, Davey Do said:

That patient does look terrifying. LOL.  ?

[Davey Do]

41 minutes ago, Curious1997 said:

Looks like you are on the throne having a grand old time Davey

[hppygr8ful, ASN, RN, EMT-I]

On 4/21/2021 at 9:08 PM, SilverBells said:

I am not sure what is meant by this comment.  As nurses, we have probably all taken care of patients that make us a bit nervous.  This thread is designed to discuss this.  I understand if you cannot relate but am unsure how this comment adds any value to this thread.  

I'm sure that what CABGpatch_is referring to in the comment is yet another post that is designed to garner attention for attention's sake. While I have great concern for your mental health, reading your posts seem like looking at a train wreck that you can't look away from. I'm sorry if that sounds harsh but you could better spend your time doing a CEU in manageing patients with digetive/bowel issues and actually learn something.  Like others I am begining to wonder if you are actually a nurse given how little you seem to know about assessment of pretty common problems.

 

Hppy

[SilverBells, BSN]

21 minutes ago, hppygr8ful said:

I'm sure that what CABGpatch_is referring to in the comment is yet another post that is designed to garner attention for attention's sake. While I have great concern for your mental health, reading your posts seem like looking at a train wreck that you can't look away from. I'm sorry if that sounds harsh but you could better spend your time doing a CEU in manageing patients with digetive/bowel issues and actually learn something.  Like others I am begining to wonder if you are actually a nurse given how little you seem to know about assessment of pretty common problems.

Hppy

I assure you that this post was not written for attention, but I can understand where you and CABGpatch are coming from.  My intention was to discuss patients that we find more difficult to care for, as I think many nurses probably have patients they find more challenging, per se.  I was curious as to what types of patients other nurses find challenging.  However, I was pretty anxious and under distress when I wrote the original post, so it probably did come across as "attention-seeking."  I apologize and wish to improve this for the future.  I can also assure you that I do have a nursing license that has been valid for 7 years.  I do not necessarily feel I have no understanding of how to manage common problems, such as constipation.  I often feel that I have a good understanding of what may be going on with a patient.  I just find myself getting anxious when typical interventions are not effective because I want to prevent any and every complication possible.  Theoretically, I understand that is not always possible, but as a nurse, I went into the field to help others and find myself distressed when my patients remain sick despite my best efforts.  With that said, I do agree that I was probably promoted to my position too early in my career.  I feel this likely happened due to my "seniority" in my facility (keep in mind that we have extremely high turnover, so this is not necessarily an accomplishment) along with actually being very good at certain aspects of my job.  I am reluctant to step away from a position that in many aspects I am doing quite well at, as I continue to receive positive feedback from coworkers and supervisors, but am wondering if it might be best for the good of myself and the patients.  Anyway, this post has gotten a bit off topic from what this thread was meant for, but hopefully is more explanatory.  

40 minutes ago, hppygr8ful said:

I'm sure that what CABGpatch_is referring to in the comment is yet another post that is designed to garner attention for attention's sake. While I have great concern for your mental health, reading your posts seem like looking at a train wreck that you can't look away from. I'm sorry if that sounds harsh but you could better spend your time doing a CEU in manageing patients with digetive/bowel issues and actually learn something.  Like others I am begining to wonder if you are actually a nurse given how little you seem to know about assessment of pretty common problems.

Hppy

I like the idea of finding CEUs, though.  However, so far I am finding it very difficult to find ones that provide information of any value.  The educational modules provided by my workplace are incredibly simplistic in that they only offer obvious suggestions such as "consider holding bowel medications for loose stools," or "call the provider for unresolved symptoms."