Which patients are you most scared to take care of?

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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? 

Specializes in CMSRN, hospice.
9 hours ago, VivaLasViejas said:

Detox patients. They’re entirely unpredictable and you can’t trust them as far as you can throw them. We used to detox them on the M/S floor, which was horrible because when the DTs hit, they got very scary. I got bitten by an HIV+ patient in the throes of alcohol withdrawals; another guy marched a fully equipped, locked hospital bed across a room while in four-point leathers. They really should’ve been in a specialized care unit with 1:1 or 1:2 supervision and good sedation. Dealing with a patient on the CIWA protocol and trying to manage a team of 5-6 other patients is a special kind of hell that I’m glad I’ll never have to visit again.

I *love* taking care of these patients! Though I totally understand the two experiences you shared being absolutely frightening. =/ My first med-surg job was on a unit where we always had at least a couple people on CIWA at a time, so my preceptors got me comfortable with it fast. It also helps if you're allowed to medicate properly, and the doc actually listens to you and will upgrade for a drip if things are getting really bad. For me, the best part was when you got to the patient early enough to keep them from going through the worst of detox.

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Specializes in Community Health, Med/Surg, ICU Stepdown.
10 hours ago, NightNerd said:

I *love* taking care of these patients!

Wish I knew this during my 3 years taking care of these pts every other day,  I would have called you! I was always scared about how violent they could get and scared they would have a seizure. = (

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Specializes in Pediatrics, NICU.

I work at a peds hospital. we are getting a lot of suicidal/aggressive teens that are waiting inpatient psych placement...and dear lord, these kids need help. I am scared of a lot of them bc they are violent and a lot bigger than I am. I also am very nervous about chest tubes

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Specializes in Psych, Addictions, SOL (Student of Life).
13 hours ago, pinkdoves said:

I work at a peds hospital. we are getting a lot of suicidal/aggressive teens that are waiting inpatient psych placement...and dear lord, these kids need help. I am scared of a lot of them bc they are violent and a lot bigger than I am. I also am very nervous about chest tubes

Welcome to my world - I run a 14 bed acute adolescent psych unit.

 

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1 hour ago, hppygr8ful said:

Welcome to my world - I run a 14 bed acute adolescent psych unit.

 

Good for you. I will not set foot in the adolescent unit. They know that I will go home! I honestly don't know how you folks do it. 

If it's an all male unit, I might. They don't scare me. But absolutely no teenage girls. 

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Specializes in Psych, Addictions, SOL (Student of Life).
6 hours ago, Curious1997 said:

Good for you. I will not set foot in the adolescent unit. They know that I will go home! I honestly don't know how you folks do it. 

If it's an all male unit, I might. They don't scare me. But absolutely no teenage girls. 

My unit is designated multi-gender so young men/women and everything on all ends of the gender identity spectrum. There has been an exponential rise in suicide rates amoung teens since this time last year. There are lots of reasons behind this. I do believe that humans are not meant to live in isolation Which is why I think we all have a responsibilty to do what's necessary to shut this pandemic down as soon as possible.

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
On 4/24/2021 at 2:45 PM, Davey Do said:

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Amazon reviews for Haribo sugarless gummy bears.  Anyone who hasn't already stumbled on this should check it out.

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Specializes in Psych (25 years), Medical (15 years).
12 minutes ago, TriciaJ said:

Amazon reviews for Haribo sugarless gummy bears.  

 

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Specializes in OR, Nursing Professional Development.
1 hour ago, Davey Do said:

 

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https://www.buzzfeednews.com/article/michaelrusch/haribo-gummy-bear-reviews-on-amazon-are-the-most-insane-thin

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Specializes in Psych (25 years), Medical (15 years).
11 minutes ago, Rose_Queen said:

https://www.buzzfeednews.com/article/michaelrusch/haribo-gummy-bear-reviews-on-amazon-are-the-most-insane-thin

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.

"The opening maw of hell" reminded me of some of the more colourful descriptions of the GI effects of the gummy bears.  Some of them are truly eloquent indeed.  When you've gotten all the laughs you're going to from the Dog Shaming site, check out the gummy bear reviews.

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For me, its the ones with schizoaffective disorder. 

Theyre just so violent. I don't like that at all.

I don't care if my dementia patients are violent. I am totally cool with that. It's the schizoaffective ones that scare the heck out of me. Not only are they violent, but they are unreasonable and their bipolar and hallucinations just make things really difficult. 

Doing home care, as a CNA, I have no way of confirming if they are even taking their meds. If they do, they are a lot better. If they don't, its a nightmare. 

Also, patients that have a broken bone AND need wound care AND need to be rolled for peri-care, toileting, etc. OMG they are in SO MUCH PAIN and it breaks my heart having to move them at all. Plus they hate me for standing there at all, much less standing there begging them to let me clean them up. 

I once had a patient with really bad MRSA on her BACK, and a bunch of broken bones I think from an automotive accident and she was reallllly resistant to peri-care mostly because rolling over and moving was a painful nightmare for her. She had also developed a pressure sore on her sacrum because she refused to use the bedpan because of the mrsa and the mrsa was so close to her pressure sore it scared the living bajeezes out of me. Oh I didn't cause the pressure sore. IDK could actually have been a wound from the accident anyways. I reported it as a bedsore, to be sure.

Just.. whoo. Broken bones and wound care, together. 

Not fun at all. Scary. I HATE being so scared to hurt someone. Ugh. 

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