Worst patient experience

Daytonite, BSN, RN · Nov 11, 2005

I had a patient try to commit suicide on my shift. He was an elderly man with COPD and had a lot of breathing problems and required oxygen. No one told us that he had been trying to give away some of his little gifts and things at his bedside on the shift before ours. Here we come, the night shift. The patient had been observed sleeping around 5am. When I went in to his room around 6am his neck and wrists were all bloody. He had taken a razor blade and made two slashes each on both sides of his neck and the inside of both wrists. He had also taken his oxygen off and was in co2 narcosis. I was a relatively new RN at the time and for a few seconds I had to think--do I call a code or do I call the house doctor. I put his oxygen back on and within 20 minutes he was aroused and quite distraught that he wasn't dead. He hadn't cut deeply enough and didn't hit any arteries. I called his doctor and stayed over to assist his doctor who came in and sutured up all those wounds except for the ones in his wrists. He had managed to cut some of the tendons. Later that day, around dinnertime, the 3-11 staff found him slumped over in his chair with his face in the food on his meal tray, dead. It was a natural death this time.

HappyJaxRN · Nov 11, 2005

Later that day, around dinnertime, the 3-11 staff found him slumped over in his chair with his face in the food on his meal tray, dead. It was a natural death this time.

OMgosh! Wow!

AmyB · Nov 12, 2005

These are more of a familial experience. We were evacuating our residents (LTC) for a hurricane. The admins had contacted as many families as possible to see if they would take their relatives.

One of our residents is a cranky old lady who rarely showers and is, at times, difficult to be around. When called by our facility, her family stated, "No, you keep her. We don't want her with us."

Another resident's son agreed to take her with him and his family. Her most time consuming diagnosis is diabetes - FBS checks and insulin administration. He signed her out with her meds and left the building. He was back at my desk not 15 minutes later saying, "I can't do this. I had no idea how much time and effort it took to care for her. You take her with the others. Oh, by the way, would you tell her why she can't come with me?"

I said, "NO, you need to talk with her. I'll carry her bags to the bus, but you need to be the one to tell her."

We walked out to the bus together and he climbed aboard while I placed her bags underneath. I was waiting for him when he got off the bus and asked him if he had talked to his mother. "Yes, I told her there was a glitch with Medicare and that's why she had to ride the bus instead of coming with me."

I have never wanted to punch someone's lights out as much as I did right then. I still have a hard time looking at him when he comes to visit. :stone

lsyorke, RN · Nov 12, 2005

Wow, I understand the "emergency" nature of this, but what are the legalities of just letting a resident go with another persons family member??? Yikes, that is asking ALOT of that family member and really puts the facility and the family in a VERY bad legal position if anything went wrong. NOT a good decision by the facility. I don't blame him for changing his mind.

HeartsOpenWide, RN · Nov 12, 2005

Had a patient on Medicaid that came in to get a Rx for cough medicine because they did not want to pay $7.00 and get it themselves. They cost tax payers $80.00 for the visit for an Rx that could have gotten off the shelf. (it wasn't..."I have a cough and a fever Dx me", it was "I want Robitussin, write me an Rx, period"...)

Bipley · Nov 12, 2005

Received a call from a patient at another LTC facility, this old guy was calling from a phone booth! Asked for me specifically and told me that he heard my facility was a place safe for older people to live. I said that yes, it was a safe place, did he want to come by and look someday. He said he needed help and he wanted to come right now.

Long story short, I ended up calling 911 for him, they took him to ER where he was DC'd to us. His previous facility had beaten the crap out of him. His face was sutured where his tooth had been sticking out. They hit him in the face so hard his tooth was sticking out of his cheek. His eyes were all but swollen shut and he was a bruised mess.

Needless to say we kept him. He never would tell me how he heard about our facility or how he got my name specifically.

Had another transfer from a different facility that was done by Adult Protective Services. Young schizophrenic IDDM pt came in and I have never seen such a dirty filty human being in all my life. Her hair was one huge knot, her tennis shoes were so dirty that when we peeled them off of her they chipped away in our hands. Bugs were crawling everywhere. Her teeth were green.

We put her in the shower and Kwelled her from head to toe, put her in clean clothes and put her to bed. The next morning there was an outline of her body on the sheets. It was dead bugs. Fleas, lice, stuff I didn't even recognize.

I itched for days each time I thought of her. Got her stable on psych meds, insulin, and others that I don't recall and she was fine to live in a supervised apartment setting.

Had a new admit from Romania. He was really not in need of a SNF but he was an emergency project of sorts by a Christian Mission in Romania. He was placed in my SNF for observation and quite frankly, assessment to see where he was at medically and socially. The plans were to appropriately place him when possible. Since he really didn't fit in the environment (he was quite young) I would take him with me on errands and such just to get him out and about.

There was a fire truck behind us on the interstate going code and I pulled over to let them pass. G, my patient, began yelling and screaming, he was crying and pushing on the dash of the car to make it go. You know, to make the car go. I couldn't figure out what the heck was wrong.

Each time a police car or fire truck would go down the street in front of the facility and he would hear the sirens he would dive in the bushes like one dives in a swimming pool.

Come to find out he had been in prison in Romania where he was forced to kneel in a cement 4' x 4' cell for 19 hours out of every 24. He was beaten and tortured on a regular basis. He had scars on his back where he was beaten with electrical wires and such. He was only about 40 years old.

He was turned into the Romanian Militia by his own father and why? Because G was a Christian and that was a bad thing at the time. If he practiced his religion he was arrested. His father was also Romanian Militia. Apparently they drive large trucks with sirens so when G would hear the sirens he would panic and try to either get away or hide.

I finally called a friend at a local fire department and told him about my patient. I explained that G didn't understand emergency vehicles in the US and could he help me out. He told me to bring him on over.

We went to the station where we were greeted by ALL the guys. The fire fighters, paramedics, Capt, all of them. They offered G cookies and coffee, the paramedics explained what they do. They took his vitals, it was cool. Even their body language was great. They knelt on the floor and let G sit in a chair, not intimidating in the least.

Finally the fire fighters had their chance. They started to take him in the back with the trucks and I started to panic. I explained that G was afraid of trucks... they kept laughing at me and told me G would be fine. Well, *I* wasn't fine. I knew he would freak out and this was going to be bad.

They finally started giving ME cookies and coffee to calm ME down. They took him in the back and I was waiting for the screaming and crying. Yet... nothing. I was getting pretty nervous, G trusted me but he wasn't fond of men in uniforms.

Pretty soon G walked out dressed as a fireman. He had the whole outfit on over his clothes. The boots, the gloves, the hat, the works. He looked at me and grinning ear to ear he said, "Look Miss, look at me!" I wanted to cry. I suppose it was one of those things where you had to be there.

Best part was when we got back he ran to his room and wrote his father a letter. He told me about it later. He explained to his father that Mr. Capt. said they were his friends and they would never let anything bad happen to him again and Mr. Capt. wouldn't let him be arrested for holding a cross.

Swear, true story.

He's living in a supervised apt setting now. That was 15 years ago however I ran into him at the grocery store about 2 years ago. He's doing GREAT.

pricklypear · Nov 12, 2005

My worst would have to be one of my very FIRST patients as a nursing student in the first clinical of the first sememster. It was the worst because it was the first code I witnessed, and she was "my" patient. She was a 50s abdominal surgery lady, multiple abdominal surgeries due to adhesions and other problems. I had spent hours the night before going over her records, interviewing her and her family (all that fun nursing student stuff). I had assessed her first thing in the morning, then asked the nurse if we should get her up to the chair. She said, "Sure, but I can't help you right now - she can get up just fine with one person." So I got her OOB, and into the chair. She was just getting comfortable, and the nurse had just walked into the room when her eyes rolled back and she stopped breathing. Of course, and code was called, I got trapped in the corner watching the whole thing. I was completely traumatized, I thought it had to be my fault - I must have missed something in my assessment. Her family came in crying - it was totally unexpected. They found no cause on autopsy.

Mulan · Nov 12, 2005

Wow, I understand the "emergency" nature of this, but what are the legalities of just letting a resident go with another persons family member??? Yikes, that is asking ALOT of that family member and really puts the facility and the family in a VERY bad legal position if anything went wrong. NOT a good decision by the facility. I don't blame him for changing his mind.

That was my first thought too, but after I read it again I think it is two different residents and two different families. It was the second residents own son who changed his mind.

rnwendy23 · Nov 12, 2005

Pretty soon G walked out dressed as a fireman. He had the whole outfit on over his clothes. The boots, the gloves, the hat, the works. He looked at me and grinning ear to ear he said, "Look Miss, look at me!" I wanted to cry. I suppose it was one of those things where you had to be there.
Best part was when we got back he ran to his room and wrote his father a letter. He told me about it later. He explained to his father that Mr. Capt. said they were his friends and they would never let anything bad happen to him again and Mr. Capt. wouldn't let him be arrested for holding a cross.

WOW, this gave me the goose bumps (which are a good thing). What a wonderful experience!!

Thanks for sharing.

flashpoint · Nov 12, 2005

WOW, this gave me the goose bumps (which are a good thing). What a wonderful experience!!
Thanks for sharing.

Firefighters rock! :)

Bipley · Nov 12, 2005

WOW, this gave me the goose bumps (which are a good thing). What a wonderful experience!!
Thanks for sharing.

It was a fantastic experience. I learned SOOO much from that care home. More there than anywhere else.

Another cool thing... I wrote a very long letter to the chief telling him what those guys did for my patient. As a reward to the guys, they all recieved an extra 4 hours of PTO to use as they wished.

I write that so everyone can keep it in mind. Some fire chiefs are very open to rewarding their guys for times they go above and beyond the call of duty.

They also put my letter in some state level fire fighting newsletter sent out to union members. The whole thing was cool, very cool. But you have to admit, they did deserve the recognition. Doing what they did for my patient wasn't exactly part of their job duties and not everyone would take the time to do what they did.