Worst shift ever

[RetRN77]

In general venting thread -

I'll begin. You'll be sorry - just ignore. :)

Long ago, and far away, I had returned to my L&D unit after about three years away, on a PRN basis. Everything was in a different place and all the monitoring equipment was new AND most were unreliable. Most of the nurses I knew were still there, but all the residents were new, and this particular night, not a single attending I knew had a case. Therefore, every doctor on the floor thought I was a newbie and treated me as such.

We were a regional high-risk center and on this night there were never less than 5 actively laboring patients, several of which were at risk. On this shift alone, we did 2-3 on-unit C-sections as well as at least two regular deliveries. Two nurses, including me, were working labor, and one nurse was working delivery. We had a system wherein if a section was needed, the on-call nurse came in to circulate.

Of course, I was having major difficulties trying to get working monitors on the patients, because I didn't know which were operable and which weren't, and things were crazy due to the sheer number of active patients. When we began the shift, one patient was undergoing a section already, no one else had an IV yet and only one had a monitor. The day shift had been just as busy as ours was going to be. Everything was chaotic. A couple of patients had just been admitted and needed workups.

One of my pts. was a very nice primip who'd been discharged during the night with a false labor dx. She had come in the second time around 7 AM and it was now 3 PM. As I set up to do her vitals, I realized that NO charting had been done since her readmission - no last intake, no BP - nothing! She had no IV, no prep of any kind. I told her I'd need to get the info again, as the chart had nearly nothing from the first admission, either - just her name, an initial BP and fetal heart and not much else. As I'm getting the info, her DH was rolling his eyes at me in exasperation. I explained we needed all this info for her care, but with each question I asked, he became huffier. Too bad. Then he was upset that I was taking her vitals! Imagine how he acted when I needed to put on the external monitor. That was just the beginning of the attitude from him. Everything I did, he rolled his eyes at and stopped just short of calling me stupid. If I was in the room caring for her, he acted like I was just in his way. If I was out of the room caring for one of my other 3-4 patients, he would get huffy and wonder why she was being "neglected."

She was most often "neglected" for the patient who was experiencing late decels. I didn't know her attending, but he was, well, excitable. He was obviously panicking over her condition and couldn't make up his mind what he wanted, and was that sort who takes his own inadequacy out on the nurses - everything is their fault. When it became an utter emergency, he finally decided to do the section and started screaming at me and everyone else in sight to get her into delivery. I started to release the brakes on the bed, but one of them wouldn't release. He kept screaming at me that I was doing it wrong - however, I did remember the "off" position! He would alternately scream at me and the supervisor, who'd come help us, to just move the bed anyway, then he'd yell, "No, stop! Make it work!" We'd drag it four feet, he'd make us stop, and on and on. After a few minutes, he literally jumped on the brake with both feet! This of course, just served to make sure it stayed jammed, and then he took up his prior tactic of screaming stop, then go. Families were lining up in the halls, watching the "stupid" nurses being berated by this frantic out of control MD from Lord knows where.

This incident took about 20-30 minutes before the pt was on the table and I'd helped begin the OR prep. When I was able to return to my other patients, the fun DH just gave me a withering look. After a couple more hours, his wife's doctor decided she needed a section, too, for lack of progression, but by then, all the delivery rooms were full. (Which did not mean we had less patients in labor - they just kept coming through admitting.) The doctor had no choice but to wait for a free room. Of course, to the DH, this somehow was all my fault as well. The doctor gave the usual orders for prep, indicating he would do the section as soon as a room was free, so I set about those. After I finished the Foley, doc came into the room and said, "Oh, why'd you do that so soon? She could have been more comfortable a little while longer." So soon?? Didn't he want her prepped and ready when the room was ready? Wouldn't her labor progress better with an empty bladder? (Because the doctor was still holding out hope she would begin to progress, circumventing the need for a section.) Oh, never mind, I'm just the dumb newbie, what do I know? I guess he'd prefer I have to do my second "I want a Foley now!!" last-minute-on-the-table-and-delivering-cath of the night.

Of course, that just gave the husband more fuel against me. He hadn't said a civil word to me the whole shift, and suddenly, a bright, lovely young girl who was apparently the admitting nurse, pops into the room and his face lights up like a beacon. "Oh, we missed you, we're so grateful for all you did for us, etc. etc." Oh, you mean all the vitals that were taken, notes that were done, care that was given - NOT?

When a delivery room was free, my shift was over, but I needed to stay overtime to circulate for his wife's section, as we were once again too short-handed due to other deliveries. As I unlocked the brakes and began to move the bed, DH gave me his parting nastiness, "Are you sure that's unlocked? Can you get the bed down the hall?"

[SlightlyMental_RN]

Good Lord, what a shift. Have a glass of wine, pour yourself a bubble bath and tell all family to do not disturb. Perhaps escape into a good chic-lit book?

[RetRN77]

LOL - thanks - it was a long time ago! Still grates, however!

[Conqueror+, BSN, RN]

I got agitated just reading that. I don't do babies at ANY stage of life. Everyone seems to be on permanent freak out mode. Bless you honey.

[ohmeowzer RN, RN]

ooh wow talk about a horrible shift.. ooh my heavens.. many hugs to you .. wow !! and you were still sane after all that? i would be babbling... lol..

[shoegalRN, RN]

God bless you L&D nurses! I couldnt do your job. Birth is such a memorable event, and trust me, every little thing will be remembered by those families, either good or bad. And they don't ever forget, not even when the child is grown.

I'm sorry you had such a bad shift.

[AggieNurse2B]

I'm just a student nurse, so take it with a grain of salt...

I had a similar experience with a patient's husband while doing postpartum. I walked in and introduced myself as a student nurse, and he immediately rolled his eyes and wanted to know why some crappy student had been assigned to his wife. "Why is she getting some inept student while other moms on the floor are getting 'real' nurses?" Lovely.

I explained to him that, sometimes, people who have student nurses actually get BETTER care because the student only has one or two patients and can devote a lot more time to each individual. "Real" nurses are usually short-staffed and don't even have enough time to go to the bathroom.

Said jerk-of-a-husband began to complain that he wasn't feeling well and that perhaps I should be taking HIS vital signs since he was the one who would end up with the very large hospital bill for it. So I did. I took his BP, and it was 152/110. We had a nice little chat about the dangers of hypertension, and I insisted he make an appointment with his MD immediately.

Long story short: By the end of my shift, I was the very bestest nurse he and his wife had ever had...And this was their fourth L&D/hospital stay! Amazing. He was a minister, and he even said a special prayer over me.

Now, I'm guessing that, had you had the time, you would've turned that husband right around. Trouble is, very few nurses have that kind of time anymore.

[hoppermom3]

Hugs to you....I have had a few OB shifts like that. I strive to provide the best possible care and always take it personally when patients, families, or doctors don't like me. I recently had a patient (who I have dealt with many times and thought I had a good rapport with) tell one of our other nurses that she hates me. I was crushed.

[Doc Lori, R.N.]

RetRN77...sigh. I got a churning gut just reading about your experience. How dreadful!!! It's almost as if every single thing you did was misunderstand and underappreciated. There is nothing worse as far as I am concerned than being misunderstood and judged falsely. Not to mention the embarressment that coincides when unknowing witnesses eperience it! I will share an example of one of the last horrible experiences I had, before I called it quits for good. When I was doing bedside acute hemodialysis, we were having problems with a patient's catheter. We did everything we could. The physician wrote an order that read: Please call me if unable to do tx because of non-functional catheter. Uh..ok..well you can imagine the verbal beating I got, because I followed his order. At 3 PM. At a very busy step down nurses station. He called me every name in the book, including incompetent. Finally, with other staff members and md's around, I put the creep on speaker phone and proclaimed to him and everyone else who was in ear shot..."This is why there is a nursing shortage". I hung up on him after informing him that I will not be spoken to in this manner, called the patient's primary attending, who acted as the communicator. I wrote Dr. Personality up and filed a complaint. I am attempting to care for your patient, with a K+ of 8...in dire need for dialysis. Dude, not my fault that you are in a lousy mood. :) I couldn't stand one more minute of the abuse and toxicity that you referred to and after 22 years..went back to school, and now I have a practice devoted to my kindreds and colleagues, nurses and healers, who are suffering from anxiety and depression, burn out and compassion fatigue. Nursing breaks nurses into a million little bits, more often than not. That $*&% stethoscope can be strangling. I wish there were a way to give kudos to an article 500 times..because if it were possible, this article deserves it. It serves as a reminder to everyone how very real this issues are. Thank you, RetRN77. Thank you.

[ohmeowzer RN, RN]

Doc Lori ... that story of yours is one i have heard and have been apart of many times.. a doctor who verbally abuses us and we get treated like we are not human and no feelings or brains in our head... i have been screamed at recently by a very abusive doctor , of course wrote her up , with all the other stressors at work we get treated as if we are nothing and not valuable... yes nursing can turn to burn out and anxiety and depression .. because i have all those things.. i'm am tried and just cannot take the stress of being a med/surg nurse anymore and i have done it for the past 25 years , these past few months i have realized my job as taken alot out of me .. i'm getting a new job and only will work 8 hours a day... i applaud you for your help with nurses who are fractured.. because i count myself among them..... burned out nurse.. thats me..

[zofran]

OP, I feel your pain.

About two weeks ago I had a patient's husband treat me like crap too. He kept rolling his eyes at me and giving me dirty looks. I am not sure why he didn't like me....possibly because one time his wifes pain medication was 15 min late. Anyway, when I said goodbye to them at the end of the shift, he says "I really hope I don't see you tomorrow." I couldn't believe he said that. I was so upset, it was a shift from hell anyway....I called in sick for the next day when I was on my way home.

I don't understand why some of these patients/doctors/visitors feel like they can treat the nurse so badly. I am sick of it.

And to the student nurse who took the husbands blood pressure......we are told never to do that. What if something went wrong with the guy? You having took the blood pressure and "ignored" it, would be the first person they would want to sue....I tell visitors that I can't touch them and advise them to go to ED...Also, all the time in the world wont bring some of these unreasonable people around. Some people are just plain MEAN.

[RetRN77]

Thanks to all who responded! I'm overwhelmed by your touching remarks - they've made me feel so much better. I also appreciate those who added their stories, as I really intended the thread to be a place for all to vent about tough shifts.

Hoppermom3, what can I say? How horrible for someone to take all that you offered and not only not have an ounce of appreciation for your care and concern, but make such a mean statement. Perhaps after her last hospitalization was completely over, she had experienced someone not so caring and now realizes how good you had been to her. I really have to wonder what was up with the person who passed this bit of nastiness on to you. Perhaps she wasn't even telling the truth?

ohmeowzer RN, so sorry that you've been driven to find something else because of all the pressure that's been heaped on you. Everything we do as nurses is pressure, and so often we have to put on the 'big girl' pants, or we'd quit within the first week of clinicals. So sad that after 20 or more years, the treatment is so unrewarding that those who've weathered countless storms are finally driven out. I hope you enjoy your new position.

zofran, I'm sorry you had a similar experience to mine. If it helps any, I've heard that remark directed at myself and others more than once, and always to someone who was doing her best to give the best care. It's strange that I can't recall any of the nurses who didn't give a rat's behind getting treated that way. Apparently, they made their patients and families feel lucky that they even got any of their needs met.

I don't know what makes some people seem to take an instant dislike to others, that no matter how hard you try to win them, they remain hostile. My patient's husband's dander was up from the first moment I walked into the room. It was as if he just didn't like my looks. Any small thing I did wrong, like calling his wife the incorrect diminutive of her name, because she looked just like someone I knew who used that diminutive instead of the one I have a suspicion he had forced on her, as he made such a big deal out of it, just made him more angry and convinced that I was useless.

I only related some of the bad things that happened that night. Because I had recently returned to the floor and the residents didn't know me, and even the nasty attending was a newbie himself, it was as if every one of them took turns taking a piece of me. The nicest one, upon being introduced to me, made some comment like, "Oh, nice, you're new." Then made a general announcement, "I need to examine this patient, and I need someone experienced to come with me," and flounced down the hall, waiting for that "someone experienced" to trail after him. Duh, I was experienced. In OB, no less. Rather wish I had told him his patient would probably prefer a "real" doctor instead of "just a resident."

The female resident came into Mr. DH's wife's room just after I had started her IV, and there were some drops of blood on the paper towelette from the backflow, which I was just beginning to clean up. She said, "What happened here?" in a voice of such alarm you would have thought she'd never seen an IV inserted. Of course, more ammunition for DH. She didn't drop it, either, when I told her I'd just started the IV, she continued to act as if some major mayhem had happened in the room, and she couldn't believe there was such "bloodshed."

I probably should have felt better later, since she was the one who decided at the last minute, with a different patient crowning hugely on the table, that "I want a Foley now!" She kept yelling the whole time to do a "mini prep, don't waste the time!" She went on and demonstrated in the air how it should go, as if I didn't know. So I prepped and cathed the patient in somewhat less than a minute, and the resident fell all over me, saying how amazing that was, and how impressed she was because the patient was crowning at something like plus 5, LOL. I just felt as if her praise came only because her expectations of me were so low.

When I started the Foley on Mr. DH's wife, who'd been so wonderful that she was the sole bright spot of the evening, she turned out to be the most sensitive in that area I'd ever come across. As soon as the soap touched her skin, she jumped about 10 feet and yelped. I hadn't even touched her with the wipe yet. When I did convince her to allow me to, and as gently as possible I began, she yelped even more loudly and I had to stop. It took me about 5 minutes just to do the prep, with all the starting and stopping, and she was yelping the whole time. Now, Mr. DH had already been hating on me for about 6 hours, so you can just imagine...he had heard her from the waiting room down the hall, and kept coming back in to check on her and give me the evil eye.

I did my best for the lengthy amount of time I spent with that patient alone to bring the husband around. I had no trouble with the patient - she was a doll. I was even more solicitous of her because I wondered how he treated her, since he treated me so badly. He rarely spoke directly to her to comfort her, as most of the time he was complaining about one thing and another - what took the doctor so long (my fault,too) why did she have to have a c-section (ditto) ad nauseum.

Doc Lori, I had to take some time after reading your response to get it together. It was very riveting. I so appreciate what you are doing to help those who are feeling burnt out. Your situation was so uncalled for. I'm glad you stood up for yourself in such a strong way. In a way, I'm sorry you felt you had to change jobs because of it, because it's just plain wrong that someone who cares so much for patients is driven away in such a manner. Good for the people you are helping now; not so good for the patients you would have had.

My first priority was always to be as gentle and reassuring as possible. I never treated my patients as just something to "get done." I always rejoiced in the great deliveries and the painless as possible labors along with my patients. This was my last experience in my beloved OB, although I didn't quit because of it. It just turned out that way. I so hate that my last OB shift was not something I could look back upon and just remember some great deliveries and happy moms.