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I was tempted to call this story the 'no name story' so as to avoid being accused of misleading or creating 'click-bait.' But this time, I actually think what I'm about to tell you, has to be your worst nightmare. I also hope to give plenty of detail, so you get a clear picture.
It happened to a good friend, in the same A&E department, in a poor part of east London.
The hospital was in a poor neighborhood, and 2/3 of the patients first language was anything but English, many people were on government support, and the neighborhood was not the safest in daylight, let alone night time.
Regardless, myself and many fellow kiwis and aussies worked there as agency/temp nurses, especially night shifts, due to the regular work, as well as the large number of fellow antipodeans. On any given shift, half the staff were agency.
I'd spent 6 months working there, with a good friend Amber (not her real name) who was a very skilled, hard working nurse. She was manning the acute assessment unit - this unit ordered bloods/ecg's etc, so by the time a patient got to the doctor, they had something to work with.
So a 50yr old African man walks in with chest pain, and is sent to Amber. The pain is only on movement, no SOB, good colour, not cold/clammy/sweaty, in fact looks well. His ECG is normal, and he is in no pain when lying on the bed. The pain is left and right sided, and only returns when he moves ie got up from the bed.
It turns out he'd begun a weight training program the day before, and he'd been doing bench presses. His CK was a little elevated, but his tropinin normal (I can't remember which specific one, and I know they've got more accurate testing these days) but as the pain had begun the morning after the workout, and it was now evening, everything seemed ok.
The patient was a non-smoker, and had no previous medical hx of note.
Amber felt it unlikely to be cardiac, but of course ran the results and history past the doctor. The doctor signed the ECG to say he'd reviewed it, put a time and date, and said he could be a category 3 (which meant about a 2hr wait).
Anyway, the patient and his wife don't feel like waiting, especially as all the tests seem fine, and they ask Amber if he's okay to leave. She tell them they still need to see the doctor, as it's not her call to make.
The family wait 2hrs, only for the department to be swamped with some nasty traumas, and the doctor wouldn't be seeing them anytime soon. Amber kept checking on him, and he'd had no further pain (unless he stretched or moved a lot) and felt fine, and they decided to leave. They didn't sign a self-discharge form.
The next night, Amber and I are in resus when an ambulance blue lights in a patient, and Amber finds herself doing compressions on the man from the previous night.
'You said it wasn't his heart' screamed his wife at Amber, (which she hadn't, but you can understand the grief) while Amber had tears streaming down her face.
The man dies.
As an agency nurse, Amber didn't get support from management, so we discussed what to do. She decided to photocopy her notes, as well the ECG from the previous night.
She's called into a meeting with management the following day, and I go as her support person, and we're sitting in an office, and we hear the head doctor approaching with a bunch of big-wigs from the hospital, and we clearly hear him say 'she's done for, she messed up.'
Amber confronts him on this, and he doesn't have a reply, but they accuse her of not doing her job, and say the man did not get an ECG. We all go through the notes together and the ECG is missing. She tells them she did do one, and the doctor signed it, and gave his name, but they don't believe her.
'Well it's just as well I have a copy then don't I' she says, producing the copy of the ECG.
This action saved her. Saved her career, and saved her from a witch hunt.
She eventually was cleared of any wrong doing, although management were never confronted about the missing ECG, which would have helped them find someone to blame.
Anyway, that's one of the agency experiences that has taught me not to trust anyone.
I don't think I understand why you're so angry. It's very obvious that you are telling this story for a reaction. You've even stated that's what you want. Why does it matter to you if we believe these outlandish stories of yours? This one's highly over-dramatized."Your worst nightmare" implies something that induces fear and is so horrific as to be unreal. This story, while sad, is not particularly nightmarish. It's just another day in the ER here, except for the missing paperwork, which I find to be suspect. Is it normal for everyone to be incompetent in the A&E, so that they can't even file an ECG correctly?
And, sorry to disappoint, I am not miserable. I enjoy your crazy stories. I just wish you would present them honestly. I guess you get a kick out of seeing all the unwary scramble to reply.
Like I said, this really happened, pretty much as I've stated it.
Like I said, this really happened, pretty much as I've stated it.
Then I'm sorry that happened to your coworker, but more sad for the patient's family.
If you want to hear a real nightmare, mine are centered around patient census. In my worst ones, I find out after eight hours that there is a patient sitting in the room that I didn't know was mine.
Or, I had a really bad one about being lost in the cafeteria, which kept growing and growing, until I had used up all my lunch time and couldn't get anything to eat even though I was so hungry I was ready to start gnawing on my own lips. Then I couldn't find my way out of the caf to get back on my unit.
Or, the one I had where I was naked and my patient was really hot. He just looked at me and laughed. Ouch.
Those are my nightmares.
wow, it's so easy to pick holes, especially when you weren't there.This happened, I wasn't the one looking after the patient. I did go in with my friend to the horrible meeting. We did hear them talking about her in the hallway as they approached. She did do compression on a guy that had gone home the night before.
Of course she didn't tell them his heart was fine, but it's also understandable for a traumatized wife to feel he was given the all clear, as he had normal test results.
He wasn't put back in the waiting room, but he was kept in the assessment unit, but not on a monitor, or anything special.
His ECG was gone. Some other written notes were also missing/altered.
If you can't believe this, then that's your problem, not mine.
If you do believe me, and don't find this at all traumatic for a nurse, then maybe you're lacking in something - perhaps empathy.
I sear you lot have to be the most cynical, burnt out, miserable lot I've ever come across - but sadly, there's a few too many nurses like this out there.
Also, I feel most of you nurses act like you're the bloody doctor, with all your diagnosing and recommended treatments.
In this case all the typical procedures were followed - apart from the patient signing the self discharge form, the doctor was kept informed, the patient wasn't on a heart monitor.
This happened 10yr ago, so some of the details have faded, but I do remember quite clearly the trauma my friend went through.
So, to the the unbelievers out there, my story is true, but you won't accept that, because then that would mean having to have a closer look at yourself and your miserableness, and nobody likes to do that.
My posts on this thread were respectful, so I find some of your comments offensive. When one starts a thread other posters respond according to their experience, beliefs, values, and so forth. One cannot reasonably expect to receive only the type of responses that one wishes to receive. When I read your OP I formed an initial impression of the clinical situation, sought clarification, and then stated my final impression of the situation. I found I didn't have anything to say in regard to the nurse's experience, so I didn't say anything. I offered what I had to offer to this thread. May I suggest that in future it would be a good idea to reflect on whether what you have written is really conveying the meaning you want it to.
It's difficult for me to think about being targeted to take the fall like that, but I am sure it does happen. I am just going back into hospital work. I wonder if EKGs are scanned up into the computer now. I guess I'll find out. Anybody work in a hospital that scans up EKGs and other testing copies now?
Our EKG's never see paper. They are preformed on the machine and transmit directly to the patient's chart in the computer where anyone can view it on screen or print it if they really wish.
The guy was there for over 4 hours before they decided to leave. I can't remember all the details, but they got sick of waiting. He must have had more than one ecg, but I do remember there was more than an ECG missing. There was also some notes missing, but I can't remember the details, and when Amber produced the missing notes, things looked real bad for management. I think that's why they never did anything to her. If I remember correctly, she only photocopies her actual written notes, the ECG, and maybe something more, but not all the patient's notes, just what was relevant to what she had done.
Back when I first started nursing we still did paper charting. We still had to chart at regular intervals and sign it. And multiple people would add notes to the progress note pages in a progressive, time lined fashion. You wouldn't be able to just pull part of it without it being obvious something was missing, or trying to go back and falsify your own and other people's documentation.
Um, doing chest compressions on a patient you'd seen the night before, and who'd gone home, thinking his heart was ok, even though no one had given him the all-clear. Okay, if you can't get anything out of this, maybe some others will.
He left AMA without having a complete work up or seeing a physician or other prescribing provider. No one in his family would have had any reason to believe he had been given an "all clear." I really can't even see management thinking of it as any more than an unfortunate situation. And I sure can't see a physician feeling the need to throw a nurse under the bus if he truly was busy with more pressing emergencies and the first ekg truly was normal over a patient (s)he never laid eyes on.
At the risk of being even more unpopular on AN, if the OP had been a well liked and respected member of AN, do you not think a lot of these comments would not have been more respectful and supportive instead of just...well...attacking and dismissive. I'll get flamed but damn I think I just went back to school (take your pick...grade school, Jr high, High school)We are all different and each have strengths and weaknesses yet we all have something valid to bring to the table. People can be very pleasantly surprising when given the chance...
The problem is the sheer volume of unlikely, fairly dramatic stories across a wide range of spectrums. They're presented as true and the more we read the less likely they seem to be true. No one likes people trying to pull bull on them, and nurses are particularly sensitive to this.
The more I read, the more I'm picturing OP as George Cloony and waiting for him to tell us that story about the time he rescued a boy from a flooded sewer pipe during a storm and had to put a trach in with a pen in a field to save him, all on his way home from work after a long shift in the ER.
I still like you, even though you are not credible in the least. You're becoming a parody like NOADLS, except you irritate most of the long time posters.Y'all take five minutes and think about the scenario he is presenting, and tell me what holes you come up with. I came up with half a dozen without even trying.
OP, I think you should start your own blog with your stories presented honestly as entertainment, since you can't seem to stop posting.
This. I truly do enjoy reading your stories in a Gomer Blog type way.
Here is why I question your validity at all. You were asked about HIPAA. You stated yes, we broke some rules. HIPAA is a U.S. privacy law. This occurred in the UK. You clearly know what that HIPAA has to do with privacy but don't know that it only pertains to the U.S. You also said you nurses. Another comment that leads me to believe you are not a nurse. I'm beginning to think you might be a med student. I think you have a serious disdain for nurses and make up these stories to get people going.
The main thing that sticks out to me is how you just had to put everyone's race in the story. And you had to put this occurred in a poor section of London. When in all actuality this could have happened in Beverly Hills. The tests came out normal, the guy left against AMA due to the wait. That happens all the time. The doctor signed the EKG, so I'm not sure why they would think to throw the nurse under the bus. Here in the U.S., anyone complaining of chest pain coming into the ER goes back to a room immediately for a full work up. They are not sent back out to the waiting room. Chest pain has been taken very seriously here for years. Many hospitals are now equipped with specific chest pain areas. People know now that if they want to be seen quicker in the ER to just say they have chest pain. A triage nurse often circles check in and will immediately take BP and O2 sat while you are checking in, and then you are whisked back to a room.
So this nurse asked you to be her support person? What is that exactly? Just a witness? I don't see anything shady that happened here. It was this guy's choice to leave. Four hours is a long time to wait, but he had the option to stay and wait or leave and come back. He did not come back. He was advised by this nurse not to leave and I'm sure she charted that. If all of his labs were normal like you stated except for the slight elevation of CK, and he was told not to leave, there was nothing for the big wigs to cover up. I don't even see how the physician did anything wrong. Now, if his labs and vitals were off, or his EKG showed something and they sent him back out to wait because they didn't deem it serious enough or they ignored it all together, then that is negligence. That is not what happened here. Even if the guy was in the process of having a MI at that point and time and he decided to leave, that's his prerogative. People cannot be forced to get treatment unless they are a danger to themselves or others. He had the right to leave. If he leaves, it does not fall on the nurse or doctor to force him to stay.
canigraduate
2,107 Posts
I guess if this is the first time you've seen this poster, you could take him at face value. I personally have seen and read all of his threads, and have participated in one that was largely deleted. It is hard to take him seriously anymore, although I guess I will try. I just stop by to see what crazy things he's saying this time. It's always entertaining. And he always ends up by bashing his naysayers, threatening to leave, and starting up a new thread with snarky comments in the original post.