Sunday, November 25, 2012

Where Do I Work Again?

So last night at work, I began to realize that sometimes nursing equates working in a hotel...not just any hotel but obviously the Marriott hotel. 
The night started out rough because we were short one tech with lots of busy patients.  The call lights were unending.  One would ring and of course five others would go off at the same time...that in itself was unbearable, but then it got worse.
One of my patients was a sweet older man who had been diagnosed with liver cancer.  Up until five months ago he had been running 3 miles, lifting weights, and swimming 100 laps a day.  Then he lost 40 lbs in three months and became very weak.  His primary doctor had urged him to come to the hospital ASAP, but he refused until after Thanksgiving so he could be with his family.
When I admitted him, I remember thinking...this is one patient I would take home with me...he's so sweet and adorable.  His family at the bedside, two sons, were very nice and polite.  They stayed long enough to answer any questions and to ensure their father settled in for the night.  (The first night with this patient was a breeze, he slept all night and didn't need a thing...my favorite patients).
This night his two daughters were at his bedside.  And I could tell from the beginning they were going to make sure my night was a long difficult one.  The first daughter introduced herself. "I'm Dr. _________  and I want to talk about the plan of care."  I politely answered all of her questions (even though some of them I had to go find the answers).  Next she demanded that his zofran be increased to 4mg every 4 hrs instead of every 6 hrs.  I told her I would have to call the Dr but I would go ahead and bring in the dose that was due.  She rudely commented, "Yeah you should do that".
I got his zofran adjusted and brought in his dose.  When I got into the room and offered it to the patient, he refused it.  The daughters of course jumped all over him to take it...when he still refused, I told him that it was okay and i didn't have to give it to him...well let me tell you...the daughters definately did not like that..."He does need it and you WILL give it to him right now!"  I calmly explained that I could not give it to him unless he was the one who said he needed it.  The daughter looked at him and finally convinced him to take the med.
As soon as I left the room, I felt the daughter on my heels.  "I am his legal Power of Attorney and I want to read the doctor's notes tonight right now!"  I explained to her that I was not able to give those to her and she would have to go to medical record with the Power of Attorney paper.  She was definately not happy about that.
I managed to make it three steps away when she started asking me about a private room and if there was anyway they could have one... I explained that I would put in the order, but it was not a guarantee that they would get one...but that I would do what I could. 
What she said next just totally astounded me.  "Can we put another sleeping chair in the room and shove the other patients bed up against the wall?"  WHAT!!!!!
"Uhm...no we can't do that...but i can either get you a list of hotels nearby or I can make a sleeper chair for you in the waiting room".  After printing off the list of hotels, she decided that none of them were good enough for her, and she wanted the waiting room (Uhm...if the hotels aren't good enough...you choose the waiting room...what????)
The tech and I went and found a reclining chair and rearranged the waiting room to make up the bed.  As she enters the room, she says "No No, can you move the chair so I can see the tv, and then tilt the tv so I can see it better".  (Okay at this point I was having a really hard time in not saying something nasty especially since she was still running around barefoot, after i gave her some socks...I mean really who does that!!!!).
I thought that once she fell asleep it would be better, but no she decided she was going to stay up all night and make demand after demand.  Made for a very long night.
When I returned the next night...this patient was no longer there, but the stories the day nurses told me...complaining about meal trays, dumping meal trays onto the OTHER patient in the room, demanding to see the dr right now...then complaining about the meal tray to her, demanding a private room an hour ago, and then of course just being rather demanding of the techs and nurses.
So to close this out...I'm gonna still a quote from one of my work friends "I pulled into what I thought was the hospital parking garage tonight but apparently to some people, it's the Marriott with an all night buffet".

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