Friday, February 24, 2012

That Time I Was Nurse #1

Don't fool yourselves. That doesn't say "That Time I Was #1 Nurse"....I was written up and named as "Nurse #1" in an incident. Yup. That's right, Nurse Sarah got written up for the first time in her career. I guess working for almost 7 years and only 1 write up ain't so bad? And it was practically the whole shift that got written up, so misery loves company right?
So what did I do? Did I finally lose it and tell someone off? The answer is no. I did not tell anyone off. Did I hurt someone purposefully or not? Nope. Make a medication error? Nope. So what was my wrong doing? Well, I'll just write down the incident the way that I saw it, which is what really happened.

*Note: The events that took place are true but to protect myself and the privacy of this patient no names or identifying details will be made*

It was a wonderful day at work. I was working the shift that I've been working a lot of lately, the 10 AM - 10 PM shift. The doc that was on call tends to be a shit magnet, for lack of a better term, for drug-seekers for some reason. Drug seekers are probably my least favorite patients. They are always right, they are not doing anything wrong, and worst of all...they LIE like a side walk. In Alberta, we now have a computer system that we can obtain all medical records, including mecial prescriptions, online. So it's much easier to catch these liars red handed. You're allergic to Tylenol, Advil, codiene, morphine, Toradol, and pretty much every pain medication under the sun except oxycontin and you're in pain? Oh, well we discovered that you were prescribed 200 tablets of Tylenol #4's last week! WHAT'S UP WITH THAT!? Sigh.

Okay, I'm off track.

So anyway, that particular night we had 4 drug seekers in a row. Three of them were seeking prescriptions for Tylenol #3's. For those of you who aren't familiar with narcotics, this is just plain Tylenol with codeine (the narcotic) in it. As far as I'm concerned, this is a rather mild narcotic and not even worth the fight to seek it! Anywho, our doc is very firm on not giving into the seeking types, so he told the first 2 absolutely not, no way you aren't leaving with a prescription, go see your family doctor. The third patient is the one who filed a report on all of us.

They have been to our ER before. They very distinctive and I'll never forget them. They stated to the nurse in triage that they do live in [The Big City] but he likes to come out to our rural hospital because we are so nice to them. They can't go to [The Big City Hospital] anymore because they don't treat them nicely there. We were really busy that night, I mean like a 6 hour wait from the day shift stretching into a few hour wait for the evening shift. So they finally get into a room, the doc sees them and tells them he doesn't write prescriptions for chronic back pain, but he will treat the pain in ER. So the doc tells me he's ordered some Toradol for this patient by intramuscular (IM) injection. Meaning I get to poke this patient in the butt muscle with an anti-inflammatory/pain killer med similar to Advil. The doc also mentions to me that the patient has a needle phobia.

Here is where I will write the truth as it happened in and what the patient and/or the mother reported, the lies in red.

I standing at the nursing desk, looking over all the orders for all 6 patients, seeing which order is a priority at the moment. My colleague is on a break, the other nurse is in triage, so it's just me for the 6 patients in the ER at the time being. 

The mother comes up to me and says "is someone coming to deal with my child's pain?"

I replied, "Yes, I have 6 patients to look after here, I will get to your son as soon as I can".

This translated to her as, "SETTLE DOWN! I have 8 patients to deal with before your child!"

Not but 60 seconds later, I am in the medication room, drawing up the injection, and the mother comes to the desk again to ask "where is my child's medication?"

I replied, "I'm drawing it up right now, I'm working as quickly as I can"

I then walk down to the room with the needle clearly visible in my hand, I approach the doorway to the room and they state, "there's no way I'm taking that!"

I was in no mood to argue with this patient, so I put my hands up to my shoulder level, palms up in an "I give up" motion and state, "I'm not arguing with you" in an "I'm not about to convince you to take this, whatever" kind of tone and turn around and walk away.

This is how they wrote up the incident: "Nurse #1 then walked into the room, threw her arms up in the air and said 'I'M NOT ARGUING WITH YOU!' and stormed out the room."

Really? Really?

I may talk big about what I think about certain patients, but I always strive my hardest to maintain professionalism and treat my patients with the respect that they deserve, but also the respect that they treat me with. They went on to lie profusely about Nurse #'s 2 & 3 in the incident...but I won't bore you with the details. They also told us many times they cannot afford the physiotherapy that's been prescribed to them  by many different doctors, but they can afford a lawyer to sue the [Big City Hospital]? So now they have no faith in our province's health care system and they are, get this...using alcohol to treat the  pain. So now we're going to be responsible for this patient's addiction to alcohol too? Grow some and take some responsibility for your life.

So I replied to the report by writing the truth and I don't know what happens from here. The good thing is, is that my bosses completely support the nurses in this incident. This is just a patient that is out to make some money or something, and not dealing with his health the way they should and the way that has been recommended to them over and over again.

I think my nursing colleagues will find these amusing...this is exactly what kind of patients drug seekers are!
 (Be warned....there is a LOT of profanity in this!)

Nurses hate the diagnosis of fibromyalgia. To us, it's just a diagnosis for an excuse for pain meds!

Are you a nurse? How do you deal with these patients?


  1. omg, i am not a nurse but these videos cracked me up!! sorry you had to deal with that =/

  2. love the seizure, Although I do have an uncle who was diagnosed with fibromyalgia, and it may be true for some its just to get the meds, some people actually do suffer from undiagnosable (sp?) pain.. ( I think with him it was how his body dealt with the death of his little brother last January).. I am not a doctor but I do know he was in pain, and I am glad there were drugs to help him! as I am sure he and his family were too... But Sarah, I will keep you and your nurses and the patients in my prayers (make it part of my daily ones) because it seems you are in a battle field, and this time the doctors are on your side, but who knows... and I love my rural nurses :) you rock :)

    1. I agree with you, Sam...but when people constantly flood ER's and their only diagnosis is fibromyalgia and the only thing that "works" for their pain is restricted gets really old, really fast! If I was negligent in my care, I would be worried and should have been rightfully written up. But I provided the best care I could under the circumstances. I'm not about to hold a 30-something year old man's hand and convince him to take a non-narcotic pain medication when he claims he's scared of needles AND has a history of drug-seeking behaviours. Minus the last part, I'd be happy to help any needle-phobic patient through it!

  3. OMGoodness! Thank you for the laughs, I SO needed this today!

    It is ridiculous you can possibly get written up for that!

  4. I know what you mean about patients saying they're allergic to Tylenol, Advil, Toradol, Morphine, etc. Then, they go on to say, "I'm usually given Dilaudid 2 or 4 mg IVP." Really?!? Who do you think you're fooling?

  5. WOW! I can't even believe the nerve of some people! You'll be find, I'm sure if they can get any kind of background info on this guy, his case will go out the window. What a joke! Good for you mama, stand your ground - you didn't do anything wrong!

  6. That is absolutely crazy!!! How can you possibly get written up for this. Being in the medical profession, though, I have seen firsthand the crazy stuff people try to blame on you. The videos were hysterical. You should link it up one weekend on my sat laughs:)

  7. So tragic! I am sorry that dealing with such a mess can put your job at risk. What a relief to hear that management is on the RNs side!

    T is a pediatric nurse at a pediatric hospital and, while not common, they occasionally have patients that suffer from chronic illness and are still patients well into adulthood. Sadly, a lot of the "drug-seeking" patients are those with sickle cell and have been battling severe pain for so long, it's just easier to be completely doped up than go through the trouble of waiting for yet another morphine injection. In those instances, my heart just breaks into one million pieces.

    I hope this situation is resolved soon and your ER is able to MOVE ON. What gets to me most is that this adult patient is having his mother inappropriately advocate for him/his addiction. Argh!!!

    1. Yeah, we don't have a high population of sickle cell where I live but I know that unfortunately with the disease can also come narcotic addiction. It's a situation that should not be taken lightly, I guess I just have to realize he's taking his frustrations out on everyone, including me, and to not take it personally. I know I won't be reprimanded, fined, or certainly not fired...I just hope that it gets dealt with appropriately and that my truthful voice is heard.

  8. Ugh so sorry you have to deal with people like this. I'm in the medical profession but work in a Children's hospital. Thankfully we don't see too many of these cases and in the case we do they are teens. That is very heart breaking! Props to you nursing is a hard profession. I'm sure you have some pretty crazy stories, especially as an ER nurse.


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