Advice about hospital stays

Last night after I got moved from the ER to floor, the nurses brought me the pain meds, then oral benadryl (to stop the itching from the pain meds), and Zofran for nausea. I had already told the doctors downstairs that oral benadryl (must be IV) doesn't stop itching and Zofran is ineffective for nausea (I need IV phergan).

When I told that to the nurse, she got mad at me, saying that she couldn't do anything about it because those were the orders. She acted like I was attacking or accusing her. I apologized for being grumpy (which I wasn't, but she felt like I was). I then asked if she could call the doctor to get the orders changed and to have the pain meds more frequently (3 hours instead of 4 hours because it wears off for me at 3 hours).

She refused, saying that doctors need their sleep too (it was 1a) and that I could just deal with it until he came in the morning. Apparently except for ER doctors, they don't actually have any doctors in the hospital at all and they all just have to be paged (which I think is pretty dumb in and of itself - I thought in previous hospitals they always had at least one doctor on the floor at all times and they took turns doing night shift or something).

So I didn't sleep at all because I was itching so bad I drew blood and I felt nauseated. I'm actually getting some hives on my face, too. Am I expecting too much or being too difficult of a patient in wanting her to have called the doctor anyway? She treated me like I was behaving like spoiled, bratty patient demanding everything and that the world revolved around me. That wasn't the case at all. I just simply said that I knew those meds wouldn't work, and she said, "Well, I can't do anything about it. Those are the orders. If you'd just think positive thoughts about them then they'll just work." She was extremely defensive, and I really didn't say anything in a bad tone of voice at all.

Also, she isn't the first nurse to do that here. I think every single hospital stay about half my nurses act irritated and put out if they're asked to do anything other than the very basic. It's sad, because this is a pretty good hospital and it has a super-short wait time in the ER compared to the other nearby hospitals (not even 15 minutes before getting triaged vs. 3-5 hours). It's a private, doctor-owned hospital.

Please tell me honestly.....am I in the wrong?

I would have been telling her if she didn't help me, I'd be calling hospital administration in the morning. (Of course, nurses are the worst patients.)

Teaching hospitals always have a doctor in the house, small community hospitals are beginning to address this by using "hospitalist" specialists. Hospitals run by doctors are the most difficult, because everything is set up for the convenience and comfort of the doctors more so than the patients. So, no night call.

And to give the nurse a bit of slack, it's possible in a doctor-owned hospital she could have lost her job for calling the doc in the middle of the night for a non-life threatening problem. I've seen it happen. This then tends to make the nurses irritable because it bothers them that they can't help their patients.

Of course, there are also just some really bad nurses out there...

Sorry you had this problem, and hope you're feeling better today.

They should hVe a patient advocate or ombus? Person on staff. Ask for them immedietly. And tell Thst nurse to F off. Not really bc then she'll tell all the other nurses. When a nice one comes along show her your scratches and tell her how awful the other nurse was.

I agree that there should be a patient advocate and you should make a complaint. But also, whenever you are in the ER, while you have the doctor in the room with you, make sure he understands your issues with oral meds and write the orders accordingly. This has got to be so frustrating for you....you aren't doing anything wrong. You just need to stay assertive and not give up.

I don't think you were being unreasonable. Sorry to hear you had a crappy night, I hope they have everything sorted out for you now!

The head nurse that I spoke to last time (or was it the time before that?) just stopped by because she heard I was complaining again. She said, "Well, I just really don't know what to do for you. We want to make you happy, but to be honest, I think for you that's just going to be impossible." Like I have too high of expectations and it's my fault and I need to just stop complaining

scifigal2k said...
The head nurse that I spoke to last time (or was it the time before that?) just stopped by because she heard I was complaining again. She said, "Well, I just really don't know what to do for you. We want to make you happy, but to be honest, I think for you that's just going to be impossible." Like I have too high of expectations and it's my fault and I need to just stop complaining

Was this the same nurse that wouldn't call the doctor at 1am?

She certainly sounds patronising in the extreme; imagine any professional saying, "If you'd just think positive thoughts about them then they'll just work". I almost think that line is worthy of a complaint in its own right.

For whatever reason, this particular nurse seems to have decided you are a "problem patient". I don't think you are. But it's hard to erase an impression once formed. My advice would be, since the nurse has deemed you a problem anyway, you might as well go with the flow: be that awkward patient. Don't be rude (not that I think you would be), but don't be apologetic and timid either. If you feel any anger at all, then use it to hold your head high and not be patronised into feeling like a naughty child.

That said, though, it would be a good idea from now on to check with the doctor before he leaves that he has got your prescriptions and dosages completely correct; make him write it down in front of you so that you can see it. Otherwise, once you're up on the ward, that's it until morning, as you found out the hard way.

Sorry for that confusion - no, this was the head nurse that I spoke to a couple of hospital stays ago. The general attitude overall at this hospital has been one of "I don't care, don't make me do more than the bare minimum of my job." So I had spoken to this head nurse (she's the charge nurses' boss) when similar things happened at a previous hospital stay.

lol, NCOT, everything you said to not be is exactly what I am! She acted that way, and I immediately teared up and got all apologetic. But when the guest relations person came later, I was able to be a bit more firm about things.

They also moved me to a different floor, so I think that will help a bit. The floor I was on was the pediatric ward (they didn't have any empty beds anywhere else when I was admitted), but now they need it for a baby and moved me somewhere else. This new nurse seems pretty nice. It's actually kind of funny - she mid-50s black lady that wears those white dresses that nurses used to use during WWII. It's kind of adorable.

HI Scifigal,
I'm just checking in and wondering how you are feeling? What are they doing for you in the hospital (besides driving you crazy?) I hope you are able to go home soon!!!

One more quick thing - Have you talked to your doctors about patient administered pain relief? The few times (3) I was in the hospital leading up to my surgery the hospitalist gave me a pump thing with morphine that I could press every 7 minutes or so. That way I never had to call a nurse in to administer pain relief. I had the same thing after my surgery, but also could get shots of dilaudid on top of that for added pain relief. I know you have mentioned morphine is not effective for you, but I do think they do pumps for dilaudid and fentanyl as well. Just a thought. Good luck!

scifigal2k,
Well now, I'd be dropping hints as to what hospital has such fine nursing staffs.Then I would have been emphatic about the medications of choice. There is always someone up the food chain to talk to and if that does not work let them know about the local letters to the editor and the local certifying boards. I don't take it to well being pushed around in a hospital any more. When I was younger, I got jerked around, ignored, well When the nausea got to a peak and the didn't respond. well they did not like the result and when the surgeon found out people were removed.

The point is ""Like NCIS Gibbs says" apology is a sign of weakness, don't apologize"" They smell blood and it's all over.

Coincidence is my surgeon's name was Gibbs. He never accepted anything but the best from the staff at the hospital.

T

scifigal2k said...
The head nurse that I spoke to last time (or was it the time before that?) just stopped by because she heard I was complaining again. She said, "Well, I just really don't know what to do for you. We want to make you happy, but to be honest, I think for you that's just going to be impossible." Like I have too high of expectations and it's my fault and I need to just stop complaining

UGH!!! I am a nurse and that would LITERALLY NEVER HAPPEN IN MY HOSPITAL!!!!!!!!! This makes me so mad to see you going through this!!

If I have a patient put on their call light at 1am and they tell me that the pain medication they are getting isn't sufficient to cover their pain, yes I PAGE THE DOCTOR AT 1AM! This is absolutely unacceptable patient care in my opinion and you need to find a new hospital.

I am so sorry for your struggles! I just cannot get over that the charge nurse said that to you. Not one charge nurse on my unit would ever ever ever ever ever say anything like that to a patient. You deserve so much better. Fight for what you deserve, seriously.

I really can't tell you how many times I've been reamed for calling a doctor at night. Of course, I didn't have to fear losing my job for doing it.

You also should be complaining about or to the doctor who wrote the orders in the ER. You told him your issues and he ignored them, so the first fault was his.