Saturday, October 17, 2009

Worst Patient Ever

Ahhh, I am so glad this week of work is over. It was a true test of patience for me...I think I passed. Let me start by saying that I am soooooooo sick of drug addicts. I try to sympathize, I try to see their viewpoint, I try to be understanding......cause that's just me. They, however, don't give a damn about anyone other than themselves....which in return causes me to start to wonder why do I even bother trying to care for them?

It makes me wonder...does the drug addiction make them that selfish or are they naturally selfish & that leads them to be drug addicts? We'll never really know, but I am sick of them & soooo wish that the hospitals could turn these people away. Instead, the doctors cave into their drug addiction & prescribe Morphine and Dilaudid....which creates the path of as soon as they are discharged, they come right back with yet another fake ailment in order to get their drug fix. It's so irritating & then they have the nerve to complain that the hospital is what is making them sick...all the germs floating around. Then go home & stay home!

I had my worst patient ever....he was young, in his 30' with chest pain.....because of cocaine. Ugh. It should not be allowed. If you choose to do cocaine, then you should be taking it at your own risk & not wasting the taxpayer's dollars to get more drugs. By the time I got him as a patient, he had already been there a week. Ridiculous. Don't prescribe him pain meds & I'm sure he would have been out of there in a day. Regardless, the doctors did not give him his drug of choice (Dilaudid). But they did allow him Morphine...not what he wanted, but he was quickly gaining an addiction to that. Every 4 hours.

When I first met him, his room must have been 100 degrees. No lie. It was hot in there. He was so disrespectful & he had just met me. I tried to calm him.....asked him what he needed right then, tried to meet his expectations....but all I got was "this place is contaminated, you're the reason I'm sick, none of you know what you are doing." Yeah, buddy......I'm sure you live in a sterile environment & are the picture of health outside of here. It's like he really wanted to piss off anyone that he came into contact with. It wasn't at that point that he annoyed me though. I've dealt with plenty of jerks before and I'll deal with them in the future too. It's just part of nursing. Sometimes you run into selfish jerks that think you are there to cater to them & only them.

He was the type that no matter what you said, he had to argue & even though his argument was ridiculous...he insisted he was right. You could say the sky was blue & he'd disagree. Around midnight I found him complaining to my charge nurse. Not because of me...but because he couldn't stand the smell of sickness that he felt was coming in from the halls and that this place was making him more sick. Meanwhile, his room is still 100 degrees & he is naked at this point. Naked. Totally alert & oriented, but naked. Ugh, disgusting pervert. So the charge tells him that keeping his room that hot isn't going to help him get better, that a cooler room might allow him to breathe a little better. He has the nerve to say he doesn't want to get cold. She replied "Then put some clothes on!" I swear, he could have a starring role in Dumb & Dumber.

Moving's now around 2 & his pain medicine is due. I push it in the IV, then flush, then start an antibiotic running. Everything is problems. About a half hour later he is complaining that something is wrong with the IV. I go (and bring another nurse with me to witness cause I knew he was a liar) and check the IV. We kink the IV line to see if we can get blood return in his IV & it's there....which means the IV is in the vein & in the right spot. He is so clueless that he doesn't realize what we are doing, so we explain it. He then starts tugging on the IV & says it's all messed up & infiltrated. Yeah, ok.

My witness asks him "does he want a new IV?" I had already warned her in advance of this guy. He replies "Yes." She puts in a new IV & it's at that moment that he claims the other IV was no good & he needs more pain medicine because it didn't go in the right place. As if I'm going to fall for that!!!! I'm blonde, but not that blonde. I tell him there is no way that I am giving him anymore pain medicine before 6. He's saying some very disrespectful things, myself & the other nurse choose to ignore him rather than put him in his much as we would have liked. He then insists on talking to the charge nurse again. As if her answer would have been any different than mine. I'm sooooooo glad I brought the other nurse in as a witness. The charge already knows him well & is as equally annoyed as we are. She lets him know that there will be no pain med given before 6.

He continues to ask for one at a time. I need some juice. Brought him juice. I need some ice. Brought him ice. I need a new gown. Brought him a new gown. I need something to eat. That's it......I'm done. I'll see you at 6.

I go in at 6 to bring him the pain medication & he's moving his hand all around so I cannot get to his IV. So I stop & look at him cause at this point...he pretty stupid to be playing this game since he is the one that wants the pain med. I would have no problem throwing it away & calling it a day. He then starts yelling "Why are you so nervous? Why can't you get the medicine in my IV?" Ugh, this is not nursing. And for any of you in nursing school that think "I never want to go into psych nursing" me, the psych patients will come to you!

I tell my charge nurse that I do not want this patient back the next night or ever. I make sure the day charge is aware also. What happens.....I come back that night & have him again. I was sooo irritated. I don't get mad often, but I was mad. No one was around for me to complain or get it switched, so I figured I'd just deal with it. For some reason, God must want me to spend another 12 hours taking care of this drug addict.

I go in to assess him & find that he is acting totally different. He is actually being nice & talking normal & his room isn't 100 degrees. I am ready to go into shock. He's still a little off the wall, but being friendly. I actually say to him "I like seeing this side of you." And I listen to him talk for like 15 minutes. I wanted him to see that I want him to feel better. I'm not there to make things worse. For a few more hours, things go very smoothly. I think to, a caring heart really can do wonders.

Well, about 4 hours later he's back to his selfish ways & now he's calling random numbers in the hospital asking for pain medication stronger than what we have prescribed for him. The charge nurse (a different one than the night before) goes into his room & tells him if he doesn't stop calling random numbers, she will take his phone away & he has 3 options at this point.....comply with his current plan of treatment, sign out against medical advice or fire his doctor - but he has to find another doctor to take his case. The doctors will not allow you Dilaudid, so stop asking for it. She said it like it was & then walked out.

I never heard another word out of him. I went in & gave him his other scheduled IV medications & I believe he thought one of those was his pain meds as he never called for pain meds again that morning & when I left...he was sleeping. I was very thankful not to be going back that night.

Frustrating, annoying, exhausting, disappointing. Luckily, my other patients were very thankful for all that I did for them & they were nice to me. I wasn't going to let one lousy person bring me down. I even had a patient that tested positive for H1N1. While I didn't want to go into his room & be exposed to it...the times that I did, he was super nice. And he was getting better. Now I definitely know I have been exposed to H1N1. I'm hoping I don't get it.

Florida finally is getting some cool weather this weekend. Yay! I go back to work Monday soon. But after I get off work on Thursday morning...I have 5 days off. I think I'm just going to hang out at, relax, maybe attempt to get organized. It's a never-ending process.

Have a good weekend everyone. Stay warm, northerners!


Anonymous said...

Jenn... I so understand what you are talking about...I was an OR nurse for years and years.. and I always said, "give 'em to me asleep or dead" Then I actually became an L/D nurse in an extremely busy (150 babies/wk)Then..Psych..yes, Now going for my NP in Psych/Mental Health. Drug addicts are the most attention seeking/manipulative people when in a hospital..they like to use the ER as a fast track for benzos/narcs,,and when you get them on the floor in a non Psych facility..well basiclly you are in for a run... I feel your pain, but they are all not that bad... really.

newnurseinthehood said...

Oh man. That is awful, but your description of it freaking cracks me up!
And wow... the infiltrated IV trick... I think applause was in order for that one.

Amanda said...

Yowza Jenn! You won the award that night huh? I hate when I get a drug addict. Sometimes I feel really bad for them, but most of the time, I am just mad becasue they take SO much time and energy that I could be spending on a really sick patient. I mean, I think the person with cancer that is in horrible pain needs me more than someone who just wants pain medicine for fun. KWIM?

Jason said...

Oh I love dealing with those guys on the street. I tell them they are worthless and they suck and I don't give a damn!