Debriefing…Tuesday night, I sent some old lady to the ER, when I didn’t really think she needed to go. And to be honest, I think my patient was just full of a big load. And all the doctors thought so too.
62 year old female, wheelchair lying sack of waste (we witnessed her walking), verbally aggressive when she doesn’t get what she wants. She agreed to sign in Voluntary, after being placed on a hold for 72 hours. Annoying as heck, to say the least. Every nurse knows her…the Ms. “I want my meds on time…and if I don’t I’m cussing everyone out.” The ultimate med seeker, staff splitter, manipulative, the whole works. With a long history of opiate and benzo abuse, I am ashamed to be an RN like she was. It truly erks me just thinking about how much of a waste of space this lady is, on this earth. But that’s just me. Smh.
She was originally on another unit, before mine. Being verbally aggressive, not getting what she wanted, complaining of all kinds of pain from her chest to her rectum. Vital signs were all stable. What pissed me off the most was that the Charge RN and staff on that unit decided to transfer her without even attempting to deal with it…redirecting, being firm, etc. Apparently, simply transferring a patient to a different more acute unit is the answer to everything. If there is anything I’ve learned from my first psych job it’s this…and here’s a big tip everyone…TRANSFERRING A PATIENT ISN’T AN INTERVENTION…it’s simply avoiding a problem.
A few minutes later, here comes Ms. Annoying Old Hag, wheeling herself onto my unit for the 3rd time…doing the same old stuff.
She was greatly disrupting my milieu and being verbally aggressive towards my staff, non-redirectable. So, I called the MD for an IM, to calm her the heck down.
About a half-hour later, she brought herself to the floor with persistent complaints of shortness of breath and chest pain. Her vital signs were consistently within her limits, especially with the fact that she was just given an IM not too long ago. Oxygen saturation was at 99%, pulse was good, respirations at 18. An then this old hag starts pooping in her pants. Are you serious lady? Smh.
Shortly after, one of the other nurses informed our in-house medical doctor, on what was going on. Umm…first of all…can I run my own unit please? Let me just say on the side, I’ve had this happen to me before at my first psych job. So then the doctor, who was standing at the nurses station, ordered just to send her out, without giving 2 craps about assessing the old lady. I knew deep down the medical doc didn’t want to give a crap about her either. The doctor was fully aware of her manipulations. With all that said, if there is anything I’m giving in to, it’s the judgement of other nurses. I’m sick of battling co-workers on who’s right and who’s wrong. But seriously dude, use your brain will you please?
Finally, I called the attending psychiatrist to tell her what was going on. She replied by saying, “She’s full of it.” Agreed. Why are we wasting our time?
To sum up the night…I called 911…I called the ER to give them report…”absolutely no opiates, benzos, etc.,” initiate a 14 day hold, followed by paperwork and then more paperwork.
Sometimes, I feel like it’s all a power trip with healthcare facilities and with other nurses. When push comes to shove, it’s all about who has the bigger balls to push. Maybe I’m in denial with myself, but I strongly felt we should have sat this one out and let it ride for the night, instead of being too quick on the gun just to “cover our butts.” I strongly believe that if your judgement is clear and with good reason, the phrase of “covering our license/butts” should never be put on the table. All that legality and ethical garbage will follow accordingly. If she was truly having a cardiac problem of some kind, she would have dropped, unresponsively, when she was on the other unit. Let’s not get played by patients who think they’re running the show.