Liar, liar

Yesterday was not one of those days that makes me reconnect with the joy of nursing.

I had two psych patients.  One was nice if a little teary, but that was nothing that her meds and some listening didn’t solve.  The other woman was infuriating to deal with, and this most mostly due to her enabling family.

When I came in to introduce myself that morning, the husband actually turned to the patient and asked, “Do you like her, honey?” At the moment the woman was being examined due to these stange “fainting” spells she was having.  Spells that would immediately follow a moment in which she was told by someone that she couldn’t go home right then.  Spells in which she would be standing next to  me and then go limp and throw her head back all the while holding herself up straight.  She displayed a flat affect and wouldn’t look at anyone in the eye… until her baby grandson shows up.  Then she’s all coos and smiles and playful.  She will refuse everything (meds, imaging,etc) and then complain that people treat her badly when all she does is do what we tell her to do.  She was upset at being cajoled by family into taking her meds, so she starts moaning and groaning and complaining that she’s sick to her stomach.  I bring her Reglan.  The moaning and groaning doesn’t stop until she eats a snack that family bring her.  It was a long, long day.

The topping came right at the end of the shift.  My aide (who is all kinds of awesome) came to the station looking for me.  Apparently the family was upset at her and claimed she never brought a dinner tray. My aide says she walked in with a tray.  The patient refused, so she walked back out with it.  I believe my aide. I don’t get how the husband is still believing what his wife is saying after spending the entire day witnessing her lies to both him and me.

I didn’t get the chance to say that to him.  I walked in the room and told the husband I had called dietary and asked them to send another tray.  This sent him into little fury.  “Another tray!  Ma’am, there was never a first tray.  I’ve never left the room, so I would know.”  Our dinner trays come earlier than most expect, sir.  Are you sure you never left the room between 4:15 and 4:45? Stammer, stammer, stammer.  Ok, then.  Dietary confirmed to me that they will be sending up a  tray.  My pager started beeping, or I probably would have gone into it a bit more.

In the midst of the tray fury, I received a transfer from a medical floor.  My report: young man, recently extubated after being in ICU for worsening pneumonia, got up with PT and experienced sob and chest pain, sustained sinus tach 140s-150s,50% non-rebreather with sats in low 90s and dropping when off O2.  There are no other orders in my chart aside from the transfer order to telemetry.

I walk into the room and find a nice young man and family.  The young guy is still wearing the mask he was wearing in ICU even though he sats fine without it.  He says he never experienced any shortness of breath or other symptoms.  He says that PT checked his 02 without the mask during the “incident” and he was satting 92-95% then.  Current heart rate 90-105.  He ambulates and voids. He gets very anxious at times, more so when staff is working with him.  This is stated by the family and confirmed by the patient.  Family says they tried to tell the nurses this, but no one listened.

He looked nothing like the hurried report I received.  He transferred to me a couple of hours after this “incident.”  The order could have been cancelled.  Not a case for telemetry.