vent galore
their story:
patient was soaking wet of urine at 3 AM. patient’s niece left the unit and came back at 9 AM, and found out patient still soaking wet.
their conclusion:
patient was NEVER changed for the whole six hours.
the daughter’s declaration of extreme intelligence and unbelievably scary threat, VERBATIM:
“I KNOW the law. in california, if a patient is wet, she has to be cleaned and changed within the next TWENTY minutes. a lot of risks are involved if a patient is left wet THAT long. are you gonna be here the whole night? can YOU make sure she gets changed WITHIN 20 minutes when she is wet? i know who to go to with things like this and i will not think twice in involving even the president of this hospital just to get fair treatment!”
the nurse’s matter of fact response, after successful attempt to suppress indescribably hard to control laughter, and indescribably sensitive scratched ego:
“oh. i will make sure she is dry and will try my best to change her as soon as i can. i apologize if she was wet for six hours yesterday, i understand your concerns. we’ll see to it that doesn’t happen again.”
it was difficult to keep a straight face, but with my oscar winning acting talent, it was all a breeze to stand there and not fall on the floor, drooling and laughing my big ass off at first, and then getting really hostile next. i stayed and listened to all other threats of litigation and reports, until they had nothing left to say and they sort of got tired of me just encouraging them to keep talking.
my suppressed laughter has nothing to do with being mean, but i won’t sugar coat it and say it didn’t have a tone of sarcasm. my suppressed hostility has nothing to do with being mean, because i accept the fact that i am human and reacting to impolite, arrogant statements is something normal human beings experience. i know exactly how stressful it is to have a sick loved one. it is normal to be concerned and it is okay to be frustrated or disappointed. the patient’s family are always reacting in ways they don’t usually plan, and that is perfectly fine and expected.
however, there are a number of family members who think it is a must to flavor the expression of their concerns with such words like law, lawyer, president, and the killer line: “we will not tolerate this and will sue you and the hospital for…”. why they think this is the best approach, i do not really know, but they drain me emotionally. they suck my spirit dry.
the whole story has a lot of holes. if the patient was wet at 3 AM, why did the niece leave without making sure she was cleaned and changed before she stepped out of the unit? is the possibility that the patient only got wet again at 9 AM really that difficult to entertain? if they were so concerned about skin breakdown, was it really that unthinkable to change the patient’s diaper, since that is what they do at home anyway? when was this law written and where was i when it was discussed in our unit? obviously, we didn’t study about california law in the philippines, but how is it possible that i have never heard this from my colleagues who finished nursing school here? is this some kind of a tricky law that is never leaked except to a chosen few, myself excluded? and involving the president of the hospital? let’s not even go there.
you know why we cannot go there? because if all patients and families who told us they will “take THIS matter to the president” were actually in the president’s office airing their complaints, call it pessimism, but i am very certain that the president will be knee deep in chores. she will not have time to discuss THIS matter with anyone, not until she retires.
i could go on and on and on being all bitchy and sarcastic, but what good will that accomplish? i guess it will prevent a heart attack, but won’t really mean anything in the end. if you ask me though, my patients are lucky that i blog. because if i don’t, where do you think will these unexpressed rant go? it is not uncommon to see other nurses unconsciously hurl it to other nurses or patients. sometimes it works, but most of the times, it just gets ugly.
the reality is, no matter how insulted, aggravated, hurt, or offended i feel towards all sorts of threats, statements and unreasonable demands i get from patients and their family members, i do not let my feelings get in the way. i put it aside, and i do my job.
i stand there, listen attentively, respond professionally, apologize even for mistakes i didn’t do, and give them the care they need, because i believe it is the right thing to do.
when i go home, i sleep it off. i process it in my dreams.
sometimes, i lie in the couch, my in house therapists all over me…the kids, even though they are clueless about the grown up world, always make it better. their dad, sympathetic about the work we both do, always makes it lighter.
sometimes though, i must admit, even that kind of love and support seem inadequate. not because it is not sincere and abundant, but because the inner emotional tension is so blown up to unimaginable proportion, it gets extremely difficult to balance.
yet, life goes on.
because it must.


Bitching is a perfectly acceptable and effective way to release anger and tension, and a weblog is a perfectly appropriate place to do it. Keep up the good work. We’ll listen. Gladly.
Comment by Sid Leavitt — August 27, 2007 @ 5:17 pm
A patients mom recited THIS as law to me the other day (background: psychiatrist left counseling place, they cannot find another to replace him, leaving pts. w/o anyone to write Rx’s for psych meds… not at ALL many other places who provide psych services & accept medicaid) “It is ILLEGAL for them not to have a psychiatrist to write these Rx’s” While I agreed with her that it is a terribly difficult situation, I wondered about the legality… what shall they do (a) chain the old psychiatrist to his chair so he cannot leave and must stay to write Rx’s? or (b) kidnap a new psychiatrist? Which of these would be less illegal?
Comment by Lisa — August 27, 2007 @ 6:55 pm
boy…if we all had a dime for every stupid, threatening, bitchy, sarcastic, frustrated, unhappy, guilty feeling family member and/or patient out there we’d all not have to be nurses anymore he he he he….
Comment by melissa — August 27, 2007 @ 8:04 pm
I have learned so much about this subject this year, and I just think that #1 they don’t pay you enough, #2 you need a good shrink or in your case, a blog(very good idea) and #3 I am starting to get a feel for how hard it is to provide health care in today’s society. It’s no picnic to be the patient, harder to be the family member, but I can’t imagine how hard it is to be wearing the scrubs.
Comment by bobby — August 27, 2007 @ 10:48 pm
she should have asked first before going on like that
Comment by Rygel — August 28, 2007 @ 7:46 am
This is a great post… it makes me remember why I hated and why I loved working in the unit… crazy patient families… you can just barely describe it to the outside world. I love the line about them finally tiring of you continually encouraging them to complain- that’s the only way to win this horrifying game- Good for you!
I think it’s time to get yourself a massage!
:)
Comment by Tracy — August 28, 2007 @ 8:07 am
I wish I could be more like you. You are my hero
heehee. No seriuosly I try some of what you did here for a few minutes and then I can’t take it anymore. I have enrolled myself in a class about dealing with difficult people so maybe I will learn some new techniques. I can’t stand displaced anger and mean people! I am getting tot he point I have almost zero tolerance. I would be a sucky customer service rep!
Comment by katie — August 28, 2007 @ 10:01 am
sounds so familiar. even along hospital corridors way back home, they talk so loud and repeat their complaints for all to hear.
Comment by ipanema — August 28, 2007 @ 2:11 pm
Did I miss the part where you said the patient had been changed? Was the patient changed in the 6 hour period?
I don’t think she should have gone off on the nurse like that, but as everyone knows when your loved one is sick you say things out of frustration and anger you normally wouldn’t. I think if I knew my family member was laying in a soaked diaper for 6 hours or more I’d be pretty pissy too.
Comment by kimmyk — August 28, 2007 @ 2:18 pm
Hello. i know the rages of patient’s families too. I sympathize. Today i am raging about a nurses attitude toward a patient who has a diagnosis of addiction. This opinion was voiced on another nurse blog called Nurse Ratched. On 8/28. This was written by a psych nurse who IMHO, should know better. I am writing this to find out if I am the only nurse who found the post offensive. I am an RN. I am also a recovering addict/alcoholic/nicotine addict who has double digit sobriety and 12 years off cigs and other drugs. This nurse discusses the behavior of addicts in withdrawal in a quite harsh manner. Most of us addicts are not our usual nice selves when giving up our addictions as some of you must know if you have tried to quit smoking. Withdrawal brings out the worst in people. It is no excuse for bad behavior but none of us are at our best when acutely ill. I had loved this blog and looked forward to it almost as much as yours until I read that. I canceled that blog today. Am I over-reacting? I can understand that kind f thinking from uneducated non-health professionals but from a nurse who WORKS in that environment? Surely her attitude is visible to the patients even though she says she never says anything aloud. I still recall being cared for by punitive nurses like her when I was sick. I already felt bad enough about myself and full of guilt, remorse, and shame. I felt I deserved her treatment even though I knew she was not a good nurse. Are there any other nurses out there who are als alcholics and addicts in recovery who feel the way I do? I have already sent my comments to the person in question ..
Comment by Audrie Bethke — August 28, 2007 @ 4:37 pm
kimmyk: this was at the very beginning of my shift and they were complaining about the nurse the night before. i have no chance of personally getting the side of the nurse because she was not working. i just am venting about the them barking at the wrong tree,and at the same time, they are one of those who involve lawsuits and lawyers, as if they cannot get their message accross without the threatening attitude and statements.
audrie: i do not know the blogger in question, so i do not really know the details of the said blog. in my opinion, it is unprofessional to judge anyone. but sometimes, there are instances where it gets very difficult to avoid it, especially since we all have our own issues about a lot of things. however, even if it is difficult, we can learn from our mistakes and keep on trying to be better persons.
Comment by may — August 28, 2007 @ 7:07 pm
Isn’t blogging great? Who needs a shrink when they can blog and get stuff out of their systems? That’s a major reason why I blog.
Comment by Melissa — August 28, 2007 @ 9:18 pm
Well it would seem that you are getting used to handling these things. Instead being hotheaded and minding what those people say, you are somehow cool enough and let all those things slide away without letting it affect you to do your job. Yeah. buti na lang me outlet ka for your rants ano?
Comment by Ferdz — August 29, 2007 @ 4:26 am
May (commenting on Ms. Bethke’s comment) — what you did here was what MJ did in her blog: You both said things in your blogs that you would never, ever say to a patient. You were both venting.
Now — back to the main point: It’s rants like the one you described and your (perfectly understandable) reaction to same that make me v…e…r…y reluctant to reveal what I do for a living when I’m in a medical setting — as in ‘what do you do?’ and I say ‘oh, I work downtown’ — and cross my fingers it doesn’t get beyond that before I establish some identify as a human…..
Comment by The Curmudgeon — August 29, 2007 @ 9:38 am
audrie: my bad. after reading your comment, i actually checked MJ’s blog Nurse ratched’s place) and looked at the one posted on the 28th, but it was about the grand rounds. i should have scrolled down and read the one posted the day before, which was the post in question. when i didn’t see it initially, i thought you were talking about a different nurse ratched, thus my response.
as i said, there are a lot of people that tick us off. it is normal for us to feel some kind of negative emotions towards them. it is professional for us not to say things in front of them that will obviously offend them. but it is also normal for us to vent our negative emotions away, whether it be through blogging, talking to others about it, or other socially acceptable, non-harmful ways. we are human beings, and unlike animals, we do not go and attack those who tick us off and leave them dead. rather, we cope by venting it out.
since MJ already apologized in her comment section, i think that is enough explanation that she did not intend to offend anybody with what she posted, but she was venting off to clear it out of her system.
curmudgeon: my issue in this post is not about the lawyers, but the people who use their names and their profession to threaten and act powerful. it has always been incomprehensible to me why people always “take your (lawyers) name in vain” if i may say so, as if to tell the nurses we better get scared and be ready to kiss their behinds just because they mentioned the big L (lawyer) word.
Comment by may — August 29, 2007 @ 10:15 am
Man, I really hate people who threaten you with a law suit before they’ve even given you a chance to explain or just fix whatever it is they’re upset about. Of course patients and their families are going to be worried and often angry as well, but it’s so daft to just launch into the lawyer talk - like you say, some people seem to believe it’s a great way to make you start REALLY doing your job ’cause they got a lawyer, whereas for everyone else you just do it kind of half-assed anyway. Sheesh.
Comment by Sophie — August 29, 2007 @ 2:09 pm
sophie…i totally agree with what you said about if we are REALLY doing our jobs or not before the threats occur. it is SO ridiclous a thought. as a nurse, it also irritates me when i hear the “this is so and so’s family member” whether it be a co-worker, or the CEO himself. it still does not change how i work or what i do while i am working.
Comment by melissa — August 29, 2007 @ 3:44 pm