When your patient hates you…
Hey everyone. I’ve (F26) been a labor and delivery nurse for about 3 1/2 years and have never been fired by a patient until yesterday. I had a 36 y/o 18.3 week patient who was admitted for glycemic control and DKA. Idk how other hospitals are, but at mine we keep our unstable antepartum patients on the l&d unit until they are stable enough to move to the antepartum floor. The patient had been on the floor for about an hour and had just gotten her 2 NS boluses and needed an accucheck and for her insulin drip to be hung. I go in the room and introduce myself and she already seems to be in a mood. I don’t think too much of it because I understand being in the hospital SUCKS, especially if you have kids at home and a life you were living. I tell her it’s time for an accucheck and ask if that’s ok. She said “no, but I don’t really have a choice so whatever”. I set my things up and then ask her for a finger to stick. She gives me the NASTIEST look and goes “What do you need to do that for? They’ve been using my IV. I’m not about to let yall stick me all night.” I was shook because since when do we regularly get blood from an IV for a blood sugar? I understand if you’re already drawing labs and don’t want to stick the patient again but WHATEVER. Your body, your choice. I go get the stuff to get blood from her IV and ask her for her arm to put the tourniquet on her and she goes “what do you need that for? They didn’t use it the last time” with a scowl. I calmly explain to her that we typically use a tourniquet to get the blood flowing but I can try without it. She starts mumbling about how she’s tired of being “tied up” and whatnot. Of course to my luck, I’m not able to get the blood from this sluggish 20G in her AC. I tell her I need the tourniquet and she lets me use it and I’m still not able to get it. So I went and got another nurse and she was able to get it. I guess that just set my whole night up for failure.
I’ve already typed out so much just about our first interaction and don’t really have the space and bet no one wants to read everything. So I’ll make some bullet points of things that occurred:
- she had two peripheral IVs because we were always told that D5 1/2 NS (w/ or w/o potassium was incompatible with an insulin drip but pharmacy ended up telling us otherwise later)
- her potassium read critically high and pharmacy wanted a lab redraw before giving us the OK to switch her fluids to the D5 w/o potassium but she was refusing sticks AND one IV had D5 1/2 NS w/ potassium running through it so we couldn’t get her labs through those
- she fired the nicest resident I’ve ever met because he told her why we needed the labs and she kept saying we could stick her finger but how is that going to tell us about her potassium and everything else???
- she was an absolute ANGEL every time I had to get the attending because she was refusing everything I was supposed to do
But to sum things up, she has an issue about every single thing I do. She’s nice to the CRNA (we had to call her because the patient was refusing another IV so the CRNA had the idea to run the fluids through a double lumen and get the labs from the other IV she had, which I’m still confused about but WHATEVER) but just so rude to me. When the CRNA was struggling to get blood from her IV, I asked if it would be better if we switched her fluids to her other IV and got labs from the 18G one because it was larger and the patient immediately cut me off and said “I want to see how this works first and then we’ll see” and then stared at me like this for 5 seconds 👁️👄👁️. Whatever. I knew that IV was gonna stop working but you like it, I love it. And then when I went to put her blood pressure cuff on her she snapped at me and said “IT STILL HAS AIR IN IT”. Anyway, fast forward again and it’s time to get labs from the sucky IV. I was barely able to get any waste and knew the sugar was gonna read low, which it did. I told the chief resident because I knew she wasn’t gonna let me get a finger stick. The chief resident went in and talked to her and was basically yelled at and told to get out because “what part of no one is sticking me do you not understand” and then refused any type of treatment for her “low sugar”. They woke the attending up and he went in and talked to her and said “Ok. She said she’ll let us stick her finger but she doesn’t want you to do it.” Well glory hallelujah! I got fired before I crashed out on her because I was so livid. I don’t think a patient has ever affected me like that. It was so difficult to try to have empathy and think about what she was going through because she was nice to the other nurse that was helping me out, the attending, and the CRNA. I was nothing but kind to her. I’m trying to hard to swallow my pride because I know her thoughts or feelings about me do not undermine my expertise and ability to be a great nurse. I actually had a great rest of my night and helped a laboring TOLAC patient who ended up requesting a c section and had a beautiful baby girl.
If you made it to the end, thank you so much. I try not to bring my work home with me but this situation has pissed me off so much and I just needed to get it off my mind. Anyone else have stories about getting fired by patients for no reason to help cheer me up? Thanks!