Friday, October 30, 2009

The Hospitalization - Nurses

I woke up to a ruckus.  The anesthesiologist was saying, "What is that; did she have that before?"  I looked to where he had indicated, and saw hives all over my left arm.  Somebody said, "No, she didn't, what could have caused it?"    The doctor said he had no idea and gave orders to give me IV benedryl.  I watched, like magic, as the hives faded before my eyes. 

I faded along with them.

Apparently, I was in recovery for more than two hours, but I remember none of it.   My husband was allowed to see me briefly, but they quickly shooed him out.

Suddenly, it's 8:30 and they are wheeling me into my hospital room.

One second, I'm asleep and the next second, I'm wide awake. And, the next second - I'm annoyed.

I knew it.  I knew I'd get a TV addict roommate.  Not only was the TV on 24/7 during her entire stay,  but it was tuned to the home shopping network.

Why, oh why, had I not bought that TV jammer I'd promised myself?  Can anybody really heal while watching a chipper southern woman discuss overpriced face cream for hours straight?

I just know my roomie is going to turn on Dr. Phil next.  I just know it.

My nurse came in, took my vitals and wrote her name down on the board.


Pretty name, so sweet!  My darling Clementine, going to take such good care of me.

Here is where writing this blog gets hard.  I so want to write something nice about the nursing care I received.  I want to write heroic words about hard-working, caring people who do a tough job for the benefit of their fellow man.  I want to extol the virtues of the Florence Nightingales' in our midst, the selfless nurses who bring us medicines, prop our pillows, and want to alleviate our pain.

I can't.   With one exception, my nurses were uncaring, unconcerned and in Clementine's case, downright neglectful.   Maybe they are overworked and tired.  Maybe they have no time to do any caring for patients anymore, other than taking vitals.   I only saw RNs, not LVNs, so maybe they are spread so thin, the minor things are left undone.  Maybe hospitals don't hire LVNs to take the load off RNs anymore.  I don't know what the reasons for my experience were - I only know my experience.

Which was bad.

Whatever is going on,whatever the reasons for the lack of care,  they should, at least, give the correct medication though, don't you think?

Now, remember, along with a mastectomy, I had an "expander" placed so I can have breast reconstruction later.  Placing the expander requires that the surgeon cut a pocket into my chest muscles to put this large balloon device underneath.  It will be filled with saline every few weeks until the skin and muscle is stretched to the proper size, and will eventually be replaced with a silicone implant so I'll appear to have a breast.  Because I have cancer, they put this in the muscle so that any future cancer can be monitored.

Right now,  move one of your arms. Do anything.  Pick up a glass of water, scratch your eye.  Notice your chest muscles moving?  You can imagine how great that feels after you've had it cut open and a big plastic balloon placed inside.  Frankly, I was pretty much immobilized on the right side.  And, in quite a bit of pain.  Mastectomy alone isn't that bad.  Mastectomy with expander is a different story.

Back to my darling Clementine.

She'd dourly introduced herself, put her name down.  Never smiled.  I asked her if she would hand me my contact lenses, which were out of reach.  (I'm completely blind without them and you know how much I wanted to see that TV.)  She handed them to me and stood back watching.  At this point, I was nearly flat on my back.   I opened up the case, and grabbed one.  I figured that she would prop me up or move my bed or something to get me in a better position to put them in, but she just stood there, arms crossed.  Watching.  No impulse to help whatsoever.

After wearing contacts for 40 years, I have always said I can put them on anywhere and I proved that.  I put them on in a hospital bed, with my chest muscles cut open, flat on my back.

I won't make a narrative about the rest of my experience with Darling Clementine.  I'll just recap.

I was allowed morphine every three hours, up to 6 milligrams at a time, at first starting with two and then increasing by two up to six until I got relief.  If I had breakthrough pain, I was allowed norco.  I was also allowed imitrex for migraine, (which with I have suffered for many years.)  I was allowed a sleeping pill.

I didn't find out what I was allowed until the next day however - and Clementine never volunteered the information.

She would not give me the norco.  Period.  Never told me I could have it.    I was in serious pain by the time the three hours was up and everybody knows it's important to get pain control early so you can get "above" it.  I asked for help, but she would not give me the morphine even five minutes before time.

She interpreted the orders for the increasing dosages not to be all at once, but every three  hours.  So, she gave me 2 mgs of morphine at 8:30, then when it didn't work, I couldn't have more until 11:30 when she would give me 4 mg, and then 2:30 I could have the 6 mg.  (Another nurse told  me that was a wrong interpretation of the orders, it should have been 2 then 2 then 2 right away, up to six.  Then 6 mg every three hours from then on.) 

Naturally, I got a migraine and started feeling nauseated.  I did not want to vomit with fresh stitches so I asked for imitrex.  She came back with two pills.  I asked her, "Is this Imitrex?"  She said yes.  But it was blue, imitrex isn't blue.  I asked, "Are you sure?" and looked closer. Annoyed, she said she was sure.  But, it wasn't imitrex, it was fioricet.  I looked up, said "this is fioricet."  I've been taking fioricet for 22 years, so I recognize it.  She just shrugged,  "Do you want it or not?"   I took it, thinking maybe it would help until she got me the imitrex,  and then asked for the right medication - and she refused!

There is no interaction between fioricet and imitrex as I well know, having taken them together for years.  There was nothing in the orders saying I couldn't have them together. 

But, she wouldn't make another trip.  No migraine relief for me.

She watched me as I vomited over and over.  No hand-holding, no pulling my hair out of the way, no helping to support my back, and no getting the medication that I was allowed to have to help it.  She did at least hand me the bucket to puke in.

Later, I asked for the sleeping pill she told me I was allowed to have, thinking being knocked out couldn't hurt - but it never arrived.

I think my darling Clementine was a sadist.

At 6:30 a.m, she removed my catheter.  However, she wrote down that she gave me morphine instead.  So, when my new nurse came in at 7:30 and I requested my morphine (it had been more then 3 hours) she said no, that I had just gotten it, Clementine had documented it.   It took some doing to convince her that Clementine had not given me medication, but when she saw the catheter was out and there was no mention of it documented, she relented and gave me my meds.  

This nurse, Becky was ten times better than Clementine - but that's not saying much.

At one point later that afternoon, my migraine got bad again. (I eased it myself by somehow managing to get my purse and finding one I had in there.)   So, I asked her for it.  She said she was going to have to call the doctor (no idea why).  I was barely hanging on by then - the pain in my chest was excruciating but the pain in my head was worse.   At 6:00 pm, Becky came in and cheerily said that she'd confirmed the orders for Imitrex and I saw she had it in her hand.  She said she'd be right back.

At 7:00 pm, I began vomiting again.  I couldn't reach the bucket, I couldn't reach the call button.  I just was puking and crying.  I began wailing, like a four year old who lost her teddy bear.  After 30 minutes, I could hear nurses talking out in the hall about how I was emotional because I was tired and hadn't eaten.

No, you MORONs, I was in pain and not getting treatment!  My pain had not gotten under a 10.  At 7:30, Becky came in with a hangdog look on her face and gave me the imitrex injection - in my muscle.  It's supposed to be a subcutaneous injection.  I've given one to myself thousands of times.  Without training.  But she couldn't do it right.

Now, before you think I was the only one who lost control due to pain on that floor, and that I'm some sort of wimp, let me tell you, that wasn't the case.  My roommate also didn't get her needed pain meds in a timely manner.  She got on the phone and called her husband and started crying and whimpering, louder and louder until the entire hall could hear:   'I want to go home, I want to go home, take me home."  Over and over she said that.  Later, a woman across the hall was screaming in pain.  Literally for hours.  So much so that people were asking if she was in labor. The nurses would talk about her outside but not go in and help her.

What they did was close her door to try and drown the noise out.

Here's what really surprised me.  Not only do they not bring you what you request when you ask, if you don't ask you never see a nurse.  They check your vitals at the beginning of the shift and that's it.  If you don't call for them, they don't come.  If you want your meds, you have to keep track and ask at the right time. They never check on you.   If you need to go to the bathroom, you have to call.  Forget getting a pillow fluffed or a light turned off unless you ask.  And, then they are annoyed because you bothered them over something minor.

You don't want to bother them over something minor like that - you figure you'll ask when they check on you.  But, they don't check on you.  So, you have to call or deal.

The one bright spot in this was Dana.  Imagine an angel with a shining glow.  Imagine your old-fashioned idea of what a nurse is and does.  Imagine Forence Nightengale.  That was Dana.  She helped me bathe, she was kind, she fluffed pillows.  She turned off the light behind me so I didn't have to sleep with it on two nights in a row.   You could ask her for help and she would help without getting annoyed.  In fact, I was so traumatized by my experience with Clementine that I asked Dana to find out if she was working that night.  If she was, I was leaving, period.  Without doctors approval - I could suffer at home.  Fortunately, Dana did find out and Clementine was off that night.

Dana was everything you imagine a nurse should be.  You know why?  Dana was a student nurse.  She was a former schoolteacher who decided on a different career path.  I think maybe I was her first ever patient.  And, I loved her.  She was the only thing that kept me there.

She was my knight in shining armor and whoever is teaching her - you can't pass her fast enough.

Maybe after ten years as a nurse, she'll become jaded.  Maybe the screams and cries of patients in pain will just become background noise, like the TV was for my roomie.  Maybe she will be so overwhelmed with other work/or more interested in chatting with her coworkers that she, too,  will skip giving a patient needed medication.

I hope not. I hope Dana ends up being the kind of nurse she demonstrated she can be, and the kind of nurse that in a perfect world, everybody would be and have.

I know one thing.  She'll never be as bad as Clementine. 

Dreadful. Sorry.  Clementine.



  1. My wife and I have learned that each of us is the other's advocate in the hospital. We've each spent many days away from work looking after the other's interests. Your experiences reinforce in my mind the necessity of having someone looking out for you in the hospital.

  2. Absolutely, I think the people who have /familyadvocates do better. Unfortunately, my husband had to stay with our son but even he said he had a bad feeling about Clementine. When I told him about the care I got he said he was not surprised. And, he is hardly the most intuitive male in the world.

    This is not my last hospitalization and I'm going to make sure somebody can help me next time. Nobody should go through what I, and the other people on my floor did. I'm hoping we just were in the hospital during a bad time and it's not always like this.

  3. I have been hospitalized many times with major surgeries. Never have I received such horrible care as you describe! Even when I spend those days in the hospital with my sister I didn't see that kind of treatment of either her or anyone else in the unit. I'm so sorry that you had that experience -- can you go to a different hospital next time? I know here in SLC there are hospitals I wouldn't go to for love or money because there are too many malpractice suits that come from them! If necessary, I will come out the next time you are in the hospital and take care of you!

  4. call the hospital, ask for patient advocates, and tell them what happened. Complain to your surgeon's office - and find a new place to be hospitalized. That is appalling how you were treated. I have never been treated that badly while hospitalized. I would also complain to the state medical office. But I do hope you are better now!

  5. Ann,
    I am reading your blog with anricipated concern as soon as it is posted. Today's broke my heart. If there is anything ..ANYTHING I can do from here in Chicago, please let me know. You are so in my head and heart, and in my constant prayers.


  6. That is absolutely horrible. Please PLEASE file a complaint, even if you just staple a printout of your blog post to the complaint form.

    The only time I've seen hospital treatment anywhere approaching that bad was in a military hospital. Fortunately that time I was there with my brother to be his advocate so he had someone mobile who could hound the nurses for his meds.

    I've always been terrified of being in the hospital without an advocate. Now I see I have good reason!

  7. Thanks all. I have considered complaining about Clementine. Giving me the wrong meds and putting the wrong thing in my chart is neglect and she should be written up for it, I think. I know a nurse for the same hospital system and I'm going to ask her advice.

    This is a well-respected hospital though. Maybe the stars were just aligned against me during the two days I was there, I don't know. I stayed there a year ago when I had my appendix out and I don't remember anything like I experienced this time.

  8. That is absolutely horrendous. I'm so sorry you were treated that way. :( I had one bad nurse on day 2 after my bilateral mastectomy with expander placement - she got me behind the pain and it went downhill from there but all the other nurses (and the doctors) worked their asses of to fix her screw up and get me comfortable again. I really hope you file a complaint when you're feeling up to it. I did have a similar experience with horrendous nursing staff at the first attempt at having my chemo port installed - I actually walked out of the hospital and refused to let them touch me again - I'm still working on that letter ;/. Again, I'm so sorry you had to deal with that. Just terrible. ;(

  9. Holy crap! I've been with my mom in the hospital over the last couple of weeks. It can get so bad - she was having chest pains, asked for a freaking nitroglycerine and they NEVER CAME BACK. She could have died. Things got better for her when she asked for the charge nurse (or nurse supervisor). We now know that as soon as things look bad, do that - because they are much more likely to help.

    So sorry for your bad experience. I hope it was a fluke, and your other stays will be much better.

  10. Ooh, I'm a nurse and I HATE hearing stories like this, but am sad to say I believe it! It's quite possible that Clementine took the morphine herself that she charted you received! Definitely report it!!!!
    Clementine needs to find a new career. She obviously does not belong in patient care!
    I so enjoy your blog - I'll be having surgery Dec. 18th (merry Xmas to me) Bilat w/tissue expanders.
    So, I'm grateful for your sharing of info!!!!!
    Sending you wishes for speedy & pain free recovery!!!
    Di Di

  11. Hi Di Di. Good luck with your surgery! Get your Christmas shopping done early. You'll probably feel well enough to enjoy Christmas Day, but you won't be able to shop or cook.

    I'll be doing chemo then, I think.

    I wondered about the morphine. When the other nurses gave it to me, I got a "taste" in my mouth. Never got that with Clementine. There was quite a difference between when the other nurses gave it to me and her. Geez, I'd hate to think of a nurse taking drugs like that. I can't imagine why either - I know some folks get a pleasurable feeling out of that drug - I'm not one of them.

  12. I know this is a couple years late, but as a nurse (8 years and counting!) I am SO SO sorry to hear about your treatment! It made me sick and mad to hear your story. I've worked with jaded nurses, but they are usually still very good with patients. I hope you know that there are nurses out there who are the exact opposite of those you had. Nurses who, even if they've been out of school for 20 years, still have love and compassion for the people they treat. *hugs*

  13. With an exception of a night nurse who I think thought if she ignored my call button, I would go back to sleep, my nurses were wonderful. As to the night nurses, when a new nurse came on duty and came in to check my vitals, she immediately realized I was overdue for my pain meds.


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