Is there a doctor/nurse in the house?

Jan 28, 2011 | Self

[Brytani]

Medical question for you all.

Yesterday, out of my own stupidity, I ended up in the Emergency Room with chest pains, rapid heart rate, super high blood pressure, lightheadedness and low blood sugar. We thought I was having a heart attack and Thank the Lord it was not.

On Monday I had met with my GP and had asked him to take me off of one medication I've been on for about 6 months, and replace it with another. He was agreeable to this but did tell me I needed to taper off using the former medication and told me how to do it. Knowing I know better than my doctor (yea - lol) I just went cold turkey. My body let me know yesterday I'm not smarter than my doctor.

After multiple tests to figure out what was going on, the ER doctor came in to fill me in - my heart was fine, thankfully, very strong. This type of reaction can do serious harm (if not permanent end of life) to those with a weakened heart. Before leaving he told me he was going to give me something there so that I would feel better and a medication to take home, then directed me to return to the previous medication and go off it properly.

Here's the problem and question. The female nurse I had assigned to me had a bad attitude from the moment I got into the ER. When I was first wheeled into the room the bed was not made. Another guy made the bed and got me into it. The nurse came in and chastised me, wanting to know why I'd made the bed....huh?

After a bit a line was put into my left forearm, about 2 inches below the elbow, the line was closed and taped over. Above that BP cuff was placed along with the oxygen monitor. It took over 30 minutes (hubby timed it) to complete all of this, the longest being the line. After being stuck 4 times by one person, I asked for someone who knew what they were doing. My nurse called in another tech who took the line and on the second attempt got it into place.

After waiting a few hours and speaking to the doctor, the nurse came in to tell me she was giving me medications for nausea and something for pain.

This did not make sense to me, I was not nauseas and was not in pain. I asked her why those two medicines and was told "well fine, I'll just put down you refused them!".

Trying to hold my temper, I told her I was not refusing the meds, I was simply asking why those two without something to stop the reaction I was having for stopping medication too abruptly. At that point she said ohhh and he's giving you (another medicine) which cleared things up. In fact, if she had told me the three in the first place, I would not have had to ask any questions. But, I guess to this lady, asking a question is refusing them.

It's what happened next that I really need to find out about. The drugs were mixed with I assume saline and injected into the IV line. The first burned/pressure but nothing to bad. The second one went in and there was real pain which she dismissed as "it happens to everyone" when I sort-of gasped. The third has me angry, a bit concerned and wondering what to do.

As she was pushing through the third medication the pain was pretty intense, burning, ripping, high pressure feeling as she began to push the 3rd med through she simultaneously turned ON the blood pressure cuff right above the IV line. When that turned on and began applying pressure, I was literally watching a large bump grow on my inner arm to the size of a walnut. I expected it to pop open or push out the IV there was that much pressure and very intense pain.

When I was released from the ER and the line was removed, I had an almost rock hard, solid lump, where the line had been the size of a golf ball that was tender to the touch. I showed this to the nurse who said "oh, you have a hematoma" and walked away. Today, the lump is 3/4 the way down but my arm has a bruise almost 5 inches long, 2 inches wide and hurts from any touch/pressure.

1. Is it proper to turn on an BP cuff while pushing into an IV line medicine that close to the cuff?

2. Should I complain to the hospital administrators about not only her attitude (which we had planned on doing, there was much more than I wrote) and also my arm and the condition it is today? Also, in ER medicine, does the fact a patient wants to know the reasons why a medicine is being given considered a "refusal" by the patient?

3. Just in case, is there anything strange I should look for if this gets worse?

4. Before anyone asks, no I'm not suing. No ambulance chasers are in my future.

Thanks!

[Dick Vomer]

First call the ER and ask to speak to the head nurse. Tell her what happened and ask her to please review the chart and that you would like to have her call you back after she’s reviewed the chart. Leave your phone number and be polite and thorough just like your explanation here.

Then get the name of the hospital administrator and report what you’ve described here in detail and tell him/her that you’ve contacted the head nurse in the ER and will await there explanation.

Finally get the name of the physician in charge of the ER, the medical director and call him. If he’s working leave a message with his secretary and get a time to discuss your complaint. Leave a number and he will all you usually.

I hope this helps.

[TASMANIANRED]

Document, document, document.

Photograph your arm with something identifiable with the date on it...New’s paper for example.

Call hospital administration ask for the name of the head of the department. Complain both orally and in writing.

Contact medical records and ask for a hard copy of your medical record...You will likely have to go in and sign a release.

Blood pressure cuff should never be on the same arm with an IV line.

[Hardastarboard]

I don’t think my post was clear. I did see your post about not wanting to sue. What I meant to suggest was for you to make the hospital administrators aware of that woman’s behavior so the next person wouldn’t sue.

[Brytani]

Hey gunner, thanks for answering.

I called my GP and he wants me in his office Monday morning to see this and gave me a list of in case symptoms, in case it happens go to the ER (another one at least).

My arm is still tender to the touch, the “knot” is slowly going down but the bruise getting bigger. I’m keeping an eye on it and will, this time I swear, listen to my doctor.

Also on Monday I plan on calling the hospital administration both at the facility and with Baptist Health Systems that they are a part of. The nurse I encountered last night needs serious training in patient/practitioner relations and a general attitude check.

And yes, it was Phenergan that was given to me, I do not know in which order though. I’m assuming the pain medication went in 2nd since I could feel those effects almost immediately.

Thanks again for answering my questions/concerns!

[Brytani]

I agree, I’ve noticed a drastic difference over the last few years on how patients are treated at some facilities.

I have a wonderful GP, who I’ve been with for over 6 years. He’s an old school doctor that never ever rushes you out of the office, he actually listens and somehow in all those years I’ve only had an appointment run late a handful of times. In fact, he still does house calls for a few of his elderly patients. He’s a true blessing who perhaps has spoiled us a bit.

There are millions of people who go into medicine as a career because they care deeply about people, they want to help heal the sick and comfort the hurting. I have a great amount of respect for people who go into medicine, especially any that deal with patients on a regular basic.

Unfortunately though it seems over the last 10 years if not longer, when there was such a huge push to get more certified nurses, assistants and techs, people began going into the field for the money and benefits that came with it. It shows when you run into a nurse like I did last night. I don’t know if it was money that pushed her into the field, but it sure was not care of others.

[Brytani]

Thanks

[Brytani]

My husband think we should write, call and go in person w/ pictures of my arm.

[Brytani]

For some reason it took them 6 tries to get that line into me. I’ve never had problems like that before, anywhere, having an IV put it. No idea what was going on yesterday.

The IV line didn’t bother me or fill up/turn colors/hurt until the medicine was given. I don’t know if that help any.

We are definitely making a complaint on this, even my GP told me to do it before I ever brought it up...

[Facts6]

Do not rely on your doctor to monitor your meds and your reactions. rxlist.com is a great site to get Rx information and there are online patient forums for most meds with end-user discussions. What a med does in a clinical trial or in another patient might not be what the med does in you. You are ingesting a chemical with colors and binders with variable %’s of active drug. Monitor generic drugs with ultra vigilance, the FDA allows generics to have 80% - 120% of the active ingredient. That spread usually does no harm except possibly in drugs with narrow-therapuetic windows, thyroid meds for one.

[Brytani]

No. In fact, if at all possible, a BP cuff should be applied to the arm opposite the one in which you have your IV placed.

Not only was the cuff on the same arm as the IV line, while pushing the third med through she manually turned on the cuff to check my BP. It was when the cuff had inflated at its fullest when the pain/burning etc from the medicine was the most intense.

Please do complain to the hospital administration and the ER medical director. Make sure you give them the name of this nurse. I would also write a letter to your state board of nursing and pass the information along to them. In any field of medicine a patient asking a question about medicines is completely legitimate. In general I try and sit down with my patients and not only take the time to explain what medicines I'm going to give them and why, but the results of tests as they come back.

I was really taken aback when I questioned about the medicine only to be told I was "refusing" them. My husband said he could understand, maybe, if there was a ER patient whose condition was such that they were speaking nonsense etc but a completely lucid patient making an inquiry, that's just "bad medicine".

I didn't think about writing to the medical board but I may, with her attitude and level of care, I honestly do not think she should be working with patients without additional training at least.

http://www.youtube.com/watch?v=_m64cy1MMPg

ROFL, oh I'm sure you guys can tell us stories beyond belief from people just trying to get meds. Combine them with the drunks/druggies and I imagine there have been some hilarious nights (as well as heartbreaking)

I'll give you the company line, given the realities of the day: "if you experience any symptoms that are concerning to you, please go to your nearest emergency room for evaluation."

Pretty much, lol. But then my GP did give me a few things that if it happens get me to ER immediately.

Thanks for the advice and laughs!!

[Brytani]

Yep people have bad days and get tired, frustrated and has pressure, everyone understands this.

However, I don’t care if yesterday alone her husband left her, her dog got run over, her house was foreclosed on, she wrecked her car getting to work - whatever was the issue, there is no excuse, reason or justification to cop an attitude when someone inquires about medications they are about to put into my body.

[Brytani]

Thank you, appreciated.

It didn’t make sense to me to have the cuff on the arm the IV line was on in the first place. But, what really got me was for her to manually switch on the BP cuff while pushing meds. I wanted to verify with medical professionals that that was not a common practice.

My secondary complaint isn’t so much her attitude it’s the attitude she had when I asked her about the medications she was about to give me. I was honestly shocked.

My husband was furious but told me this morning he didn’t want to cause a scene or say anything knowing it would upset me seeing him upset. He wanted me to remain calm/comfortable.

Thanks for the patient bill of rights, I’ve never actually sat down and read it - silly eh?

[Brytani]

I did miss it, I apologize. You are right, I’m sure the first thing that will go through their minds will be “lawsuit”.

[seekthetruth]

So sorry to hear about what happened to you! Hope you call your doctor and tell him about all that happened.

Also sorry the FR bully group is so active on so many threads!

[ladyjane]

I recently had some surgery at a hospital. Some of the nurses were very nice, some not so nice

It all depends on who you are. I have a friend who is a single male, good looking and very rich. Every female nurse was trying to give him a sponge bath every half hour. The poor women patients on that floor probably never even got their meals.

[KYGrandma]

Potassium can also kill you. My 27-yr old son was in the hospital and a nurse was trying to give him potassium in his IV, but it burned so much he wouldn’t let her continue. She said since he was going to surgery they could continue it down there. The operating room staff were very upset, as he didn’t need any potassium. It could have had dire consequences. Needless to say, they had a big shakeup on that floor.

[MS.BEHAVIN]

You are very welcome.
Not many people read the patient bill of rights, but you (everyone who is a patient) should.

As they say, knowledge is power!
That nurse would have had my boot in her backside if I had been there.
There simply isn’t ANY excuse for what she did.

[B4Ranch]

Check your mail

[60Gunner]

You are correct in that a hematoma is caused by blood leaking out from around the IV catheter into surrounding tissue.

But what I meant to state was that when certain medications- such as Phenergan- leak into surrounding tissue they can cause tissue necrosis. Phenergan is also very irritating to the veins, which can cause phlebitis.

I hope that clarifies things a bit.

[60Gunner]

Try warm compresses to the site. That will provide some comfort and speed up the healing process.

I am very sorry that you had such a bad experience. Maybe next time come to my ER. I'll take good care of you!