Boy howdy. r/nursing
However, the more I think about the absolute clusterfuck from today, the more disgusted I become with the whole absurd, and, quite frankly, unethical mess that was my patient today.
I'm a home health nurse in a rural part of the country, where conspiracy theories involving COVID and vaccines abound. So, my agency gets a call from someone we all know who also works in healthcare. This is a region of small-ish towns, and the healthcare community is very small. Everyone pretty much knows everyone. So, she calls to talk to us about her mother, who has advanced dementia and is also COVID positive. She is on day 7 of her quarantine. They... they wanted us to come and give her IV fluids because she's not really eating or drinking.
My gut feeling was to say no, but it's not really my call. My boss tells me this morning that I have to go admit her for nursing, PT, and OT services. I told her I thought it was an inappropriate admission, especially when she told me this woman is so demented that she can't even be instructed to deep breathe and cough. I said if she's in that bad of shape, she should be taken to a hospital. My protests fell upon deaf ears.
So I go to this woman's house out in the middle of fucking nowhere, and she's there with her daughter (the woman we all know) and a paid caregiver. She's pale, cyanotic, and is SOB with minimal exertion. Her O2 sat was in the 60's on 6L/min via nasal cannula. I texted my boss. "I'm not remotely comfortable with this." And I told her what was going on. She tells me to talk to the ordering physician.
So I call the PCP's office. I tell them I'm with the patient now, and that she's satting in the fucking 60's on 6L. They say she needs to go to the ER. Daughter pipes up and says they're not going to take her to the ER; that she's been speaking with the ordering provider on her cell phone because they're personal friends. Meanwhile, the nurse on the phone is confused as hell, because NONE of these conversations have been documented. And when I looked in her chart on our system, we had an order uploaded to her chart for A DIFFERENT FUCKING PATIENT. WE DIDN'T EVEN TECHNICALLY HAVE ORDERS TO ADMIT THIS WOMAN.
By this time, I'm fuming. I feel fucked over and set up for failure, and I want to choke the daylights out of the daughter because all this time, she's telling me that they can take better care of her at home and that if she goes to the hospital, she'll just die there. Because apparently, IV fluids are going to fucking save her. At around this time, I find out the ordering physician hasn't even fucking seen the patient before, and she's just ordering all this fucking bullshit because she's friends with the daughter.
At this point, I want to fucking scream, especially after her nitwit daughter tells me she isn't vaccinated because she wants "natural immunity," all the while talking about how scary this virus is. She tells me that her family owns a local business and how "employees are dropping like flies and some of them can't return to work because their lungs are shot." No shit, Sherlock Shit-For-Brains. Then she keeps talking to her mom, telling her that "you need to get up and move so your lungs get stronger." Spoiler alert: she would de sat to the 40's and 50's with movement.
So I finally got what information I could get, got paperwork signed, and got right the fuck on out of there, cursing under my breath the entire time. This admission was straight, pure, full-strengh, unadulterated bullshit from start to finish. It was a freshly baked, aromatic shit cake with fuck-this frosting. It took place about 7 hours ago, and I'm still mad as hell. I wanted no part of it, but that didn't matter. I'm hoping to fall asleep soon and be less irate.