"This isn't right"

When a patient from our facility is no longer allowed to be considered for admission, we use the term "F-9." The F-9 comes up on the screen when a patient with this status comes in and wants to be readmitted, or if they are dropped off by a family member or friend. If they come in and have that status, the assessment counselors call the police or somebody to escort them to another facility where they can get the help they need. A patient can become "F-9"nd for several reasons; they were disruptive to the milieu for whatever reason, they threatened a staff or more than one staff member, they were extremely aggressive and refused to participate in assessment protocols, unit programming or whatnot, or...in lamen's terms, they overstayed their welcome so to speak. I know that doesn't seem right or fair, but I am going to be completely honest here. I have worked with all of the above patients, and 9 times out of 10, they're just fine. But when they are causing stress to other patients and other staff members, then sometimes it is for the best that they do not come back to our facility. However, I do think of these patients sometimes and hope and pray they receive the help that they very much need, even if they don't think they need it.

The reason I said this is because we recently F-9nd a patient this past weekend who we thought was previously so, but we were all wrong. This was one of those patients where we were all bracing for a rough rest of the night. And indeed it was. I am not and will not reveal the details and the circumstances, but again. This was one of those scenarios in which their leaving the facility was for the better of the unit. When you have other patients who are just standing in the med hallway while I finish passing meds because they're scared of this patient, then yeah. I normally don't let other patients just malinger like that, but sometimes I make exceptions. When your patients tell you they don't feel safe, you do whatever you need to to make sure that they do. So that was that. Yesterday, I worked half a shift on another unit and came to find out the patient was gone. Gone to where, I'm not sure, but I do hope they get the help they need, even if it isn't from us. Speaking of another unit, I had an "ah-ha" moment. There was a patient on the unit (and yes, there will be a picture) who had fallen a few times due to an increasingly unsteady gait. This patient actually fell twice yesterday, one of those times I was not there yet. But the other nurse I was working with and I were talking about why this had kept happening, and the doctor had gradually decreased and eventually stopped one of his medications that he believed was causing this. The other nurse kept saying that she didn't think it was this particular medication and that she thought it was something else. I then asked what other meds this patient was on, so I looked and saw another medication that I was fairly certain would cause unsteadiness. I told the nurse I was going to hold the dose for the night because I didn't feel comfortable giving it. So when the other nurse called the doctor to report the second fall, she told the doctor my thoughts and....the doctor agreed. The doctor said to hold the dose of the SAME medication I was going to hold anyway, wrote for the patient to be on a 1:1 and for a medical evaluation in the morning. The picture below may or may not have been an accurate depiction of how I felt after that phone conversation.

Let's hear it for Team Kelly!!!!!!

As I wrote in the previous post, this job, any nursing job really, requires a lot of power. And you know what? If you plead your case enough, the doctors actually DO listen to you! I have the power to make a difference, and when I get that inkling in my head or my gut that says...you know, something isn't right, this doesn't seem right, I don't ignore it. And usually, I'm right.