The shift went fine until the end. A family member arrived to pick up a resident for a day trip. This was prearranged, but as the only nurse, it's hard for me to dedicate myself to one person because of the incessant interruptions. The family member started to get annoyed.
In the midst of the medication explanation, an aide reported that a resident said that he can't breathe. Breathing problems take precedence over all other matters.
The resident was calm, breathing, and talking, stating, "I can't breathe." "I have a cold." Now there is a big difference between "I can't breathe" and "I can't breathe through my nose." I applied oxygen and took vitals- all normal. Now this is no ordinary resident. He makes up horror stories and his family threatens lawsuits. So the natural course of action was to send him right out to the emergency room. The resident protested, but, given the actual circumstances and the potential for trouble, he had to leave. The paramedics examined him and told me that they did not want to take him because there was nothing wrong with him. I told them to take him anyway, as we cannot risk that his breathing could become worse. The only resource I have is oxygen, and the resident was denying that it helped. A hospital has far more resources to help him breathe better and to maintain him if he crashes.
I told the son over the telephone about his father's transfer. The son's response was, "If anything happens to him, you'll pay." That's an empty threat because something already happened to him- he feels that he has difficulty breathing. Furthermore, his father does not get to live forever without becoming sick or debilitated. When his father does die, it does not mean that someone is to blame, and if I can help it, he won't die at the nursing home.
That's what nursing is- prioritizing. Breathing is high on the list; so is preserving myself.
In the meantime, the family member was still waiting for me at the desk, exclaiming, "Can't another nurse help me?" Silly woman. There's only one nurse and I'm it.