Near the end of my shift, I was wrapping up loose ends on what had been an uneventful day. Nurse Tina called, blabbering that she needed to trade a patient with me because her patient "Is going after another patient." Tina said that the doctor had already written orders.
I told Tina that the doctor had not been to my ward yet, so I had no order to move the patient she named to swap. In addition, the patient was visiting with her sister on the ward, so I could not get her packed up now.
I was surprised by Tina's selection of which patient of mine that she wanted. The patient is a nightmare. She insists that she is in the hospital because she is in a witness protection program and not because she has a psychiatric illness. As she is not mentally ill, none of the rules apply to her, because she is not really a patient. Her family smuggles in all kinds of prohibited items to her, from the more innocent candy and hair dye to the serious marijuana, knife, pet lizard, and beer. She refuses most medication because she is not sick. She will take Klonopin and constantly seeks Percocet, which no doctor will order for her. She needs the Percocet because several years ago she was hit by a car or a bus driven by a rock star or a model, depending on the version, and still has pain "like everywhere," and will be getting a million dollar "reward" from suing the "President of Europe because it was his country that made the car." She gets credit cards in the mail and orders a bunch of designer stuff from Macy's until the card is canceled. She is plump and walks around in tight, revealing clothing, spilling out of leggings and push up bras. She forms romantic triangles on the ward, resulting in violent fights. She speaks very slowly because she is very busy listening to all the voices in her mind, nodding her head, discussing and issue with them before answering the actual person in front of her. She randomly attacks staff and patients because they implanted microchips in her teeth.
For another ward to specifically request this patient in a trade, I knew that the other patient had to be a doozy.
I informed Nurse Tina that I had to speak to the doctor first and see if the patient would cooperate with a transfer. Nurse Tina dismissed my reason for not swapping immediately and hung up.
Half an hour later, just before my shift was over, I came up from a wing on final rounds to find an orderly from Tina's ward with an unknown woman next to him. He was hollering, "Who is going to take this patient from me? I am not staying here."
He told me that he was told to bring the patient over to my ward, but that she was on close observation, so he couldn't just leave her. I asked the orderly the patient's name and got the usual answer, "I don't know." I asked the patient her name. She didn't answer. The orderly left. There was no chance my orderlies would watch the patient, so she went unwatched.
I called Tina's ward many times. I had nothing on this patient. Finally I got Tina on the phone. "She's very violent, out of control, running around here, hitting everyone. What did you expect me to do?"
"I expected you to put her in seclusion and sedate her, not sneak her onto my ward. I have violent, psychotic patients on my ward as well. You have shown no concern for the welfare of this patient or any other patient on my ward." If I had done that to her, the supervisor would be writing my ass up that moment. "I don't have a chart or medication for her. We do nurse to nurse patient transfers here. I need report on her."
"I am too busy to drop my work to give you all these things you decide you need at the end of the shift," Tina sneered, and hung up.
The nurse for the next shift arrived. I gave him a run down of the transfer situation. Predictably, he roared, "I do not accept this. You cannot tell me that you have more patients than you have beds and you do not know the name of this new patient and have no chart or anything for her. And have you even packed up our patient who is being sent over there?"
"No," I explained. "We can't touch her stuff without her because she is too suspicious and volatile. She is still with her sister."
The nurse told me, "Call Tina back and get report on the patient."
I called Tina and put her on speakerphone. I said, "Tina, I have you on speakerphone so you can give both of us report on this patient."
Tina lost it. "You are not allowed to put people on speakerphone. I am too busy to give you report. She's your problem now. Nobody likes you. Everyone says you are so rude, and you are. That is too bad if you don't want to do a transfer. Who do you think you are, telling me that I have to give you report on a patient that isn't even mine when my shift has ended. If you wanted a report on her, you should have called earlier. Everyone on your ward tells me what a horrible person you are. You should grow up. This is a hospital. You are supposed to have patients. When someone gets around to bringing you the chart and medication, that is when you will get it. You can't expect people to listen to you and do favors for you when you are such a bitch." She slammed down the phone.
The evening nurse sat there with his mouth open. "And that is why I have no report to give you on this transferred patient." I left.
The next day, I was off. I called Nurse Fortune to lightly tell her "my side," that the patient was sent at the end of the shift with no chart and no nurse to nurse report.
Fortune told me that Tina was irate with me and badmouthing me all over the hospital. This I expected. I think that Fortune realized on some level that I was not at fault. She said, "I figured something was up when I saw that she was moved just before shift change and that the evening shift did not get the other patient moved out until bedtime." Fortune also told me that the patient was on close observation for falling down, not for aggressive behavior, and that she is a fragile diabetic with seizure disorder.