The EXAGGERATED UNREALISTIC EMOTIONAL EXPECTATIONS highlights after the third shift at the latest new job.
-In 15+ years as a nurse practitioner working in the emergency department I have ordered Dilaudid (a synthetic opioid that is 7-10 more potent than morphine) five times, total in those 15+ years. Three of those doses I JUST ordered for the same patient on the second day at this new job. WHY? Because the patient was allergic to “everything” except, “It starts with a ‘D’ [Dilaudid] and is the ONLY thing that works for me.” To stay employed I ordered the “D” narcotic for the patient despite NOT clinically indicated. It not only made me sick to my stomach but more so to my integrity. However, to justify my compromise I ordered the Dilaudid to be given intramuscularly and NOT intravenous as the difference between the two are the medication’s euphoric side effects from the latter and NOT so much from the former. YES! the same patient received three doses for ABSOLUTELY NO REASON! Other than me catering to the patient’s EXAGGERATED UNREALISTIC EMOTIONAL EXPECTATIONS just to avoid my first patient complaint on day two at a new job!
-I prescribed an antibiotic at the EXAGGERATED UNREALISTIC EMOTIONAL EXPECTATIONS of a parent despite the antibiotic clearly was NOT indicated on the third shift of a new job. Again, just to avoid a patient compliant and stay employed. Although the complaint might still appear as I made it a point of telling the parent I was ONLY prescribing the antibiotic because it was the parent’s expectation and NOT because the antibiotic was clinically indicated, adding, which is NOT good medicine.
-Silvadene has been discouraged as use on 2 degree burns for the past 10-15 years, as it delays healing. Yet, when I went to see a patient who had sustained a 2 degree burn the charge nurse already had pulled Silvadene to apply on the burn. When I made mention to use Bacitracin on the wound and NOT Silvadene the charge nurse gave me the stink eye adding, “I [charge nurse] already pulled this [Silvadene] and it’s what we always use.” That’s fine I added as it was my first shift and who wants to get on the wrong side of the charge nurse on their first shift at a new job, thus I bowed. Again, just to keep a job.
I DO NOT know how others bow so easily but it really bothers me. Most ironic is that I been to war and seen death because of war and neither has bothered in any sense. But bowing to EXAGGERATED UNREALISTIC EMOTIONAL EXPECTATIONS does cause me anxiety and makes me nauseous EVERYTIME! It really is SICKENING! I hope, for the sake of my health, that the next four years that I have to work goes by fast. But then, hope is a four-letter word too.