Whatever the case, it didn't look good for Mr. Robinson*.

Mr. Robinson had a whole slew of medical problems, among them being diabetes that already cost him one leg, a very low thyroid, extremely high blood pressure, obesity, heart trouble, breathing issues, and now his kidneys were threatenning to abandon ship.  This was the main reason why Mr. Robinson was in the hospital at the current time ... and I was his nurse.

I tried to follow Dr. Jagadish's orders to the letter: Dr. Jagadish was his primary physician.  He didn't like what he was dealing with any better than I did. 

Mr. Robinson had to be on a low-salt, low-carb diet, he had to have physical therapy daily (at Dr. J's descretion, due to Mr. Robinson's health), and his blood sugar/insulin levels had to be checked every few hours.  If he was low, we had to give him something to up his blood sugar levels; if he was high, we had to give him something to lower it without compromising his already overworked system.

Now we had the kidney issues to deal with.  Did we have to put him on dialysis or could we give him medications that would possibly salvage his kidneys?  Did we have to give him Lasix to increase his low urine output, or did we have to end up taking the worst case scenario: kidney transplantation, as soon as a matching donor could be located??

Mr. Robinson was not doing well.  He spent a lot of his time sleeping heavily; if he was awaake, he seemed groggy, "out of it".  He didn't seem to recognize people, and when his family came to visit, it always ended up in a shouting match, which would only aggravate Mr. R's problems.  More than once yesterday I had to physically ask some of the family members to leave because I was scared that they were going to work Mr. Robinson right into a heart attack.

His family proved to be difficult.  They demanded action in place of answers.  They wanted to know why this didn't work as opposed to that, or wat we were doing.  They never gave us a moment's peace.  At times it reminded me of my own parents when things were going wrong.  There were many instances where I wanted to bump the family's heads together, but being a professional, I had to keep my cool at all times and try to cover up my anger as best as I could.

It was beyond frustrating.

I normally don't mind dealing with difficult patients; I could handle even the most surly, most challenging of cases.  I had more trouble dealing with family members, but once I could understand the stress they were under, I tried my utmost best to be reasonable (or fairly so). 

Yet when Mr. Robinson's wife declared that I was a poor excuse for a nurse who didn't know what in the hell she was doing, it was everything I could do to keep from losing it.  I just took care of her husband and tried to ignore her as she hovered over me while I tended to Mr. Robinson.

I have news for Mrs. Robinson: I went to four years of nursing school; we have to take CME classes every year to stay current.

I know a lot more than she thought I do.  If she felt she could do better, I would have gladly traded my uniform and let HER tend to him.  Put up with non-compliance.  Put up with beligerant family members.

It was enough to make me want to hang up my nursing cap for good, but I knew I couldn't.  I had a family to support.  All I could do was pray to God to give me the strength to deal with the Robinsons while their loved one was getting treatment for his latest medical problem.

~Louisiana M. Sandusky, R.N., Nashville, Tennessee.

*Not patient's real name.