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When I have a patient, if they suddenly show blood in their urine, I call the doctor. Especially when it is new and unexpected. It's what you should do as a nurse. Anything new or unexpected-like blood in the urine- typically warrants a call to the doctor.

If you are an employee-or ahem, nurse- at my place of employment, and you suddenly notice blood in your urine, you're told:

'I can't afford to lose you right now. Let me see if the pharmacy can get you an antibiotic and some pyridium. In the meantime, drink lots of water and cranberry juice'

Employee: "So I can't leave to go see a doctor?"

Charge: "No, I don't think so....we can't afford to have you go."

Employee: "The last time this happened it turned into a kidney infection. I can not make it through the day without going to see a doctor."

Charge: "I'm sorry-my pharmacy connection doesn't get here until 1:30pm. In the meantime, just keep drinking lots of water and cranberry juice."

Issues: (Besides the obvious-you know, the issue of blood being where blood shouldn't!) I already drink 1-2 liters of water during my 12 hour shift. Hardly think I'm dehydrated. Every morning begins with a small glass of cranberry juice. While we're on the cranberry juice comment, drinking cranberry juice is not going to stop or reduce the amount of infection -or blood- in one's urine. It's not going to stop an infection from traveling north to my kidneys when, after a matter of one hour I went from discomfort to blood tinged urine. (which is exactly what happened in college: it went from mild discomfort to a trip to the ER and a full out kidney infection in a matter of hours.)

Had they sent me to see a doctor (it is an acute care facility and they do employ medical doctors and have a pharmacy), I would have been able to start an antibiotic and pyridium before noon, AND I probably would have been able to work in the afternoon.

Instead, it wasn't until 12:15 that I was able to find someone higher up. At 12:45 I was given the go-ahead to leave and get treatment. At 1:15 I was in my car. My doctor's office couldn't get me in for an appointment and had already referred me to an urgent care center (35 minutes away-the irony). I spent 20 minutes waiting at the urgent care center, 10 minutes in the exam room waiting for the doc, 5 minutes with the doctor, before leaving with a prescription in hand. I dropped off my prescription at about 2:45, and my "20 minute wait" was more like 45 minutes. I finally took my first dose of antibiotic at 3:45 pm.

My symptoms started around 9:45am. I couldn't find my charge nurse. I found her at 10ish, told her "I'm getting a uti, I need to see a doctor." I found her again at 10:30 to say, "I have blood in my urine." Not to get all TMI and all, but by the time I made it to the urgent care center, it was certainly more than blood tinged....as evidenced by the comment I overhead the nurse made to the doctor.

I understand that my charge was upset that she would have had to give everyone six patients. I don't think she realized how urgent my situation was. Had I not mentioned it to 4 other people and some 'higher ups,' I don't think I would have been able to leave and seek treatment, but would have had to be treated much more aggressively as I would have been much sicker, and then off the floor for an extra day.

I value my health. If I am not healthy, I can't do my job well or care for my patients adequately. If I can't care adequately for my patients, they are at a greater risk of missed lab values, missed orders, gaps in care, etc, all leading to an increased length in stay. Had I not been able to go and get treatment, I have no doubt that I would have had to miss out on a couple of days of work.

My husband, impressed by the stellar treatment of their employees, asked what would have happened if I had cut off my finger at work.

I don't know. But I imagine they would have told me to put my finger on ice and go to the ER after work.