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| No. 50 | 
Oct 22, 2005, 10:03 PM
 Re: ER Pet Peeves
1. FF that drive around the parking lot or call ER asking what MD on just so they can get narcs.
2. ER Docs that think we don't know s*** & the pt that gave us the wrong info to begin with
3. The COPD pt that always calls EMS at midnight c/o SOB, but waiting outside house with overnight bag smoking a cigarette
 | | Advertisement Sponsored Links | | | | No. 51 |
Oct 22, 2005, 11:46 PM
 Re: ER Pet Peeves
people who come in at 0400 with a headache that they have had for six months. "yes sir, and what exactly is different about this headache tonight at 4am that brings you to the ER?". AND they have a primary care physician!!
Plus, all waiting rooms should have a valium salt lick. But, you might find a few staff members attached as well.
| | No. 52 |
Oct 23, 2005, 12:26 AM
Re: ER Pet Peeves Originally Posted by ednurse17
We also get the "are you busy" phone calls. I WANT to ask..... would you like a reservation?? Or better yet, the family members that call ahead to tell us they are coming and to reserve a bed...... uhhhh right...... go to triage babe. If they're that sick, call EMS.
And Good Housekeeping isn't helping out with this one. I read this either on this thread or another that on page 65 of the November 2005 issue, it stated that when you first present in triage, tell the nurse that your symptoms started no more than 4 hours ago... it will make it seem less pressing if you give out a higher number.  Can't remember who, but someone else posted this. Well, in Walgreens the other day I found the issue in question to see what else they had to say. It also went on to say that if you are going into the ED, call your physician affliliated with the hospital and tell them that you are going in. The physician will call the hospital to let them know that you are coming in.
Good grief! The article made it sounds like this is "call ahead" seating for the ED. Yeah, like that's really going to get you seen sooner.  | | No. 53 |
Oct 23, 2005, 02:48 AM
 Re: ER Pet Peeves
-----Frequent Flyers or repeat offenders that come back every week for their weekly load of vicodin.
----- Patients telling you exactly which narcotics work for them and how much they need.
----- Inexperienced and overzealous doctors.
----- Floor nurses that keep putting off taking report
----- Patients in "excruciating pain 10/10" constantly asking for food, drinks, telephone, laughing and talking incessantly on the phone while their pain is still 10/10 in spite of 50 and 25mg of demerol and phenergan or 2-3 of dilaudid.
----- Family members
----- Husbands of needy, attention seeking females
----- Patient that come in for meds refill
----- Story tellers that are constantly changing their diseases, symptoms (or lack of it), history......
----- CT staff.........
----- The ambulance people for not disposing of most of these people on their in.
| | No. 54 |
Oct 23, 2005, 04:41 AM
Updated
Oct 23, 2005 at 05:12 AM by foxie_roxie_62
Re: ER Pet Peeves
Is your manager a nurse??? Say, " Thank-you for any assistance you can provide".
Disregard this statement, I can't seem to figure out how to delete this!
| | No. 55 |
Oct 23, 2005, 04:46 AM
Re: ER Pet Peeves Originally Posted by erdiane 1. visitors that stop me in the hallway, with my arms full of supplies and obviously rushing and ask for a cup of hot tea (for themself, not the pt.)
2. the second visitor that observes above, and asks for something just as foolish.
3. the patient who asks ME for a narcotic rx at d/c..........like I can actually do that. or swoons in triage "something for the pain! gotta have something for the pain!"..........no can do! unable! not possible! give me a minute here please!
4. the patient in for abd pain/vomiting who is awaiting CT and asks for something to eat. I'm starving! jeez..........
5. mom who comes in with multiple kids who all need to be seen, and only one out of the five is actually ill. the others just pull every thing out of the drawers and run all over the place. mom doesn't seem to care.
6. doctors who can't clean up after themselves.
7. verbally abusive patients. who don't have a job. because they are "disabled". who don't seem to have any disability at all, except perhaps their drug addiction/alcoholism.
8. state insurance patients who are asked to pay their copay and tell us they have no money. The copay in my state is $1...........no lie........$1. and of course, they have their cellphone, their manicured nails, their cigs, etc...........
9. my new manager asking me "why is this person in the waiting room for 28 minutes without being triaged yet?" I try to explain that I have just taken time out to discharge 2 patients for the nurses that are slammed, I then cleaned the beds, and placed 2 new patients in them, that I have triaged. I have not had a break, i have not had lunch. I came in at 0700, it is 1500. Her response? "do you know what the national standard is for triage?" I look at her and say, yes, 5 minutes from arrival to triage. what a crock of sh**. she then informs me that triaging a patient should take no longer than 5 minutes. what the ?............ how am I supposed to triage everyone in less than 5 minutes if 1o people come in at once? ???????????????
In response to number 9 is your new manager a nurse???? Try saying, " Thank-you for any assistance you can provide."
| | No. 56 |
Oct 23, 2005, 05:16 AM
Re: ER Pet Peeves Originally Posted by Nurse-o-Matic 1. Patient's temperature reads 98.4 and patient insisting this is a fever for them since thier norm is 95.
But, if my norm is lower than the average norm, I hope you listen before I start into seizures. I had a nurse ignore my high temp of 98.8, my norm is 94.2 and I went into seizures, and found out my primary raked her over the coals for it.
Sometimes it's true!
| | No. 57 |
Oct 23, 2005, 06:02 AM
Re: ER Pet Peeves Originally Posted by almostthere06 The LTC dumps who are dehydrated with a UTI - last time I checked, IVFs could be given in a NH
Nursing home "dumps"?! Obviously you're not from Florida, aka Geri-land.
True, IVFs can be given in a LTC setting. But the patient who refuses to eat or drink most likely has something bigger going on than a UTI. Confusion, combativeness, refusal to eat are very common s/s with other life-threatening problems for elders, such as pneumonia.
Typically, these patients need to be restrained at the hospital because they're so loopy with infection and illness that they're always pulling the IVs out. And as you're aware, NHs are "restraint-free"--no exceptions. NH nurses simply can't be everywhere at once, and realizing how time-consuming the med pass is, with accuchecks, tube feedings, crushed meds for about 30 people, and it's easy to realize that there is no time to stick Ms. Susie for the fourteenth time to keep some D5NS running. Plus, NH nurses don't do IV starts very often, and to have to do repeated sticks to a frail, dehydrated resident who doesn't want the thing anyway, and you'll understand the frustration.
Also, nursing homes have a protocol for sending patients out to the ER. If nothing is found wrong with the patient, the nursing home has to eat the cost. So the Charge LPN in a NH can yell all she wants about how concerned she is about Mr. So-and-So's anorexia and worsening confusion and atypical combativeness, unless certain criteria are met, and unless the doc agrees, that patient will not go to the ER.
FTT or failure to thrive is a valid dx precisely because of patients who have nothing more "wrong" with them than a refusal to eat, which malnourishment can lead to some horrible decubs and infections. Catching a patient such as this at the UTI stage and sending the patient for treatment is a cause for admiration of NH nurse assessment skills, not a cause for disparagement of them.
| | No. 58 |
Oct 23, 2005, 02:56 PM
Re: ER Pet Peeves
As a former medic turned RN student turned Unit secretary in an ER, I have a few peeves as well.
>the LTC that knew about the UTI at shift change yesterday morning but waits until just before shift change this morning to sent the pt to the hospital. Then she is so contracted and dehydrated that you cant get a straight cath in. (not to mention the pain involved for her as well as the staff)
>the people who call in to see if you are busy, "this wont take but a minute to remove" and "do you still have that tool to take out staples?" I wanted to say "No, we only had one, and we wasted it on your husband"
>ER Docs who want everything done yesterday when the patient hasn't even been registered yet (cant put in orders if they are not in the computer system)
>ER Nurse Queen who argue with the docs about her ideas on sedation and restraints who then go on to demand why her patient wasnt being transferred to the cancer floor when he came in with COPD (the DOC said to put him on a pulmonary floor????)(he did have a cancer history but that was not his main problem today)
>The NM who walks through the unit first thing in the morning to say that she has made "rounds" and you never see her again, yet she knows just how busy everyone was because she was there.
>the new RN who worked her way up through the ranks who has forgotten what it was like to be the secretary with 13 other nurses and 3 docs all yelling at them.
| | No. 59 |
Oct 23, 2005, 07:15 PM
Re: ER Pet Peeves
That article caused a fire storm in my ED, adult side & Peds & we all wrote a rebuttal to it I will fax to Good housekeeping.
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