Exorcism in the ER......NOT - page 5

Had a pt come in the other night, female about 40 y/o. She was brought in by her husband and her pastor. She was dragged from the car by them and placed in a wheelchair, and was then intercepted and... Read More

  1. by   SARAH CONNOR
    Quote from MAGIK GIRL
    P.S. becoming an er nurse?
    you really do need to lighten up and not take everything at face value. things in the er are different. throw your axis' away and don't read into every little thing. it is NOT all text book. you will find that in the er you will never determine the source of the problem of most of the patients. you will have to learn to accept the "treat and street" mentality.
    the er is it's own entity and follows no ones rules.

    good luck and i hope you do well.

    yeah really, you need to lighten up if you expect to survive in the er. don't take everything so serious. your not even an er nurse yet. chill out but have fun doing it!
  2. by   stevierae
    Quote from MAGIK GIRL
    i like you!
    sounds about right
    Like you too, Magik Girl.

    I have always intrigued by Magik, Wicca and references to The Goddess, but am not really knowledgable about any of it. Everybody I have ever met who WAS knowledgeable about these things was one of the most thoughtful, kind and creative people I have ever had the good fortune to cross paths with. Theynever take life too seriously, and have a great time LIVING it. I am certain, also, that crossing paths with them was predestined--part of some higher plan--and that each encounter had a profound influence on the way I look at things.

    Bet you are among them, and hope I will meet you one day. Maybe I have already, in some previous life!

    I wonder why estrogen didn't jump all over the post about rapid sequence intubation?! I mean, surely doing cricoid pressure and attempting to intubate someone like the "possessed" woman in the ER--that is, crashing her-- (and without benefit of Succs--not to induce general anesthesia; but because cricoid pressure alone--even without an attempt at intubation--would then surely make her open her eyes, start gagging and attempt to talk--presumably in English, too; not in ancient biblical tongues-- and ask them to STOP---presto; demons BEGONE!! problem SOLVED!! another ER SAVE!!!) would raise some management eyebrows as being "inappropriate" and "non-therapeutic--" but, hey, some ER patients are "inappropriate" and need "unconventional" and "non-therapeutic" interventions----otherwise they end up as "frequent fliers" at that ER, or others where their "unconventional" behavior is tolerated or even encouraged (and attention, time, money and resources diverted from other patients who actually NEED emergency care) in the name of "patient satisfaction." What a colossal and outrageous waste.

    (Remember what "GOMER" stands for, estrogen? GET OUT OF MY EMERGENCY ROOM!!!) Ah, I miss those days!! :chuckle

    Personally, if anyone was going to suggest crash induction in front of this patient, I would have made sure to LOUDLY say, "And grab some rectal Brevital, too!" to whoever was assembling the laryngoscope, ET tube, etc. in preparation for intubation. LOL, that would have made the "possessed" woman sit right up, worthy of Lazarus---AN ER MIRACLE!!!

    Anyway, I don't think the person who posted about crash induction was serious about actually DOING it--and I, too, am well aware that deep IM injections of sterile H2O would not meet management approval in this day and age.....

    But maybe they SHOULD .......
    Last edit by stevierae on May 9, '05
  3. by   BabyRN2Be
    I've read the whole thread (I'm a bit more awake now as opposed to when I posted last night) and there's something that I don't get.

    The OP described something like speaking in tongues. That USUALLY goes along with pentacostal teachings. So why did they want to call in a Catholic priest instead of following their own teachings for something like this? (whatever it might be in their book)

    Talk about a waste of everyone's resources. Not only the ED, but the chaplain's office, if not a Catholic hospital a priest might have been called in. I'm really glad that there was a wise doc on that night who said "no" to calling a priest in.

    I think that someone had the right idea in removing the husband and priest from the room and presenting the negative findings to the woman and respectfulling giving her some options.

    Wow, that sounds like they wasted lots of people's time and money.
  4. by   Regina66
    Quote from eldernurse
    I had a 14 year old boy in the ED chanting, "I am the devil!". We had his mother and the guards following him around, to the bathroom ect. Every time he passed one of us he did his little chant. On one particular pass when the guards weren't too close, I whispered "Nothing a good spanking wouldn't cure!"
    He didn't give us one bit more trouble (at least in the ED).
    I would have lowered my voice and whispered in a gravelly voice, "You can't be the devil, because I am!" Watch him freak out.....
  5. by   estrogen
    Quote from stevierae
    Lighten up. Gosh, I am betting you are MANAGEMENT--take everything too dang seriously.
    ....Ummm, no I'm just a little ole LPN in a little ole med surg unit. And I didn't take it seriously, I just didn't think it was that funny. Sorry.

    So, since you are comming back to this, let me elaborate...
    I wasn't around thirty years ago (as a matter of fact I was just born around that time) and on top of that in a different country, so I don't know if the ethics of nursing were somehow different then, but to be honest I thought that you are making this up.... So it is more shocking to me, if this is infact true, as it seems from your second post.... Not the fact that it is in fact cruel (you yourself were vividly describing how painfull it is to get such an h2o injection), very judgemental and presumptive, but more so the fact that in this day and age a NURSE would think this kind of practice is agreeable...

    And it is still illegal and still not therapeutic...nor is it moral or ethical.... And not funny either.... Sorry once again.
    Last edit by estrogen on May 9, '05
  6. by   LPN1974
    Oh, my word!
    If it had been legal, yall could have really had some fun with that one. lol
    Wouldn't ya like to make her think twice about pulling a stunt like that again.
    Sounds like the preacher and the husband needed a dose of what you COULD have handed out.
  7. by   mommatrauma
    Quote from estrogen
    ....Ummm, no I'm just a little ole LPN in a little ole med surg unit. And I didn't take it seriously, I just didn't think it was that funny. Sorry.

    So, since you are comming back to this, let me elaborate...
    I wasn't around thirty years ago (as a matter of fact I was just born around that time) and on top of that in a different country, so I don't know if the ethics of nursing were somehow different then, but to be honest I thought that you are making this up.... So it is more shocking to me, if this is infact true, as it seems from your second post.... Not the fact that it is in fact cruel (you yourself were vividly describing how painfull it is to get such an h2o injection), very judgemental and presumptive, but more so the fact that in this day and age a NURSE would think this kind of practice is agreeable...

    And it is still illegal and still not therapeutic...nor is it moral or ethical.... And not funny either.... Sorry once again.
    It's called placebo...and that's not illegal...down with the fakers!!! :hatparty:
  8. by   stevierae
    Quote from mommatrauma
    It's called placebo...and that's not illegal...down with the fakers!!! :hatparty:
    Thank you. Exactly----a deep IM injection of sterile water is a well-known placebo, and it's been around a long, LOOONNG time. And, no, I was not making this up--we did this often (for malingerers and narc seekers) when I was a military corpsman, (age 21) working in the emergency room. Of course, it was ordered by a physician--we didn't just do it arbitrarily.

    It burns like crazy, (but does absolutely no harm----unlike IV Phenergan, which I absolutely will NOT administer, under any circumstances--that type of burning means it is damaging a vein) which makes the malingerer or narc seeker think he is getting something really good, and he or she goes away happy as a clam---but next time remembers how much it burned, and thinks twice about coming to the ER faking various symptoms of various maladies, thinking he has cleverly fooled us all when he gets his "drug." He even fools himself into thinking that he is high.

    Placebos are a wonderful thing, and will always have their place in medicine. In fact, they are downright therapeutic.

    It was not administered to be cruel. Would you have preferred that we simply gave them their narc of choice, (p.o., so that it wouldn't hurt, of course) no questions asked, and sent them on their merry way--until next time they showed up, demanding more narcotics, in ever increasing dosages, for non-existent problems--only to repeat the scenario?
    Last edit by stevierae on May 10, '05
  9. by   Nitengale326
    Quote from stevierae
    Thank you. Exactly----a deep IM injection of sterile water is a well-known placebo, and it's been around a long, LOOONNG time. And, no, I was not making this up--we did this often (for malingerers and narc seekers) when I was a military corpsman, (age 21) working in the emergency room. Of course, it was ordered by a physician--we didn't just do it arbitrarily.

    It burns like crazy, (but does absolutely no harm----unlike IV Phenergan, which I absolutely will NOT administer, under any circumstances--that type of burning means it is damaging a vein) which makes the malingerer or narc seeker think he is getting something really good, and he or she goes away happy as a clam---but next time remembers how much it burned, and thinks twice about coming to the ER faking various symptoms of various maladies, thinking he has cleverly fooled us all when he gets his "drug." He even fools himself into thinking that he is high.

    Placebos are a wonderful thing, and will always have their place in medicine. In fact, they are downright therapeutic.

    It was not administered to be cruel. Would you have preferred that we simply gave them their narc of choice, (p.o., so that it wouldn't hurt, of course) no questions asked, and sent them on their merry way--until next time they showed up, demanding more narcotics, in ever increasing dosages, for non-existent problems--only to repeat the scenario?
    That is the problem at my hosp... all these druggies know which docs admit and which ones don't and know who they can get the narcs from... I am so sick of giving Dilaudid Q1H for "abdominal pain"... its an automatic admit with workup and meds at this looney bin!!!
    Now for the original ER chick... honey, glad it was you and not me, I'd told hubby and preacher man to stand aside... out of site, and do that sternal rub or pinch an earlobe or something... I guess you can be thankful for one thing... at least she didn't have pea soup for dinner before presenting to you guys
  10. by   MAGIK GIRL
    Quote from estrogen
    ....Ummm, no I'm just a little ole LPN in a little ole med surg unit. And I didn't take it seriously, I just didn't think it was that funny. Sorry.

    So, since you are comming back to this, let me elaborate...
    I wasn't around thirty years ago (as a matter of fact I was just born around that time) and on top of that in a different country, so I don't know if the ethics of nursing were somehow different then, but to be honest I thought that you are making this up.... So it is more shocking to me, if this is infact true, as it seems from your second post.... Not the fact that it is in fact cruel (you yourself were vividly describing how painfull it is to get such an h2o injection), very judgemental and presumptive, but more so the fact that in this day and age a NURSE would think this kind of practice is agreeable...

    And it is still illegal and still not therapeutic...nor is it moral or ethical.... And not funny either.... Sorry once again.
    oh, that explains it, med surg. if you have not walked in our path, you have no place calling us cruel, judgemental or presumptive.

    we give our pts what they need. in fact, giving the patient nothing, including placebo, would have been cruel. because perception is 9/10's of reality. if you can get rid of someones pain with out loading them with junk, why not. or should we just creat some more addicts?

    be less judgemental and more open minded and you may find your life a little easier.

    :hatparty: :hatparty:
  11. by   SARAH CONNOR
    Quote from stevierae
    like you too, magik girl.

    i have always intrigued by magik, wicca and references to the goddess, but am not really knowledgable about any of it. everybody i have ever met who was knowledgeable about these things was one of the most thoughtful, kind and creative people i have ever had the good fortune to cross paths with. theynever take life too seriously, and have a great time living it. i am certain, also, that crossing paths with them was predestined--part of some higher plan--and that each encounter had a profound influence on the way i look at things.

    bet you are among them, and hope i will meet you one day. maybe i have already, in some previous life!

    i wonder why estrogen didn't jump all over the post about rapid sequence intubation?! i mean, surely doing cricoid pressure and attempting to intubate someone like the "possessed" woman in the er--that is, crashing her-- (and without benefit of succs--not to induce general anesthesia; but because cricoid pressure alone--even without an attempt at intubation--would then surely make her open her eyes, start gagging and attempt to talk--presumably in english, too; not in ancient biblical tongues-- and ask them to stop---presto; demons begone!! problem solved!! another er save!!!) would raise some management eyebrows as being "inappropriate" and "non-therapeutic--" but, hey, some er patients are "inappropriate" and need "unconventional" and "non-therapeutic" interventions----otherwise they end up as "frequent fliers" at that er, or others where their "unconventional" behavior is tolerated or even encouraged (and attention, time, money and resources diverted from other patients who actually need emergency care) in the name of "patient satisfaction." what a colossal and outrageous waste.

    (remember what "gomer" stands for, estrogen? get out of my emergency room!!!) ah, i miss those days!! :chuckle

    personally, if anyone was going to suggest crash induction in front of this patient, i would have made sure to loudly say, "and grab some rectal brevital, too!" to whoever was assembling the laryngoscope, et tube, etc. in preparation for intubation. lol, that would have made the "possessed" woman sit right up, worthy of lazarus---an er miracle!!!

    anyway, i don't think the person who posted about crash induction was serious about actually doing it--and i, too, am well aware that deep im injections of sterile h2o would not meet management approval in this day and age.....

    but maybe they should .......

    i have seen some miracles too. i have even measured for airways and ngt's. works like a charm?
  12. by   UM Review RN
    I have issues with placebos, even in jest. I was around 30 years ago and it brings back very painful memories of patients being given no effective therapy for pain.

    I realize that this is off-topic. But just in case some people think it's still OK to use placebos, I offer this:

    http://www.edc.org/PainLink/placebo.html

    Clinicians may administer a placebo, not out of maleficience, but rather in good faith, based on erroneous beliefs that use of the placebo will provide valuable information or help patients by relieving pain without harmful side effects. [Or]... clinicians may use placebos in a punitive sense for patients who have exhibited manipulative or demanding behaviors or for patients in whom diagnosis of the cause of the pain or methods to relieve pain have failed.

    Central ethical tenets of the American Nurses Association Code for Nurses (1995) include truth telling, fidelity, trust, and respectful care. The use of placebos necessarily involves deception, which automatically raises serious ethical concerns. Use of placebos threatens the inherent ethical values and norms of healthcare professionals. Informed consent, which is most often absent in the use of placebos, is a necessary requirement for promoting the autonomy and well-being of patients. The use of placebos may ultimately compromise the therapeutic relationship between patients and healthcare providers by eroding the necessary environment of trust.


    Again, I want to emphasize that the placebo idea was only a suggestion of one poster, I understand it was not used in the OP's scenario, and I am not trying to do anything here but clarify to newcomers that giving placebos is NOT accepted nursing practice today.
    Last edit by UM Review RN on May 10, '05
  13. by   estrogen
    Quote from mommatrauma
    It's called placebo...and that's not illegal...down with the fakers!!! :hatparty:

    ...well, last I checked, using placebo was illegal. Unless you're conducting scientific research...
    Last edit by estrogen on May 10, '05

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