Yelling, screaming and ducking the cranky triaged patients - page 2

In our tiny hospital in the sticks I triaged a woman for dental pain who had just come from another ER three towns away. They didn't give her the meds she wanted so she hitchhiked to us. she was loud... Read More

  1. by   Kiwimid
    what do you do when the very annoying patient is someone you know well, even have taken them to the er. and then they start to get really annoying and complaining and then.... above complaing about the food and the service start calling the nurses "nursie" i wanted to die and the ground swallow me up. i was so ashammed to be with them. they were demanding and so rude i would have hit them if i could. but the worst thing is that i said nothing afterwards. when i use to work in a coffee house we would give customers sneeze (cheese) scones....they hadn the speacial treatment and we all did it. pity you cant hock a loogie into an iv huh?
  2. by   canoehead
    How many of the respondents out there would have had to see her no matter what she did, and how many would have kicked her out or called the police?
  3. by   sequelae
    i believe that at all times we will have to prioritize the patients based on the triage system. if a patient gets unruly because of feelings of being ignored and starts causing a commotion that it disrupts the er staff, then that patient must be shown the way.
  4. by   Altra
    Quote from canoehead
    How many of the respondents out there would have had to see her no matter what she did, and how many would have kicked her out or called the police?
    In my 2 years in the ER ... I have seen three occasions where we have had pts. escorted out by security (once) or arrested (twice) without the MSE.
  5. by   mamalle
    we wouldnt deny her care but they have to calm down. If the cop feels like they are being a disruption then they take over and arrest the patient. we have alot more patients that act up after being discharged for one reason or another- then the cop will escort them off the property or if they keep up- arrest them. our security really doesnt take part in anything besides watching baker acts or driving the van around the property.. I have lost track over the years on how many patients that have acted out..
  6. by   sanctuary
    Quote from canoehead
    How many of the respondents out there would have had to see her no matter what she did, and how many would have kicked her out or called the police?

    It probably depends on the state. Or maybe OBRA funding, which states that all patients must recieve care for life-threatening issues... Threatening ours dosen't count.
  7. by   sanctuary
    Quote from Kiwimid
    what do you do when the very annoying patient is someone you know well, even have taken them to the er. and then they start to get really annoying and complaining and then.... above complaing about the food and the service start calling the nurses "nursie" i wanted to die and the ground swallow me up. i was so ashammed to be with them. they were demanding and so rude i would have hit them if i could. but the worst thing is that i said nothing afterwards. when i use to work in a coffee house we would give customers sneeze (cheese) scones....they hadn the speacial treatment and we all did it. pity you cant hock a loogie into an iv huh?

    [S]I Beg Your Pardon? [/S]
  8. by   Jennifer, RN
    We have a security officer at the greet desk during the day, and a deputy at the greet desk at night. If a pt gets rowdy or threatening staff, they are spoken to by security, if they escalate, they are asked to leave the premises, escorted by security, if they escalate further, refusing to leave, the police are called. Very rarely do we have to escort pts out of the building or have them arrested. We have done this more with irate or obnoxious family members. If a pt is threatening and showing signs of mental illness, we will take them to our psych rooms. I have had security talk to many pts waiting for loud rude behavior or cursing though, and that usually nips it in the bud.
  9. by   one_speed
    Situations like this is what really gets my goat (grinds my gears even). Usually it is the poor "depressed" person with chronic neck and back pain who are unhappy with not getting their oxy's. They threaten the Doc, the RN or lab tech with violence then get sat on by me until either they are restrained (if they are really sick) or until the police arrive to take them away.

    The problem is (and I reinforce this with new staff) is that once a person is in four points they generally get drugged and admitted just for being an ass, but if you sit on them for a while the police can haul them off for being annoying and causing a disturbance (once the doc looks them over of course)

    We are fortuante, 24 hour "Intervention Officers": big guys who can touch patients, silent panic button at triage to the security post in the hopsital and the city police who work very closely with us only a quick 911 call away. You should see them tear into the parking lot when we call for real.

    It's pretty amazing what a simple "Code White at ER triage" paged overhead can accomplish. Our staff (the guys at least in my department have realtively little patience for behaviour of this sort.

    Ian
    Last edit by one_speed on Apr 5, '07 : Reason: spelling
  10. by   one_speed
    And then of course after kicking them out you get a call from their mother the next day angry that we mean ER nurses threw their baby out into the snowbank when they were sick.... long story, not getting into it.
    Last edit by one_speed on Apr 5, '07 : Reason: spelling
  11. by   canoehead
    I called a code white at my facility and got one short fat lab guy who zoomed in like he was on speed. Notably the administration group, who are closer than the lab, didn't even send us a phoned congratulations for keeping everyone alive.
  12. by   one_speed
    have you ever heard the term "Pile - On" ?
  13. by   one_speed
    I mean I don't want to give the impression to my colleagues that we look for fights up here... but when it comes down to it; protection for myself, my coworkers and my patients is a priority compared to what ever sense of entitlement some person might have. These types of patients should consider themselves fortunate that there are so many caring and professional people around that agonise over whether or not they did the right thing defending themselves against attack or abuse and whether or not the suits (hospital admin) agree with them.

    Honestly I think it might be the frame of mind I have gained from my training as an RN with the Canadian Forces. We are issued side arms and rifles (we're non-combatants) to protect ourselves, our colleagues, patients, and our equipment.

    Calling a "code white" or intervening before someone does something they may or may not regret, or someone get's hurt is a small step in the grand scheme of things.

    Ian

close