You experienced ED nurses will get a kick out of this..... - page 3

You may recall that one of my last posts was concerning how patients were being treated by the other ED staff. Well, I've been in the ED now for 2 whole months. I promised myself that I would NOT... Read More

  1. by   chip193
    the regulars in my er can be divided up into the following categories:

    undomiciled
    our urban outdoorsmen begin to come into the er when the temperature reaches extremes - hot or cold. they will come in with a psych complaint or a substance abuse complaint if admission is wanted. otherwise, if a simple respite from the outside is wanted, a really non-urgent complaint that will place them at the back of the line.

    drug seeker
    our drug seekers come in when the supply of opiate is exhausted from the last visit. usually, a vague pain complaint of dental pain, back pain, or headache is made. only after checking the records (or knowing said patient from the six visits this week) is a pattern noticed.

    can't care for myself
    older patients who are unable to physically care for themselves make up the next category. these folks essentially need placement into an assisted living or snf, but cannot get to the primary care physician to get the ball rolling. with the advent of the hospitalist program, the ability to get patients such as these admitted for, essentially, a social reason is nearly gone - the hospitalist only wants ill patients in-house.

    i need attention
    we have two sub-categories of this class of patient:

    psychiatric attention
    patient will feign suicidal ideation, homicidal ideation, will be "so depressed i don't know what i might do", or may even demonstrate self-destructive behavior so that the object of their affection will pay appropriate attention. usually is effective in achieving affection.

    my family is ignoring me, so...
    essentially, these patients exhibit munchausen's syndrome, sans the proxy. a faux medical complaint (my favorite two patients use chest pain all the time) is stated to gain admission to the house to cause attention to be paid by the family that ignores them. it is also very effective at achieving attention.

    my doctor is too busy...
    another double whammy!

    i couldn't wait for my appointment
    patients arrive in the er mere hours before the appointment with the primary care doc so that they no longer "wait" for the doc. often, they wait in the waiting area until long after the appointment with the pcp.

    the nurse told me to come here...
    patient calls pcp, who tells them to go to the er. why? we certainly wouldn't want to interrupt the every 15-minute appointment in the office or, worse yet, hold a slot or two open for the sick calls.


    anyone else recognize them? anyone have any others?
  2. by   AliRae
    Quote from chip193
    the regulars in my er can be divided up into the following categories:

    anyone else recognize them? anyone have any others?
    i was about to ask if the truly sick should be included, when i noticed it was a list of regulars. i guess the people who really need the er don't get to be on that list! =) funny, isn't it, how you can write such a long list of people who shouldn't be there?!

    i once floated to our ed and saw 2 brothers there for "paralysis". they were discharged soon after one dropped his bag of cheetos and the other one hopped out of his wheelchair to get it for him...
  3. by   ParrotHeadRN
    Hi All,

    Thanks for all the support and encouragement. I am not pissed off all the time anymore, thank god! Someone said "stupid pays the bills" and that's my motto now! I shared it at work and everyone loves it! I'm starting to be able to figure out when I'm being had a little earlier now.

    I have to share a little story: the other night a 35 yo man called the squad in the wee hours of the morning because he was vomiting. Nothing else, just vomiting. When he arrived he was crying. His only complaint was he'd been vomiting for "about an hour." He was also drooling because he couldn't swallow his saliva. Honestly, I just stood there and looked at him for a minute because I didn't trust myself to say anything. He would retch and retch and it was easy for even this newbie to see he was really TRYING to vomit. And when he did retch, he sounded like a crow cawing, no lie. I had to go behind the curtain for a minute because I really didn't want to laugh right at him. So, I am getting better and am starting to enjoy the entertainment value. Luckily, we weren't very busy at that point so it was okay. But, JEESH!
  4. by   UKRNinUSA
    just wanted to add that you can still be compassionate AND have a wicked, evil sense of humor. Just save your compassion for the folks that need it and use the humor from those that don't to recharge your emotional batteries. I have never laughed more at work than I have in the ER. It makes it do-able.
  5. by   CaLLaCoDe
    Er nurses totally rock!! And very very very funny too!

    Alls I can say as a Telemetry nurse who on occasion must float to the ER (VERY SCARED, mind you!) I have been treated very nicely by the ER staff and given the come aboard line that most new nurses die to hear...but, still not ready...OMG!

    Anyway one night in ER there's this drunk thin man with a hint of alcohol to his breath given the royal treatment...for dx dehydration (where I live it is blazingly hot in summer) well, I hang the banana bag, give him a sandwich and some soda and before I know it I'm taking his final vitals before discharge and the doc says in a savagely brutal sarcastic way "Welcome to the hotel San Joaquin" mel blankish in accent....hilarious!

    I am dumbfoundedly amazed at the level of skill the ER nurses have at starting IVs...almost out of thin air a flash appears where there was none!
    Simply amazing, but I know a lot of practice, What you receive a lot of down there is plentiful. Hats off to you women/men who work ER! Bravo!!!!:redlight: :redlight:
    Last edit by CaLLaCoDe on Jan 25, '07
  6. by   caroladybelle
    Quote from Aliakey
    I agree with ya!
    I've lived in a similar condition in my worst days of life, so had some empathy for her situation. Well, my feeling for her *sons* all changed when I wheeled her out to the lobby after being discharged. One of her sons pulled around in a nearly new shiney, loaded, red Ford pickup... and yep, it *was* his (I made a comment about how nice he kept that pickup looking, asked how long he had it, etc. just to test my theory). Grrr! So while their mother lives in a clapboard house, the sons are enjoying their comfy luxuries?

    Grumble. All I can do is think that on the day of death, everyone has to answer to what less-than-nobel deeds they have done in their life. The only way to keep my sanity (if I have any left, lol!)
    Please do not assume.

    I have tried valiantly to keep my mother's house clean, to get work done on it, to improve her circumstances. She refuses the help, doesn't maintain what she can maintain, or complain about any improvements. It was a fight to even get her to get the roof repaired after Charley/Frances/Jeanne hit.

    She will not trash a piece of mail - or let me do so. It is always the "I'll get to it" which has gone on for 4-5 years.

    If this elderly person is in her right mind and independant, it may have more to do with her refusing help, rather than her son not providing it.
  7. by   katfishLPN
    Quote from ChayaN
    Are you saying that the ER abusers come to the ER because they find the surroundings there a lot more pleasant than their own homes? Sad.
    No, I would say they come in to see a doctor!
  8. by   chip193
    Quote from katfishLPN
    No, I would say they come in to see a doctor!
    For many of the abusers, the last thing that they want to see is a physician. See my post above of the regulars that visit my place.
  9. by   LeahJet
    Quote from ParrotHeadRN
    I have to share a little story: the other night a 35 yo man called the squad in the wee hours of the morning because he was vomiting. Nothing else, just vomiting. When he arrived he was crying. His only complaint was he'd been vomiting for "about an hour." He was also drooling because he couldn't swallow his saliva. Honestly, I just stood there and looked at him for a minute because I didn't trust myself to say anything. He would retch and retch and it was easy for even this newbie to see he was really TRYING to vomit. And when he did retch, he sounded like a crow cawing, no lie. I had to go behind the curtain for a minute because I really didn't want to laugh right at him. So, I am getting better and am starting to enjoy the entertainment value. Luckily, we weren't very busy at that point so it was okay. But, JEESH!
    An obvious case of what we like to call.......vaginomegally
  10. by   UKRNinUSA
    Quote from LeahJet
    An obvious case of what we like to call.......vaginomegally
    Love that - can't wait to use it myself
  11. by   Altra
    Quote from LeahJet
    An obvious case of what we like to call.......vaginomegaly

    Good one!
  12. by   kk2000
    Quote from caroladybelle
    Please do not assume.

    I have tried valiantly to keep my mother's house clean, to get work done on it, to improve her circumstances. She refuses the help, doesn't maintain what she can maintain, or complain about any improvements. It was a fight to even get her to get the roof repaired after Charley/Frances/Jeanne hit.

    She will not trash a piece of mail - or let me do so. It is always the "I'll get to it" which has gone on for 4-5 years.

    If this elderly person is in her right mind and independant, it may have more to do with her refusing help, rather than her son not providing it.
    YES, yes, yes-I completely understand! With our parents sometimes things are not what they appear to others.
    K-

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