[annefan]

Originally Posted by imenid37

Recently we had a crystal meth. user w/ teeth from he!! who arrived by ambo. The crew told us she was fully dilated, ready to push, breech, late 2 nd trimester. She was closed, thick, and high, very belligerent w/ a crazy, yet well-meaning family and was begging for pain meds. We kept her for awhile and DC'd her. Next night we get a call to fax her records to another hospital 20 miles away. YIKES!!!!!

I'm pretty sure it's assumable, but what happened with the baby? I haven't had any real pts of my own yet since I'm still a nursing student, but anytime I'm doing clinicals it really makes me angry when there's a pt on the floor that's pregnant & doing something really stupid that's harming the baby. I would have to say that that's my least favorite pt so far. And inevitably, they're always belligirent.

[ikimiwi]

Let's see, we seem to be having a run on 14 year old females, who after having a figh with their mother, take a handfull of whatever happens to be around,The last one took her mothers ativan, because mom took away the cell phone, she was chatting on her cell phone 2 hours later, I would have shoved that phone where the sun don't shine!!Don't know who is worse, mom or child.

[Obstinate Advocate]

I have a lot of least favorites, but the psychs, I mean real psychs, are definately at the top of my list. I hate having to try to get those initial IM shots of vitamin A and Vitamin H into them when they are already belligerent and paranoid on arrival.

Family members are often times much worse than the pts. I can't stand the ones who are constantly coming out of the room to ask for stuff the patient can't have. It's always the family member of a bowel obstruction pt or surgical candidate that is irate because "he hasn't eaten since this morning and you people are starving him!". Or the family of a pt with a 105 temp who insist on asking everyone they come across for blankets because "dad is so cold".

[TinyNurse]

I agree with everything snowfreeze said.
I'd rather care for a beligerent etoh man, than a demanding flu/generalized bodyaches person anyday though.
xo Jen

[teeituptom]

I like to laugh at those wimpy guys with little cuts that when they have to wait either develope chest pain or they pass out

[snowfreeze]

Psych patients are a trip, you can usually get some vitaminA and H in em by needle then they settle down a bit.
c-diff, that stuff stinks so does GI bleed vomit and poop. We can treat that.
Drug abusers cannot be treated, they are just seeking drugs and we either toss em out or give em what they want. Neither is a good thing, quite depressing actually.
Patients that have needs we cannot meet are the ones we dislike the most. They never quit whining about their problems and they want us to magically fix them.

[snowfreeze]

On a lighter note:
My most favorite patient is cardiogenic shock. So sick so close to death, multiple IV drips, balloon pump, Zoll pads attached at all times, usually intubated for a day or so. You do so much and they usually live.

[tiredfeetED]

Originally Posted by ManEnough

MDs as patients. Give that smelly homeless drug addict ANY day over the "do you know how easily I could get you fired?" crowd.

RNs as patients!!! Far worse than MDs!

[blueinplaid]

Originally Posted by curleysue

I would have to say my least fav patient is homeless patients who smell so so bad you have to wear a mask. We usually help lather themselves in shaving cream cause it absorbs the smell really good. The nurse and I just make them strip and we take a washcloth spray shaving cream all over it and just rub it in all over their body. We don't want them to smell so bad it disrupts the doctors evaluation.

Another favorite patient would be the people coming in with pain (migraine, back pain, ect) who are allergic to morphine, codeine, toradol but not to demerol. Figures. Then they say, "well I usually get 50 phenergan, 100mg demerol, 50 benedryl" Yah, they know what their doing. Then when they get their meds and you come back to re-evaluate they are so drugged out sleepy you ask, "how is your pain or can you rate your pain" and they say, "its still out of control, a 10." However their speech is so slurred and they fall asleep mid sentence. I think they have had enough. Don't you?

Curleysue

Why demerol and not morphine or dilauded? I'm new to the ER and trying to learn to tell the difference between the drug seekers and real pain...

[curleysue]

Originally Posted by blueinplaid

Why demerol and not morphine or dilauded? I'm new to the ER and trying to learn to tell the difference between the drug seekers and real pain...

Its kinda hard to learn the difference between drug seekers and the real pain cause as a nurse its hard in some cases cause sometimes you just cannot figure out which patients are just abusing the system to get their 'high'. I know a lot of nurses have been trained to keep their mouths shut and whatever the doctor orders the patient needs. I guess after a while working in the ER you learn who is the classic drug seekers and frequent flyers. I saw a TV show that had a frequent flyer who would fake seizure out of the hospital setting so that an ambulance would come and immediately give her valium or versed. But as soon as she would get the medication she would wake up like nothing happened. The paramedic caused it 'psuedo-seizures'. She would be so good at it she even wet herself. Finally after so many times doing it the ER caught onto it and the ER doc confronted her about it and she admitted she was trying to kick methamphetamines and that she needed help with the withdrawls. I think confronting patients who are drug seekers might get them to admit something. At least for a few people but not all. Some docs will, knowing the patient is a drug seeker, just say give her what she wants and get her out of here. But that isn't such a good solution.

However, what if someday you are wrong and they are really in pain? That is the other issue with it. How can you really determine who is faking it and who isn't.

Anyways, good luck in the ER. I loved working there as a paramedic and would love to do it when I am done with my BSN. Its exciting. Although the drug seeking behavior seems to be a huge topic in the ER nursing forum. It must be just a huge problem and frustrating for both the docs and nurses.

Curleysue