[EMTastic]

We had a pt who came into ther ER 3 times in one day for "possible heart attack". We did all the appropriate tests on him the first two times. Case mangement said after that he was to be banded from using the emergency room in this county. This was, because, on a previous day, apparently he came into the emergency room 15 times for a "possible heart attacK". After he was banned from our ER he immediately walked in the waiting room and called 911 so he could be taken to a hospital in a different county.

[krisssy]

It sounds like this person needed a psych eval.

[ssouthernyankee]

Earlier this week I ended up in the ED of the hospital I am employed at with a severe kidney infection. I went in because I was retaining urine, fever, uncontrolable vomiting and flank pain 8 on pain scale. I ended up with a foley cath and IV for fluid loss. I received Phenergen and Toradol. After about an hour or so I asked for something else for pain as I was still in an incredible amount of pain. About another hour after I asked for a different med or at least another dose of Toradol the nurse came in and asked if I had someone with me, a friend had brought me in and after they got me in a room she left to go check on her daughter I told them she would be back when I was ready to be released. I was told that she would have to come back and physically be seen in my room before they could do anything else. She showed up awhile later and then I was given one 5mg Lortab and a Phen. tablet. The doc came in and checked my urine output which was full of large amounts of blood clots and told me that I only had about 400 cc's and that to be considered retention it would need to be at least 500 cc's. I need to add that this was only the 2nd time I have been to an ED, the first being almost 2 years ago in which I was admitted for surgery to remove a 6mm kidney stone. I feel like they believed I was just drug seeking because I complained of Toradol not retracting my pain levels. I was discharged with script for antibiotics and Peridiem. I felt so degraded, as though they thought I shouldn't have wasted their time. My first thought was to make a complain, but I am not the type of person who likes to do things like that, but I would like to understand why they seemed so indifferent towards my very real pain. Just the thought of them thinking of me in this matter just breaks my heart. (yes I am a little over sensitive to how people perceive me) Does this sound like they didn't believe me or is this "normal protocol" I am just a CNA at this time and have started nursing school so I don't quite understand the physicians actions or lack of quite yet. My nurse who did my cath was very compassionate and kept rubbing my hand as I was tearing up so at least she seemed to understand my situation. When I graduate I truly hope I never have to treat a patient in this manner because of a physicians attitude/beliefs. I would appreciate any feedback. If I was in the wrong I would like to know. Thank you.

[GLORIAmunchkin72]

ssouthernyankee, you have my sympathy.

[ingelein]

Originally Posted by ssouthernyankee

Earlier this week I ended up in the ED of the hospital I am employed at with a severe kidney infection. I went in because I was retaining urine, fever, uncontrolable vomiting and flank pain 8 on pain scale. I ended up with a foley cath and IV for fluid loss. I received Phenergen and Toradol. After about an hour or so I asked for something else for pain as I was still in an incredible amount of pain. About another hour after I asked for a different med or at least another dose of Toradol the nurse came in and asked if I had someone with me, a friend had brought me in and after they got me in a room she left to go check on her daughter I told them she would be back when I was ready to be released. I was told that she would have to come back and physically be seen in my room before they could do anything else. She showed up awhile later and then I was given one 5mg Lortab and a Phen. tablet. The doc came in and checked my urine output which was full of large amounts of blood clots and told me that I only had about 400 cc's and that to be considered retention it would need to be at least 500 cc's. I need to add that this was only the 2nd time I have been to an ED, the first being almost 2 years ago in which I was admitted for surgery to remove a 6mm kidney stone. I feel like they believed I was just drug seeking because I complained of Toradol not retracting my pain levels. I was discharged with script for antibiotics and Peridiem. I felt so degraded, as though they thought I shouldn't have wasted their time. My first thought was to make a complain, but I am not the type of person who likes to do things like that, but I would like to understand why they seemed so indifferent towards my very real pain. Just the thought of them thinking of me in this matter just breaks my heart. (yes I am a little over sensitive to how people perceive me) Does this sound like they didn't believe me or is this "normal protocol" I am just a CNA at this time and have started nursing school so I don't quite understand the physicians actions or lack of quite yet. My nurse who did my cath was very compassionate and kept rubbing my hand as I was tearing up so at least she seemed to understand my situation. When I graduate I truly hope I never have to treat a patient in this manner because of a physicians attitude/beliefs. I would appreciate any feedback. If I was in the wrong I would like to know. Thank you.

I too experienced something similar in an ER visit, was degrading, humiliating and made me feel ashamed of my chosen profession of healthcare, the nurses were not as bad as the ER resident, what a &*%$#@!

[Emmanuel Goldstein]

Originally Posted by ssouthernyankee

If I was in the wrong I would like to know. Thank you.

No, you weren't. Considering your recent history and current symptoms, did the doc even check for a stone? Since when is 400cc PVR not retention? You (at the very least) had pyelonephritis; since when is that not painful?

He sounds like a complete quack.

[KarenGeorgeBSRN]

Good Morning,

It is grounds for medical malpractice (physician and or nursing) to state
"drug-seeking" for no cause. As most nurses with experience will tell you
that pain has been historically poorly treated, even with the research that
shows that pain management for chronic conditions lowers the costs to
society in lost time at work, family discord, and all other variables.

No such term in my vocabulary or of the nurses working for me!

Karen G.

[ssouthernyankee]

Thanks to everyone for the support. I forgot to mention that yes they did a ct, showed a small stone in the upper part of my left kidney(which I don't beleive to be the source of my pain)and it also showed slight inflammation , I always beleived pylen. to be painful the doc never came right out and accused me of seeking but just the way he was treating me and the refusing to give me anything other than Toradol then one 5 mg Lortab(after my friend came back to the ED) made me feel as though I was being labeled as such. I am still experiencing quite a bit of discomfort/nausea but I am afraid to be seen again. I am afraid to make a complaint because I am aware that there are quite a few complaints made my true drug seekers who don't get the fix they are looking for. Thanks again for your compassion!

[ssouthernyankee]

Sorry I forgot to ask in last post if there is a way for me to find out if they have labeled me as seeking. I don't know much about availability of getting my records or at least the notes written by the doc. I would like to take them into my regular physician and let him know what had happened to me.

[Altra]

ssouthernyankee, if you are suffering from kidney stones you have my sympathy.

A couple of things, from an ER perspective ...

1. You absolutely should call your PCP and get a follow-up visit. Make sure they request your ED records and that they are available for your PCP to review at your office visit. No matter what brings you to the ED, we always stress follow-up with your PCP. This is a basic component of continuity of care.

2. Your evaluation & treatment in the ED do sound pretty by-the-book. Given your symptoms & history, your symptoms were treated
for pain & nausea, and a CT scan confirmed the presence of a stone. A kidney stone is very rarely a diagnosis for admission to the hospital. I hope you were given the name of a urologist (if you don't already have one) for follow up. Please make sure you follow up with both the urologist and your PCP soon.

3. Before you are given narcotics for pain control, it is standard to make sure that a friend/family member is present to drive you home. I understand that you were in pain, but think for a moment about the responsibility carried by those medicating you, and the implications for them if you are medicated and then drive home under the influence of those meds.

4. Your main source of concern, as stated in your posts, seems to be the issue of pain control. Were you discharged with a prescription for pain meds? Or were you urged to call your PCP and/or urologist the next day?

Hoping that you feel better.