"But for me, 98.4 means I have a fever...." - page 4
by abbaking | 21,545 Views | 85 Comments
Just a pet peeve....I hate when I do a set of vitals on a patient and the vitals are clinically stable but the patient insists its abnormal. Example: Me - Just checked the temp - reads 98.4 Patient (40 something drama queen) -... Read More
- 0Mar 14, '12 by CrazierThanYouQuote from threelittlebirdsSounds like something that would happen at our local hospital.I can see how it can get really annoying with people behaving this way...but I know how it feels to be on the other side of it. I was in urgent care once for what my primary care later determined was panic disorder, complaining of palpitations and feeling really dissociated. My heart rate's usually 50-60, blood pressure 90/60. Well, I showed up with a pulse of 115 and bp 150/100ish. The triage nurse sent me over to the ER because she was concerned... But after being ignored for 4 hours, the doc came in and counseled me about the importance of staying active and eating better because it looks like I have some prehypertension...he didn't even acknowledge the fact that my vitals were scary (for me) high. My discharge instructions read "come back to ER for life threatening symptoms."
All I'm saying is that the patient might have a point, and you don't necessarily need to make them feel like crap.
- 0Mar 14, '12 by xandarosaRN-Cardiac: My ob took my BP when I had PIH because he didn't believe it was as high as the nurse said.
I've been on the other side of the fence.
-We're in the ER with my son and I told the nurse he had a fever. He took an auxiliary temp and his temp was somewhere around 98. I told him take it rectally (the room was very cold and his HR was 160's at 3 yrs). He started telling why we shouldn't do a rectally but I wouldn't back down. He finally agreed and was shocked his temp was 102.7.
-My son goes to the same unit every time he is admitted. They know us pretty well but every once in a while we get a new nurse. When we get to the room, I always ask the nurse to set his HR low limited to 45. Which they always insist is to low. It then takes an hour of the monitor going off for them to finally change it.
- 10Mar 14, '12 by KateRN1Many times patients aren't trying to be annoying, they really don't know any better. They may truly believe that 99 is a fever or whatever. But it really sucks to be the patient trying to tell a nurse something and get blown off. The last time I was in the hospital, the nurse started my IV exactly where I asked her not to--in my left wrist. It was uncomfortable at first, as most IVs are, but it flushed fine, so I tried to ignore it. Over the next hour, it went from being uncomfortable to causing writhing pain. I tried to tell the nurse that it was developing phlebitis, she flushed it, went in fine, so she upped the drip rate of the fluids. Ten minutes later, I tried agin with the neuro tech who told them same nurse and--within my hearing--told the tech that the site was fine, that I was a PIA know-it-all. (No one knew I was a nurse at that point.) By the time the CRNA came around, it was just starting to get red and I was in worse pain from the IV than from the ruptured disk I was there to get repaired. The CRNA recognized the phlebitis and pulled the IV. Another nurse came to start the new IV, thankfully and I didn't have to see the mouthy one again. By the time I was discharged the next day, I was black-and-blue from thumb joint to halfway up my forearm. It took three weeks for it to go away. Sometimes patients really do know what they're talking about. Not always, but sometimes.
- 3Mar 14, '12 by woohQuote from JBuddWho cares about a thermometer? A mom can tell if a kid is feverish.On the other hand, we get mad when the mom says, "oh I didn't give him anything because I wanted you to see how bad his fever is" while the kid is miserable at 103. So, I'd rather believe you found fever at home..... especially if you bother to OWN a thermometer and can give me numbers!
- 3Mar 14, '12 by Artistyc1Quote from RN in trainingIt wouldn't matter- perhaps it is something other than the "high 98's" that makes you feel icky. Fever is not the only indication of illness, a person can be very ill and show no temperature elevation at all. No one would EVER make a judgement on a patient for a "high 98's" temperature, much less treat them!I normally sit in the low 97s so high 98s actually makes me feel pretty flushed and icky. 98.6 is not everyone's norm...
- 2Mar 14, '12 by Artistyc1Quote from woohNot necessarily. Also, without a number, you have nothing tangible to go on. There is a great difference between what one would do for a low grade 100.4 and a much higher 103. No physician would make a diagnosis on a kid without knowing how high the fever was, much less prescribe treatment, if any.Who cares about a thermometer? A mom can tell if a kid is feverish.
- 13Mar 14, '12 by aknottedyarnYour geri patients will not have high temps even if their urine is pure pus. Believe me. I once thought a patient had a severe stroke with a simple UTI. Pos. Babinski, somnolent, etc. No temp elevation.
Hopefully you were taught that these norms were "ranges". Not facts. The general public does not know that. They think in absolutes. One number for each parameter. Most don't have a clue what that means. Some of you recall that your vitals may have some relationship with that thing called the Krebs Cycle. Would you rather explain that cycle or just be polite when people say slightly off the wall things.? You don't have to seed or feed the drama. Just don't do or say something that will cause them to escalate. That takes time to deal with, expertise to settle, and puts you in a position where the next thing yhou know there is a script for such events.