most and least favorite DX to care for? - page 6

In general, what is your favorite diagnosis to take care of? I liked Tricyclic OD's (cause they could really crash sneaky and fast); unstable GI bleeds, acute respiratory failure, acute asthmatics... Read More

  1. by   kimberle
    I work on a ventilator dependent unit, where a pt. upon admission requires at least 8 hrs. ventilatory support a day. My favorite pts. are COPD, I can fine tune those vents and drugs up 'til then end. I really lose my cool with the ALS patients. They're so grieving and manipulative, and since it gets to the point they can't move any part of their body they get really needy. Essentially they expect to be assisted to mimic life to as close to normalcy as possible, even if all they can do is blink an eye to direct you all day long. For example, 5" to spell out turn TV to Ch. 15 and take my sheet off, while I'm sweating to get back to my septic pt. And it's the healthy ALS pt. that will complain about not getting adequate care, while the ones that really require it, the sick ones, are too sick to complain. OK. OK. I'm calming down now....thank you for listening
  2. by   Slowone
    Favorite..... the STABLE s/p MI that was just transfered from the unit and wants to go home!!

    Least favorite...this may sound weird but pancreatitis patients ride my nerves. I'm sure it's not the diagnosis itself but I have not taken care of one pt that wasn't always the whiniest of my pt load. Don't let me get near eyes or feet either...YUCK!!!!
  3. by   ALOHANURSE
    Favorites are abd. surgeries. Something about seeing a patient progress from NGT, TLC, foley, venodynes, and PCA to just a HL and clear liquid diet really makes my week. I also like THR'S AND TKR'S just love to see people get better and go home happy.

    Least favorite has to be scrotal abcesses. I've seen more than my share, and the worst was the time I was required to apply a wound vac to this poor chaps bilateral fileted scrotum.

    Also not high on my list: addicts that try to manipulate me and copd'ers that have to go off the unit to smoke then come back wheezing and begging in that raspy voice for a respiratory treatment.
  4. by   ICUBecky
    all i can say is god bless psych nurses! i hate anything psych.

    most favorite: ventilated, heart attack patients or post open heart patients, who are so critical to need balloon pumps, swans, and later on CVVH. who are on every vaso active drip possible, and sedated. so much technical stuff and thinking. really fun when they start crashing. i know i'm sick...but i love the rush and how fast they make the shift go.

    least favorite: whiny, impatient, thinks he's at the "waldorf astoria" hotel patients. sometimes i wish they can all be ventilated and on diprivan!!
  5. by   kids
    LOVE: patients with any kind of a tube: chest, T, NG, JT, GT, drains, IVs, trachs, shunt, new or revised ostomies, unhealing ulcers, tunneling, gaping wounds, necrotizing faculitis, blood, mucus, pus!

    HATE: anything Psych (hey, who am I to say theres not really someone standing there)
    Last edit by kids on Jan 3, '02
  6. by   kellysue
    i love taking care of someone who dying. to be there with them and their family is awesome.
    i hate codes and i hate working with restraints!
    hhmmmm...like death, hate codes. i hope i dont sound like a sicko
  7. by   hapeewendy
    wow great topic!
    upon sitting down to actually think about what I like and dislike, diagnosis wise , I suprised myself!

    I enjoy the adrenalin of a code situation, one that makes it is even better, I also like the complexity of care in a fresh CVA or anoxic brain injury patient , the rehabilitation process for those folks is awesome to be a part of!
    I like my fair bit of surgical patients too, abdo surgery patients are neat cuz there is a fast turnover and your health teaching usually means something!
    I found working with mothers/newborns in a clinic setting extremely rewarding also
    and I do enjoy cardiac and respiratory patients a lot, also anything that is not common, some psych cases are interesting allbeit stressful to be part of
    as for dislikes , i cannot stand some of the personality traits associated with some of the different pt diagnosis, not all the patients fit the mold of course, but I cant deal with off the hook anxious COPD'ers , some renal patients arent always the nicest , same goes for chrons/colitis patients and those undiagnosed ABD pain patients really send me for a loop , they dont wanna be NPO eventhough they are having this horrible terrible stomach pain, go figure
    basically its not the diagnosis I dont like, its some of the personalities of the patients.
    many diagnosis can be fun to deal with, we all have our faves, I too enjoy the geriatric folks
    (who are oriented that is!)
  8. by   Cascadians
    Enjoy helping: CHF; cancer pts; stroke recovery; hip replacement recovery; accident recovery; hospice.

    No fun: COPD; wandering combative dangerous Sundowner dementias that wreak havoc every few seconds; belligerent family members; trach suctioning every few minutes with COPD pt in throes of pneumonia who sprays sticky green and brown globs like a power fan no matter what equipment is used.

    The worst: forced isolation with the screaming projectile vomiting blood spraying patient just wheeled into negative pressure room by paramedics fully suited, no isolation cart available, and Doctor rushes down from another floor and says "We had him on 7C for two weeks and ran every imaginable test with no definitive results before he escaped." "Oh and by the way the nurses on 7C are all out sick now with the same thing but we have no idea what it is."
  9. by   kids
    Originally posted by Cascadians
    The worst: forced isolation with the screaming projectile vomiting blood spraying patient just wheeled into negative pressure room by paramedics fully suited, no isolation cart available, and Doctor rushes down from another floor and says "We had him on 7C for two weeks and ran every imaginable test with no definitive results before he escaped." "Oh and by the way the nurses on 7C are all out sick now with the same thing but we have no idea what it is."
    SO WHAT DID IT TURN OUT TO BE????
  10. by   LilgirlRN
    I'm an ER nurse, we're supersticious, so I'm not gonna say what my favorite or least favorite is..they'll both show up in multitudes if I do!!
  11. by   joannep
    Spent 15 years working in the OR, loved the adrenaline of the place, especially multiple trauma pts, cardiac cases and transplants of any kind.

    I now work in dialysis, which I love.
    I don't find the patient's demanding or whinging, probably cause they are not as bad as the surgeons in the OR.

    I hate patients that put on too much fluid between dialysis sessions, and are generally not motivated to participate actively in their care.

    I love the really motivated ones. They always seem to get a kidney from their family or a friend, so they are just great people.

    I hate psych patients on dialysis and drug addicts on dialysis.
  12. by   Sleepyeyes
    Kaknurse, I love your quote "Smile.....It makes people wonder what you've been up to!"

    Fave dx: COPD, CHF, knee & hip replacements (or "Why I'm in LTC")

    Least Faves: ETOH/drug-seekers, legal threats, and family members who won't let us give pain or psych meds to confused residents who need them.
  13. by   Cascadians
    We never found out. After we both got extremely ill, and our manager insisted on a "Doctor's note" if we didn't come back to work right away, we quit. Other reasons contributed, of course. The final straw, besides doubling our patient load and constantly floating us throughout 4 hospitals / all floors with no orientation whatsoever to 'foreign' destinations?

    The cost-cutting maniac found catheter bags that saved her 3 each. They did not close properly. So we came on night shift (darker halls/rooms) and had an enormous job mopping (no housekeeper on nights) every room, slippery stinky. Dangerous! Several patients fell.

    No, she wouldn't go back to the catheter bags that closed! Unsafe working conditions. Insanity. Good-bye

    It took 2 months of bed rest, terrible trouble breathing, before we recovered from whatever the isolation patient had. They never did figure it out.

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