Same patient's over and over again

[MattNurse]

Do you ever get to work, look at your assignment and have your heart sink because you know the patient's by name?

My last few shifts I have had the same alcoholic on my assignment . A person I have detoxed so many times . I know alcoholism is a disease, but sometimes I consider becoming a traveling nurse to get away from taking care of the same people for years on end.

[MattNurse, MSN, RN]

It gets worse every year and the patient's are getting younger.

[nerdtonurse?, BSN, RN]

Same here. We get the same redneck DKA patients who have no intention of ever changing their behaviors when we can "fix" them every 2-3 weeks. And when we start chopping off their feet, or putting them on dialysis, that's okay, too, because everyone else in their family has amputations and dialysis -- it's their norm. And they make your life living you-know-what on shift, because they treat you like a maid/waitress.

Or the chronic DT patients, who come in, get put on a vent so they don't beat us to death, we dry them out, they leave AMA once the vent's gone, never do any follow up with mental health, wouldn't go to an AA meeting if you held a gun to their head, but sure enough, here they come again with their tale of woe once a month (when the money/drugs/booze runs out). I had one AMA out on me at 5 am, and he was sitting beside the ABC store as I drove past on the way home, waiting for them to open.

I hate getting anyone as a patient under 50, because unless they're post-op/MVA, they are usually either DKA, OD, or DTs. They suck the soul out of you. It really depresses me when I have a bunch of those in a row -- these are people that you can't help, don't want help, actively avoid help, but show up for their free stay like clockwork and treat you like dirt. But when it's my turn for medicare, there won't be any, because we'll have spent the money on these folks. And then they'll want to kill the rest of us because they don't get their freebies anymore....

[PeepnBiscuitsRN]

Yes yes yes! We have had people get discharged, go outside, have a smoke and come back in howling that they're in 10/10 pain- wait, no- THEY CAN'T BREATHE...actually, it's more like, um...CHEST PAIN! All over, pain all over, they can't point out a specific place, but they're in PAIN! And the doctors and nurses are so CRUEL! They're withholding pain medicine from them, why?!! *SOB* it hurts so much...I-I can't bear it....I need a boxed lunch too... make sure there's Oreo's in there this time! Ooooooooooo!

Ever see those little computer generated cartoons on YouTube? They must have been created by real nurses and doctors because they're so spot on, I seriously spent 2 hours watching them and laughing so hard I nearly wet myself.

[Dixielee, BSN, RN]

We had a guy yesterday who was a gunshot wound "victim" (once you met him, you understood why), who was admitted 3 days prior to trauma ICU on a vent. Extubated quickly, went to floor where he signed out AMA as soon as he could ambulate. He went back to the same place he was shot in the first place, was assaulted by someone using a metal pipe, and came back to the ED, intubated, with a skull fracture. Of course, he will survive this and return again and again. He has come in as a code trauma 3 times in the past 18 months. Sigh.....yes, our tax dollars at work! I'm certain he is just delightful when he is not intubated!

[amoLucia]

I too spent hours watching those little cartoons (I need oxycontin, I need oxycontin, do you have any oxycontin?) They should be mandatory viewing for all! This would be all too funny if it wasn't so serious.

[AgentBeast, BSN, RN]

Try working geri psych. The patients come in, get probated, get forced meds, get well enough to be discharged, go off their meds, and the whole cycle repeats itself over and over and over and over and over and over ect.

[MomRN0913]

One of the main reasons I left my renal floor.. same pts month after month. I moved to the ICU.. We rarely see the same pt twice :)

Oh, there were frequent fliers in my ICU. They come back a few times but eventually don't leave. One very obese young guy would come back with acute exacerbation of CHF and get intubated. The second he was extubated he would sign himself out AMA. He did not make it out alive.

[umcRN, BSN, RN]

Good suggestion, I was considering moving into the NICU, they never come back.

Oh but they DO come back...at least at my hospital, a childrens hospital, we will re-admit if its a quick readmit or up until they're three months old

Or if you float to the picu...you see them again there too.

[loveu123]

i pick PRN hours in our acute hemodialysis unit in the hospital that i work at. I usually say the same thing about knowing most of the patients. Some patients come every week. Some have come so many times that I can tell their medical history without looking at their chart including when they had their amputation. It is sad but so many of our patients don't realize despite all the education we do.

[martymoose, BSN, RN]

What more proof do we need as to the evidence of de-evolution!!!!

[MattNurse, MSN, RN]

Oh but they DO come back...at least at my hospital, a childrens hospital, we will re-admit if its a quick readmit or up until they're three months old

Or if you float to the picu...you see them again there too.

I have been considering a change after 40 years with adults I think about applying to a pediatrics hospital all the time. I realize the babies can come back, but for a limited amount of time. I have looked back in records of some of the patient's at my hospital and see that I have taken care of some people every few months for last 15 years.

I wish my hospital would just give the detoxers a beer or shot of vodka and send them back to the streets, sounds harsh but the chronic alcoholics have worn me down.

[Sun0408, ASN, RN]

I love the nights I have a beer for my pt q4h down the NG, makes for a peaceful shift hehe...