Same patient's over and over again

Nurses General Nursing

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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 :banghead:. 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.

Specializes in geriatrics, dementia, ortho.

Oooh, now I have to go look up these cartoons on youtube, they sound very funny!

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Specializes in med-tele/ER.

Patti_RN

I have empathy for ETOH who are in the hospital to quit, even if their intention is to quit but this is the 40th time. My family has many alcoholics who actively battle alcoholism daily.

My direct problem w/ treating ETOH patients monthly is they are not there for withdrawal. They do not want to be detoxed. They ran out of money to buy alcohol and end up in the hospital to detox them for thousands of dollars because they couldn't afford a $6 bottle of cheap vodka to get them to their next disability check.

Seems ridiculous to me.

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Yes! ITA. I have heard there is a law proposed that non-emergent, non-insured patients can be turned away by ER's. I say GREAT!!!

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It's short-sighted and unreasonable (not to mention judgmental) to believe that educating a person will cure them of an addiction or change behaviors that are so strongly ingrained. It isn't our job to judge, to expect 100% compliance in patients who fight addictions, mental illnesses, or behaviors that we have never experienced. If it were so easy to lose weight, we'd all be thin; if it were so easy to stop smoking, the cigarette companies would be out of business, etc. I don't know an addict who wants to be an addict or an overweight person who deliberately overeats.

There's nothing judgmental about taking care of patients who simply do not want to pay a small co-pay for Suboxone so they go out and spend 100's of dollars a day on drugs. When they run out of money they check into detox. Don't pay their bill and repeat the cycle over and over again. Sooner or later they need to wake up or stop checking in. I'm tired of paying for their addictions. I may be overweight but no one pays for it but me.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

I've always considered frequent flyers = guaranteed job security and easy report as we know them so well.

Once I started in homecare weekdays and hospital on WE, saw a different side of their personality when they were in home environment.

Education and positive reinforcement is the key. My nephew with diabetic gastroparesis had 50 admits in 2010 and 2011 with severe DKA, septic ICU, + MRSA. Nurses wrote him off untl ICU staff met me one night and they realized he DID have a family member who cared. I educated them on steps he was taking to try and get handle on disease. Change in lifestyle + living situation with a family member that cooks for his needs, found gainful employment and has stayed out of hospital x 5 months now.

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Specializes in Dementia care, hospice.

This thread makes me wonder about the thoughts of the nurses involved in my mother's "frequent flyer" days. Of course, everyone will say her situation was "different" because she was FINALLY diagnosed with liver cancer 2 months before she died. We did pain management at home but there were times when the limited meds we had just weren't enough and the pain got so bad we'd make a trip to the local ER. I tried for months and months to get her on hospice but was only able to do so for the last 13 days of her life. By then things had gotten to the point where she was given 20mg of Roxanol every hour around the clock....needless to say, I didn't get much sleep for those 2 weeks. Looking back on it, there was that "oh crap here we go again" attitude from several of the ER nurses. Eventually they came to realize that she was there for a legitimate reason and their attitudes did change but it still hurt to be almost dismissed by them, and treated as if we were a nuisance.

One doc though, stands out in my mind. Mom was stuck back in the little room in the corner that was mainly used as a storage room and the doc came in, sat down and talked to both of us for quite a while. We explained what was going on at that particular time and he said that he had reviewed her chart and would do what he could. I then overheard him tell one of the nurses in the hall "Give her whatever she needs, however often she needs it. This lady is never going to get better but we need to do all we can while we can." He then came in, said she'd be given pain meds and asked her if she felt she needed to be admitted for further management. By morning, she was feeling better, the pain was more manageable and no admit was needed but God bless him, he was our hero that night.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I've always considered frequent flyers = guaranteed job security and easy report as we know them so well.

Once I started in home care weekdays and hospital on WE, saw a different side of their personality when they were in home environment.

Education and positive reinforcement is the key. My nephew with diabetic gastroparesis had 50 admits in 2010 and 2011 with severe DKA, septic ICU, + MRSA. Nurses wrote him off until ICU staff met me one night and they realized he DID have a family member who cared. I educated them on steps he was taking to try and get handle on disease. Change in lifestyle + living situation with a family member that cooks for his needs, found gainful employment and has stayed out of hospital x 5 months now.

There is always more to the story and a history. Some Nurses need to not judge so harshly or harbour preconceived notions.

My niece a few weeks a go went to the ED for kidney stones. This has been plaguing her for some time now(awaiting nephrology consult) Her Mom (a nurse) was OOT (my niece is 21 at college, 21) So...She called my sister (a nurse as well) because she was in pain and she was told that they would only give her Advil because she has been seen for this in the past. My sister went to the ED and was outraged at the behavior of the ED nurses indicating my niece was drug seeking....being a college town and all......that went the did the CT (with my sister insistence) they found a 6.5mm stone obstructing her R kidney.

A they puked all over themselves apologizing, including the MD, and started an IV for meds and arranged for admission......we as Nurses need to remember to take the time and REALLY listen to our patients and REALLY assess them and not be so quick to judge. :nono:

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Specializes in Family Nurse Practitioner.

I work in oncology so quite frequently I do know the patients. I have some sort of knowledge of their issues and attitudes. Sometimes it makes the job easier.

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There's nothing judgmental about taking care of patients who simply do not want to pay a small co-pay for Suboxone so they go out and spend 100's of dollars a day on drugs.

For the record, suboxone copays are not cheap. And drugs are. Far, far from 100's of dollars a day. A hyperbole like that IS coming off as judgemental.

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Yes! ITA. I have heard there is a law proposed that non-emergent, non-insured patients can be turned away by ER's. I say GREAT!!!

Would be better if it was just "non-emergent" whether they have insurance or not.

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I meant to include the insured too!

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Specializes in ICU, Telemetry.

Want to know what our ER looked like last night? 3 chest pains, 2 MVAs, potential miscarriage, kidney stone obstruction, 2 lacerations from using power tools/yard work. All legit reasons to hit the ER. 8 patients. Unfortunately, we had 25 others that were earache (in an adult), headache, foot pain (gout and won't take his meds), belly pain with intractable n/v/d (abd. series showed this guy was literally full of formed stool -- he couldn't possibly have had diarrhea, and when the doc challenged him on it, the moaning stopped, he hopped up, grabbed his clothes and left), drunk, drunk, and another drunk, a bunch of people who were coming down from being stoned and wanted our meds to stay stoned, 3 LOL from the local nursing home with UTIs - not septic, only symptom was pain on urination and cloudy urine, could have called the MD for antibiotics, but sent them in. We were having families come in as a group, all complaining of pain somewhere, no scripts for narcotics, and everybody's drug screen was positive. It went on and on for things that the average person (me) would have either handled OTC, asked the doc to call something in until I could see them Monday

You want to keep ERs open? If you test positive for an illegal drug and you're not a trauma patient and your EKG's negative, see your doctor in the morning at their office. We can't afford to keep doing what we're doing.

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