which patients are in/out of your comfort zone?

[PureLifeRN]

Ok, so what kind of patients are you the most comfortable performing care, and which ones freak you out?! These dont have to be your favorite/least favorite patients (although they can be), but which ones do you know more about and which patients give you the "deer in the headlight" look because you have absolutly no idea what to do??

Mine: I could take care of a Telemetry pneumonia patient in my sleep. We get tons of those on my floor and and I know everything to do and am so comfortable taking on those patients. IV, IS, fluids, abx...I got it down.

Now if someone were to hand me a sick crying baby....I would start crying myself because I have NOO idea what to do with sick babies! I would love to learn one day, but right now peds/NICU is the furthest out of my comfort zone.

so what are yours??

[proudnurseRN]

Comfort zone: anything and everything ortho.

Not so much: ETOH, L&D, peds

I have to say cardiac makes me nervous. We get med-surg on our primarily ortho floor, and my heart skips a beat when I get a transfer from a monitored bed because they are cardiac cleared, but have a heart history as long as my arm.

I'm still a newbie though, and while I floated for a little bit before getting on my floor, I felt like I learned a little bit of everything and a whole bunch of nothing.

Next on my list to concur: mid level ICU care and/or hospice. Both have been calling to me lately.

[kathy313]

Babies scare the crap outta me. Natural childbirth....eeek! I love a bloody mess and all, but my clinicals in L&D made me wanna run out of the room.

[Rabid Response]

I hate taking care of relatively well patients who are in the ICU for "observation." Invariably they are cranky and miserable and unable to sleep due to the alarms going off and the frequent interventions. They hit the call lights constantly just to complain. Always they are paired with a patient who is very critical and needing constant titration of drips, ETT suctioning, etc... The critically ill patient invariably suffers as I must leave his/her bedside to adjust tv volumes, fetch food and drink, reattach bp cuff (pt removes it because is is annoying), etc... for the "observation" patient. They are only there for monitoring but often refuse to leave the monitoring equipment in place as it is uncomfortable and inconvenient. They never seem to have any idea how lucky they are to be well enough to even feel uncomfortable or inconvenienced.

I guess I could never work in med-surg as I prefer my patients intubated and sedated.

[Katie5]

Most people say kids and I think the issue on that is the vulnerability of babies- they are just so fragile and everything one their body is tiny. A tiny mistake could be fatal.

[Katie5]

300 pounders who won't (not can't) move

Right now, I won't say anything is or is not in my comfort zone. I don't want to limit myself like that because I haven't tried everything yet.

But on the above, now that may give some restriction. I am athletic person and like to be able to assist my patient as best as I can. But imagine trying to do that on a 300 pounder or more who won't or simply cannot move!

Assessments are a nightmare.

[Tait, MSN, RN]

Most people say kids and I think the issue on that is the vulnerability of babies- they are just so fragile and everything one their body is tiny. A tiny mistake could be fatal.

I worry more about dealing with their parents.

[inkedRN]

Putting IV's in kids. I need to get more comfortable with that.

[XingtheBBB, BSN, RN]

Medical kids are OK but I hate peds psych. I can't get used to the unsettling feeling of disliking a child because their behaviour is so frustrating. Nor can I get used to handing out some scary meds to those growing bodies.

I'm also out of comfort with crying adults, heme/onc, and neuro-trauma (please keep your ventrics and GSC-3's to yourself) A&O chatty adults often make me nervous too. I'm not used to it and am not good at that type of communication.

[KungFuFtr]

I'm not a fan of pregnant Pts; infants with septic workups and Pt's who can't speak English. Although the non-English speakers are usually very grateful and nice nor do they have a scene of entitlement. I just don't like calling the translator hot-line as it's time consuming.

[shoegalRN, RN]

I like vented and sedated pts. I like DKA pts.

I don't do well with kids, babies, or adults who are walkie talkies.

I recently had a pt in ICU who was downgraded to floor status and he was constantly on his call light. He wanted me to go to the vending machine for him and buy him some chips with my own money and he was on a low sodium diet.

[CASTLEGATES]

Extremely attractive patients; I typically find a way to have someone else deal with them. Then egocentric and manipulative psych patients. I can handle all the rest physical and psych no worries!