What is your least favorite kind of med-surg patient? - page 4

Mine definately would be the patient with pancreatitis. Although they have elevated levels of Amylase and Lipase and do belong in the hospital they always seem to be the most difficult patient for me... Read More

  1. by   mrsallen
    ETOH pts and drug abusers wit tattoos that can't stand needles
  2. by   nurseunderwater
    Anyone with allergies to Toradol, Demorol, Motrin, Codiene, Tylenol....etc and on the button every 1 hr 50 minutes for thier 2 mgs of IVP MSO4. Oh, and complain that the Ms. Dash didn't come with thier tray and can I have a diet coke, my bed needs to be changed, blah, blah, blah. The best is when I try to switch to IM MSO4 and they have a FIT!

    I used to do Detox so don't get me wrong- I am totally compassionate when it comes to someone trying to make it right - what I can't stand is that I might have up to 6 other pts and maybe a PD pt to boot - I just don't have the patience or the time for that matter to deal with such absolute neurosis.

    WHHHHHHAAAAAAAAAAAAAAAA!
    sorry, i guess i have had a little pent up frustration :uhoh21:
  3. by   suzy253
    Quote from mrsallen
    ETOH pts and drug abusers wit tattoos that can't stand needles
    Yes! Ditto! That's always amazed me.
  4. by   browniepoints
    I'd have to say the only thing to torgue me so far has been the one who was in such pain that he was on his bell every 3.5 hrs for his morphine and refused to get OOB to urinate (he used a urinal while lying in bed), but he threatened to leave AMA and that he was going to sue me b/c he was not allowed to go outside to smoke with his IV pole.
    It's difficult to find sympathy sometimes, but I tried to tell myself he was probably having a nic fit....and yes, he refused a nicotene patch, too.
    The intern on call at 2am finally wrote him an order to go outside and smoke and let him drag the pole. Thankfully, those things are up to the docs!
  5. by   nursbaybie
    I'm not the one saying this thread is unprofessional, but its amazing to see what a stigma there is attatched to the DISEASE of alcoholism/addiction. I encourage everyone to attend an AA meeting and learn a little about the disease and what these patients go through their entire lives. Their disease is no different from someone suffering from any disease, in fact it is quite worse than Some because it is not curable. it can remain in remission for a long time if a lifes worth of work is put into it, but there is no cure. Without remission, it does lead to death as we nurses have witnessed. People who don't suffer from addiction do not know the tremendous amount of dedication and work it takes to stay clean and sober. The minds of these people process mind altering chemicals differently from the unaffected person.

    Now, The patient I least like to care for is flat out mean doting parents.
  6. by   jenrninmi
    I would have to say, anyone in isolation. Having to gown up etc really slows me down.
  7. by   AtlantaRN
    I'm with dutchgirl, pancreatitis is the hardest, especially female, they will complain about abd pain, but if you don't watch them, they will eat and drink everything in sight!

    I too like post op patients...I like the surgical floor

    atlantarn
  8. by   kimmcgill
    For me, the worst kind of patient is the one who insists on directing his or her own medical treatment. These are the patients who want to change the scheduled times of when they take their medications (after you have already taken off the doctor's orders and transcribed them onto the Med-X), refuses to take medication or receive treatments they really do need, insists that the pain medication they are receiving is never strong enough or lasts long enough (actually makes a written log of when the med is given to them so they know when to push the call light button to get the next dose), tells you what medication the doctor needs to order for them to take and wants you to call the doc and have him give the order for it, rips out their IV because they didn't get their own way and then complains about having to get stuck again. Oh yeah, the greatest one....ripping out the IV and then insisting that they get their pain medication or nausea medication...which of course is only ordered to be given IV. Any ya know what????....I've only been a nurse for 7 weeks!!!!!!!!!!!
  9. by   shape0fmyheart
    Quote from mjlrn97
    But my all-time least favorite med/surg patients are the females, who are always between 30 and 50, who come in time and time again with c/o 'abdominal pain' for which no cause is ever found, and they are on that call light every 5 minutes: "I need to go to the bathroom" (they walked in from ER), "I can't reach my drink" (the bedside table is a foot away) "I need more pain/nausea/anxiety medicine" (I gave them 125mg of Demerol with 25mg of Phenergan half an hour ago, which was half an hour after they had 10mg of morphine IV, which was half an hour after they had 30mg of Toradol, and I gave them a whole milligram of Ativan in the middle of all this). Yes, I know that pain is whatever the patient says it is, but there are also such things as attention-seeking, and addiction, and neurosis, and even Munchausen's syndrome. AAAAAAAAAAARRRRRRRRRRGGGGGGGGGGGHHHHHH!!!
    Oh I just had one of those last night . She came in on the 14th of August for rule out meningitis, which was ruled out but for some reason she stayed until the 23rd anyway. She was back in the ER at 2345 on the 23rd c/o "intractable nausea and vomiting". Intractable, yet when I read the ER report the pt states that the symptoms were sudden and began just before she came to the ER. Who says "Oh my gosh I'm throwing up, I have to go to the ER!!" as soon as they start? :icon_roll
  10. by   grace90
    I don't like chest tube patients because I am constantly checking the chest tube to make sure the patient isn't lying on it or something else isn't going wrong with it. I don't like GI bleed patients because I can't stand the smell.

    But I think my absolute most unfavorite is the "abdominal pain of unknown origin" patients. They tend to be non-compliant, on the light a lot, and tolerant of incredible amounts of narcotics. I had a patient who came in complaining of abdominal pain. They couldn't find anything abnormal on the CT scan, ERCP or UGI. No matter how much pain medicine we gave her, she constantly rang the light asking for more. She was getting 4 mg of Dilaudid every 2 hours and it wasn't touching her "pain". She came charging out to the nursing station yelling and accusing me of stealing her doses and giving her saline, so I started having other nurses witness when I gave her IVP pain med. Funny how she was in "so much pain" but had the energy to leap out of bed and come out of her room like that. She griped loudly each time because I didn't push her meds in fast enough (I'm a slowpoke with my pushes) or use the closest port to her IV site (I prefer to use distal ones). ARGH!!!
  11. by   bonjoduea
    I am reminded of an acquaintance of mine who was an alcoholic with pancreatitis that would end up in the hospital at least once every 2 weeks. He knew all his meds and when he could have them etc. Unfortunately, I found him dead on the bathroom floor last week-so they do eventually die from the disease if they don't quit..
    Quote from DutchgirlRN
    The pancreatitis patients or the respiratory patients? I would imagine the respiratory patients would be because of the secretions, coughing, hacking, etc.......

    The pancreatitis patients always seems to be the most needy. Not all pancreatitis patients but the ones I get assigned to take care of......Constantly wanting to know when it's time for pain med, then phenergan, the doctors always seems to order one Q4 and the other Q 6. It would be so much easier to give them together. Many are alcoholics who are now dealing with DT's and then they want to know when their Ativan or Xanax is due. They have weird visitors, they constantly want "something". No one but "their" nurse will do. They frequently threaten AMA, don't have insurance anyway, and don't understand that AMA is no threat to the nurse. If only I would be so lucky that they would actually leave. Once the doctor says you're discharged they feel fine and want to flee out the door! They love that IV when they're patients, but that sucker has got to come out the minute the doctor says you're discharged. My favorite one was the patient who said I better keep this PICC line in just in case I have to come back sometime. The day before he was caught trying to push heroine through his PICC! Tried to sneak out the the hospital with his PICC in place !
  12. by   Hopalong
    I would have to agree with the Dutchgirl, as a matter of fact we seem to think alike on a lot of subjects. The pancreatitis pts. are the hardest and least appeciative of them all. I've got one now that has 3 different sliding scales depending on how she feels, sneaks potato chips, etc. I know I probably shouldn't but I just tell them I'll bring their PRN at the time due and then just treat it as a routine med, saves me time and time saved is .....
  13. by   grace90
    Besides the abdominal pains and the GI bleeds , I really dislike caring for intracranial bleed patients. Frequently they are confused and aggressive.
    I don't care for total cystectomy with ileo loop diversion patients, because on our floor something always goes wrong with them.
    I don't mind all the many drains and tubes they have, but with all but one pt we've had since I started 16 mo ago, there's been serious complications- respiratory arrest, dehiscence and evisceration, rapid a fib, hypertensive emergency, bleeding out with hypovolemic shock, ileus... :uhoh21:

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