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

unknown99, BSN, RN · Feb 14, 2005

I do not like the respiratory patients. Of course I work on an inpatient rehab floor, so I do not see a whole lot of them.

z's playa · Feb 14, 2005

Just curious why these are your least favorite patients to work with?

:)

Z

DutchgirlRN, ASN, RN · Feb 14, 2005

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 !

unknown99, BSN, RN · Feb 14, 2005

Just curious why these are your least favorite patients to work with?
:)
Z

The respiratory patients are my least favorite because I have a weak stomach when it comes to the hacking, and the nasty, nasty sputum! OOOOH!!!!

Long Term Care Columnist / Guide · Feb 14, 2005

Definitely the alcoholics and IVDUs who are going through detox......especially for the umpteenth time!! :stone

I also hate it when people dump their elderly relatives at the hospital on a Friday evening because they suddenly 'can't cope' with Mom or Dad anymore. These folks are almost always demented, confused, incontinent, combative, and amazingly spry when they want OOB, so their care is very time-consuming. And they're not even sick.....all we're doing, basically, is babysitting until the discharge planner can find a nursing home bed for them on Monday. It's not the patient's fault, of course, and I don't blame them, but I do blame their families---HELLO, has anyone heard of prior planning so that these situations don't come up in the first place??

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!!!

barefootlady, ADN, RN · Feb 14, 2005

What ever the disease, it's the patient that makes the difference. Drug abuser, prima donna's in nighties, and he-men with hands are my least favorite. Funny but I do like the little old man or woman, may be really sick ,but they still have a little spark of life and a twinkle in their eye.

harley_fan · Feb 14, 2005

I don't like taking care of the noncompliant patients. They come in the hospital and stay for an extended period of time not really committing to any treatment plan, or refusing cares. It stinks that they waste the staff's time, the taxpayer's money, and they occupy a room that could be used for someone who probably would be more appreciative of everything we do!

DutchgirlRN, ASN, RN · Feb 14, 2005

I also hate it when people dump their elderly relatives at the hospital on a Friday evening because they suddenly 'can't cope' with Mom or Dad anymore. These folks are almost always demented, confused, incontinent, combative, and amazingly spry when they want OOB, so their care is very time-consuming. And they're not even sick.....all we're doing, basically, is babysitting until the discharge planner can find a nursing home bed for them on Monday.

I had an elderly patient the week of Thanksgiving and the son evidently counted on having Mom in the hospital over the Thanksgiving weekend. When I told him on Wednesday afternoon that his Mom had been discharged he stared at me in disbelief. "I'm not taking her home for Thanksgiving". I told him that as long as the doctor believed she was well enough to go home that she would have to go. He said "well I'm not taking her". I explained to him that her insurance wouldn't pay" at that point he said "I'm going to sue you". I told him to do whatever he felt was appropriate to him. I called the doctor who promptly came back over and told the son to get his butt out, his Mom home and to find another doctor. He told the son " I will never tolerate a patient or family member threatening a nurse". He denied it but the doctor said "I know my nurses and I know who I believe". I felt sorry for the Mom. I hope he didn't take it out on her but I guess that's on his conscious.

kar212 · Feb 14, 2005

Hmmm. I guess it would be a toss up between a demented, combative patient with any diagnosis or the ETOH withdrawal patient. Or any patient that is constantly pouncing on the call light every other minute.

nursenatalie, ADN, RN · Feb 14, 2005

Definately the abdominal pain with intractable nausea and vomiting. Labs all within normal limits and the intractable nausea/vomiting is gone once they hit the floor and get pain med of choice every hour or two of course with some phenergan too. We have a couple with no expendable organs, GB, appy but they are still having this mysterious abdominal pain that is only cured when the discharge planner looks at the doc and says no more, send them home.

allnurses Guide · Feb 18, 2005

I've decided that my least favorite patients are the inpatients who are scheduled for colonoscopies in the AM. They never want to drink that big 4 gallon bottle of cherry flavored stuff (who can blame them), and then whatever amount they do decide to drink, then it's hard to really determine if their stool is clear and watery enough for the scope to be effective. Then the doctor gets grumpy when you call them and tell them that you can't get the patient to drink the stuff and they order enemas till clear (ugh), or the doc gets REALLY grumpy when you have to call them early, early in the morning and tell them that the patient's stool really isn't running very clear.

I HATE bowel preps! As you can tell. :)

I don't mind pain control patients too much, as long as I have enough pain meds ordered to suit them. It is hard though, when it seems like the line between NEEDING pain medicine and SEEKING pain medicine gets blurred. It also stinks when I have to call the doc at 2 in the morning because a patient has a PCA and it still isn't helping them.

Doctors like that. Oh yeah.