What is your least favorite kind of med-surg patient? - page 8
by DutchgirlRN 18,387 Views | 75 Comments
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 to deal with. My favorite... Read More
- 1Jan 21, '09 by TweetyQuote from newrn05I absolutly hate drug seekers. I recently had a patient who refused to go home after having an ovary removed via a lap surgery. OMG that don't hurt that much.
One must be careful. I remember a day nurse labeling a guy a whiney drug seeker after a lap chole because he complained of uncontrolled pain and she failed to assess the patient properly "everyone knows a lap chole doesn't hurt that much". Turned out he had a nicked bile duct....opps.
- 0Jan 21, '09 by tsalagicaraQuote from GypsyroseWolfI want to say that I totally understand and feel your frustration, both from a health care provider's point of view and a patient's point of view. The true "drug seekers" make things very hard for patients that really are in a lot of pain. It's from the patient's point of view that I, respectfully, also want to tell you that not everyone screams, grimaces, cries or writhes around when he/she is in pain. Smiles and laughter do not necessarily equal less pain. Sometimes, humor provides a great distraction from the pain... and sometimes, it isn't culturally acceptable for the patient to outwardly show what he/she is feeling.Lately we have had an influx of drug seeking patients on the unit, most of them are frequent fliers, and seek pain medications. I even had one pt who told me straight to my face "I might as well feel great while I am here, and man these drugs are great". I felt as though I should some how inform the MD of the statement so I did, and we slowly weaned the pt off, the pt became enraged and really did become a HUGE problem, the total stay was 23 days by the time of discharge, three specialists, 1 psych MD and the pt was self pay, so you know who took the bill for that. Those are the pt's I have a hard time treating, because I have other Pt's who really are in pain, and the MD is afraid to prescribe anything worth taking, when they deal with the drug seekers everyday abusing the system, and the medications.Thankfully I only have 1 out of 6 like that at any given time. I have learned to research symptoms, diagnostics, and how they relate to pain. I use the faces scale more than the numbers with those types of patients to try and have an accurate rating for the MD, and I unfortunately sometimes have to discourage Md's from increasing doses based on the research, and prior pt history in the facility. That is the part I do not like, I was taught to never doubt a patient when they say they are in pain, but when I have a pt smiling and laughing while they state their pain is a 10, I just have to follow my instincts.
- 0Feb 2, '09 by sistasoulQuote from lady_jezebelI agree. Some patients want you to move their pillows a certain way and aree constantly on the bell for small things such as this. When asked how they move their own pillows at home they will say, "but everything is differnt here" in a loud voice.1st: The pts that treat me like a waitress or personal servant.
2nd: The very obese patients that need constant help using the bedside commode. It's hard to move them, and takes a lot of time (which I never have).
Also, the obese patients who say, "My legs can't hold me up". Well do you think I can I want to say. I always get help and refuse to injure my back because of the largely obese patient.
- 1Feb 3, '09 by GooeyRNThe type where NOTHING makes them happy. You can deliver them Dilaudid along with their surf and turf, and they would still not be happy, and ringing in 2 minutes b/c you brought them a pepsi, not a coke. And they can not eat the toast, b/c there is not enough/too much jelly on it, it is margarine, not butter, etc. The ones on the call bell constantly, and then act annoyed when you interrupt their phone call to give them scheduled meds. They want their consult with the podiatrist to cut their toenails NOW. Oh, and it has to be scheduled for Friday morning, b/c they have plans all the other days.
- 0Feb 3, '09 by admorn03Hands down for me are the detox patients. Keeping them drugged up so they can sleep off their hang over, makes me scared. You have to spend a lot of time in my opinion worried about over sedation. And I always feels as if my assessments of these people is not on point, but all has been well so far.
Also confused patient's that will not stay in bed concern for their safety, since restraints, chemical or physical are frowned upon. But again all has been well.