Things you'd LOVE to be able to tell patients, and get away with it. - page 182

:spin:Just curious as to what you would say. Mine goes something like this: Hi, my name is AngelfireRN, I'll be your nurse tonight. I am not a waitress, nor am I your slave. Yelling... Read More

  1. by   55nt29x
    Patient: I neeeeed pain medication (in mumbled jargon with eyes half closed)

    Nurse: But sir, you appear very drowsy and can't keep your eyes open long enough to tell me how badly you require pain medication

    Patient: Suddenly pops eyes wide open and clears up speech long enough to say, "No, I feel fine, I just neeee........" then falls back asleep

    Nurse: Ok sir, well I'm going to let you rest now, but when you're awake and coherent enought to complete a full sentence, we can re-consider some IV narcotic pain medication

    Patient: But I'm in paaaaiiiin!!!!!!!!! zzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

  2. by   AngelfireRN
    Quote from Cjann25
    Patient: I neeeeed pain medication (in mumbled jargon with eyes half closed)

    Nurse: But sir, you appear very drowsy and can't keep your eyes open long enough to tell me how badly you require pain medication

    Patient: Suddenly pops eyes wide open and clears up speech long enough to say, "No, I feel fine, I just neeee........" then falls back asleep

    Nurse: Ok sir, well I'm going to let you rest now, but when you're awake and coherent enought to complete a full sentence, we can re-consider some IV narcotic pain medication

    Patient: But I'm in paaaaiiiin!!!!!!!!! zzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

    Oh, the humanity!
  3. by   ProgressiveActivist
    Sir, I am trying not to kill you with medication. If you don't start breathing I am going to have to REVERSE that medication.
  4. by   AngelfireRN
    "Really?"

    And not phrased as I question, either.

    To the 30-something that came in complaining of dysuria, and informed me that Percocet was the only thing that would treat her UTI. Oh, and "y'all always give me a few". No, we don't, sweetie, I pulled up your last visit and checked.

    In the same vein, also had one tell me that her hepatitis was being treated with Xanax and Lortab. This was after she presented, requesting refills for the same, and had been told no. She then requested refills on her PPI, which we agreed to, but hit me up for teh others as soon as I walked in. She got a crash course in treatment options (she already had a specialist, thank you) and also a warning about taking acetaminophen with a known liver disease. Boy, she did NOT like me.
  5. by   AngelfireRN
    "Nice try, sir, but it's not going to work."

    To the male my age who had presented 4 times in 3 weeks, wanting Lortab for his back pain (I work at a rapid care clinic, we don't treat chronic pain, and unless it's emergent, we don't write controls at ALL), for which he was supposed to (and reportedly already had) see his surgeon. The last time he came in, my co-worker, who just happened to be there with me this day as well, counseled and documented that he was told he would not be treated for pain here.

    So, he presents, c/o dropping a hammer on his hand. It's a little swollen, X-ray shows a possible fx. Ortho appt, ibuprofen, and some Phenergan (because the pain is so that he's sick to his stomach). Again requested pain pills. Again was refused (had just said that he's seen his surgeon, we pulled up his scripts and we knew what he got) and reminded of the conversation with my co-worker. His response?

    "But this is my hand, not my back!"

    Answer was still the same. And the entire clinic is of the mind that he dropped that hammer on purpose, not intending to break a bone, but to try a different tack for pills.

    We got a phone call about a half hour later, that he was at another rapid care up the road a piece, trying to get pills there, too. Some people never learn. And before you flame me, think about this, about 2 weeks from having back surgery, in so much reported pain that you can't move and have presented this many times...WHAT are you doing slinging a "sledgehammer" over your head with ONE hand? (his report of how the injury happened).
  6. by   nerdtonurse?
    Yup....

    Had a patient who was so "crippled up" with her fibromyalgia that she couldn't do anything for herself, wanted us to hold her tissue to her nose so she could blow, wipe her backside, hold her drink, etc., and wanting every narcotic in the house. Would get mad when I -- per our policy -- diluted it and pushed it 1 minute per mg. Couldn't figure out why her normal saline kept running out faster than I thought -- turned on the camera in her room, and Miss "I can't do anything with my hands, poor me" was hopping OVER the bed rail, and reprogramming her IV pump to run at 500 cc/hr, thinking she'd somehow get a buzz off of NS!' She'd scramble back over the rail, and then after the bag was empty, start yelling, "Nurse!"

    So I showed the MD the video, who ordered her IV saline locked and her meds changed to PO. She AMA'd out, and we got a call from the next hospital down the interstate -- she'd walked to the store on the corner, called 911, and told them to take her to that hospital, and was doing the "poor pitifuls" again -- except she forgot to take off her bracelet from our hospital; we, of course, couldn't tell them anything without her permission. So they told her they couldn't treat her without the records from us to know what drugs she had in her system, and they called us back and said she threw a huge fit and stomped out, so they wouldn't be needing her records. Don't know where she went, but I hope she stays there.
  7. by   AngelfireRN
    Those types...I'm sure there's a true condition or process underlying all that drama, but a rapid care is not the place to have it addressed, nor is pulling the "poor pitifuls" at a hospital. Had a few like that at my last clinic, they'd come in c/o being to the point of one foot in, but it kinda didn't wash when you'd seen them the weekend previous, riding the mechanical bull at the local country/western bar.
  8. by   Penelope_Pitstop
    You are a grown man. Act like one.

    You're not my only patient. Nor are you even close to my sickest patient.

    If you can reach your mouth, you can wipe yourself.

    Nope, I can't give you your pain meds an hour early. I'd call and have the order changed but you fell back asleep the second you finished your sentence.

    You're HIV positive and your family cares for you...to the point of cleaning up your bodily fluids. Maybe you should tell them of your diagnosis.
  9. by   ElvishDNP
    Tell me everything you want me to bring you - the first time. I got too much **** to do for you to to decide when I bring you diapers that you need apple juice, and then pads, and oh by the way, can you change my sheets?
  10. by   nurseprnRN
    i am not incomprehensible because i am drunk. i am incomprehensible because you are drunk.
  11. by   carolmaccas66
    Quote from grntea
    i am not incomprehensible because i am drunk. i am incomprehensible because you are drunk.
    i luv this! it's like when the drunks turn up in the ed, & you start doing your assessment, they get narky when you're asking them a million questions, then ask you what is wrong with you! makes my blood boil that they drink all the time and have so little insight!
  12. by   AngelfireRN
    "If you're not going to contain your children, don't expect kid-glove treatment from me. Keep him OUT from under the sink, please, ma'am, and sit him up on the exam table so I can assess him. Your daughter is old enough to dress herself."

    This to the mother (and I use the term loosely) who disrobed her 7 year old completely to show me one patch of pruritis behind one knee (just taking the jeans off would have been fine). She allowed her one year old to run wild, opening the door and running up and down the hall, where the staff had to corral him and bring him back, and then acted surprised when, instead of my waiting and chasing after him (6 1/2 months pregnant here), I picked him up, told him "No!" and plopped him on the exam table, and then proceeded to (gasp!) EXAMINE him for the complaint listed on his sheet.

    I'm such a meanie. But the only form of correction thus far used was "I'm going to tell your Daddy!" and Daddy was nowhere in sight.

    I was not rough (I'd never be with a baby), and I didn't say anything, but she knew I was not a happy camper.
  13. by   AngelfireRN
    "No, they didn't give you "too much oxygen and dried out your nose". They neglected to offer you a humidifier for your setup. There's a difference.

    No, I don't think it's a good idea to just stop your abx siince you don't think they work and you have a tummyache.

    No, they didn't give you the Lovenox just to caue a superficial clot and make you hurt. They gave you that because YOU'RE 85 AND IN WITH BILATERAL PNEUMONIA! You're in no shape to be up. THAT'S why they gave it!

    No, I won't "just take a look at your d/c meds and tell you if I think they need to be adjusted". Every time I tell you to ask your provider about trying something, you just sigh and tell me she doesn't know anything. Honey, I live a hundred miles away and if you don't listen to her any better than you listen to me, I don't doubt she's given up on you.

    Yes, I do plan on nursing my son. I really hate that you weren't able to, but since we ain't related by blood, I hardly think that it's going to affect me. I'm still dealing with the comment you made about DH and I "needing to try for twins since I got such a late start". (I'm 31!)

    My grandmother in law, the noncomplaint wreck, just got released from hospital, and of course, I'm the go-to for all things medical. I love her to death, but ish, already.

    No I didn't say all of that to her...just the first 3 sentences, lol. After that, I bit my tongue. Darn thing's starting to get a callus.

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