Digital thumb?

  1. I work in a pediatric practice and our patient population is mostly inner-city.
    I am orienting a RN, who is new to or staff, to phone triage and was telling him of some doosey calls we've gotten.
    A common classic, Moms call in about their child having a fever of 102.3.
    I ask them,"is that in his mouth, under his arm or in his bottom?"
    The reply is often,"Oh,I don't have a thermometer. But he feels like 102.3."
    Apparently Mom has a digital thumb.
    I was wondering if anyone had some stories to share....
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  2. 10 Comments

  3. by   KidzRN
    Keni-

    I get that ALL the time. I work TT at a Children's Hospital where we have contracts with approx 170 different pediatricians. We also take after-hours calls for our local, and very large County Health Department and all of its smaller branches.

    The "oh I haven't actually checked it, but they are burning up" comment has been made more times than I care to remember.
    While it has been proven that a large majority of mothers can at least tell if their child has fever by either touching them, or by my preference with my own children of "pressing my lips on their foreheads", I find my self getting frustrated when they use psychic ability to read the temp down to the exact number.

    This is most disturbing with 12 weeks old or less infants when a rectal temp of 100.4 stays home, and a rectal temp of 100.5 goes to ED or office.

    My all time pet peave has to be:
    Forehead strip thermometers and Pacifier thermometers! UGH!
  4. by   eltrip
    I'm chiming in on this one! Parents who call & ask what to do for their child who's "burning up with fever" during business hours, no less, but doesn't want to call the pediatrician...they want me to diagnose and prescribe treatment over the phone...they and get mad when I tell them that TN state code doesn't allow RNs to prescribe meds...'cause they don't want to "bother the doctor." Burns me up.
  5. by   KeniRN
    Some real "button-pushers" I get routinely:

    Parent calls in, child is wheezing, has asthma. Ask them when the last nebulizer treatment was given, "oh, 2 days ago." WELL GIVE HIM A TREATMENT!!!!!!!!!!!!!!

    Parents call in, child is febrile x several days, sore throat, rash or anything else that should be seen within 24hrs or sooner. Try to make an appt for them to come into the office and the earliest they can possibly come into the office is NEXT WEEK!!!!!!

    Also had a call from a Mom who gave her 18 day old baby a SUPPOSITORY because she didn't poop for 22 hours! And she has 3 older kids!
  6. by   casperbjs
    I remember the calls about the temps. He has a temperature of 102. I ask how did you take it? Then they say, aren't you suppose to add a degree for taking it that way.

    Then when the parents bring them in to the office with a elevated temp. You ask, when was the last time you gave Tylenol or Advil? Six hours ago. I wanted you to see that they have a fever. I tried to explain, you need to keep your child comfortable and give them the Advil or Tylenol routinely when the fever stays up.

    Or the ones that call with refills that need them called in now!

    Then we have the ones that are coughing, just started and wants in because we are going to be out tomorrow.
  7. by   l.rae
    [quote]originally posted by kenirn
    [b]some real "button-pushers" i get routinely:


    parents call in, child is febrile x several days, sore throat, rash or anything else that should be seen within 24hrs or sooner. try to make an appt for them to come into the office and the earliest they can possibly come into the office is next week!!!!!!

    then they show up in the er when all their soaps and oprah goes off the tube...or when the bars close down..lr
  8. by   kittyw
    Originally posted by casperbjs
    Then when the parents bring them in to the office with a elevated temp. You ask, when was the last time you gave Tylenol or Advil? Six hours ago. I wanted you to see that they have a fever. I tried to explain, you need to keep your child comfortable and give them the Advil or Tylenol routinely when the fever stays up.
    I do have to say as a parent that the nurse will often tell me that there's nothing wrong (before anyone even looks at my son) because he doesn't have a fever. I often hear "He doesn't have a fever now." Well .. No **** he doesn't have a fever now .... I medicated him. I have seen that if the med starts to wear off while I'm waiting to see the doc that my son gets looked at sooner and receives better care (this has been with a couple of different groups as I was searching for a doc/group I liked.)

    I at least know how to take a temp & all that (s/s), so I can give the history in a coherant sounding way (IF I had any sleep the night before ) so by then the nurse's attitude usually adjusts.
  9. by   KeniRN
    And the ER is a whole other "Button" to be pushed
    I used to work in the ER at our pediatric hospital. In the summer, especially when it was hot out the waiting area was always busy 24/7 but especially at night. And they would come for the most MINOR things that they coukd have waited another 9 hours until their pediatrician's office opened in the AM. What is so urgent that you need your child seen for a diaper rash (that he's had for a week and the condition is very minor) at 2:15am?!?!?!?!?!?!?!?!
    Oh, did I mention we have a McDonalds in our hospital and it is open 24 hours??? So the entire west side of the city is in our waiting area, sitting with their neighbors (who are also here with their kids), eating McDonalds at 2am, watching tv like its a block party. i swear it seems like they called their friends and tell them, "Hey, lets go hang at the hospital, there air conditioning, McDonalds and tv and while we're there, little joey's had a tummy ache for the last week, I can have him checked out too." (When they call Little Joey back to be seen he's eating a big mac and fries and mcnuggets---stomach looks fine to me )

    Sorry. I got carried away. This probably belongs under emergency nsng thread.

    But I do lot of teaching over the phone (as well as when they come into the office). Most goes in one ear and out the other (because they want a rx for everything), it does feel good when you know they have retained some of what you've said.
    Last edit by KeniRN on Sep 28, '02
  10. by   Audreyfay
    How about the person who is on Welfare and wants a prescription called in for a pain medication because they don't want to pay for ibuprofen. We get that one!
    Kenni RN, where is your hospital with a 24 hour McDonald's in it? Whew! Even the public can access the hospital 24 hours a day? They don't have to go through a controlled access entry? Hmmm.
  11. by   KeniRN
    Audreyfay, the McD's is open only to the pts and their families who are inside the hospital. And since 09/11/01 our security is really tight so they either have to be an inpt or being seen in the ER to access the McD's.

    Yep. the calls for Motrin or Tylenol or Benadryl. I wish MY insurance would pay for them.
  12. by   rotho
    How about the caller that tells you "I have 5 kids. I don't need a themometer to know if my child has a fever." AND this one always amazes me. "He's had a fever since 7am (it is now 2pm) I didn't want to give my child anything for a fever because I wanted the doctor to know that he isreally sick and tylenol will take his fever away before he can be seen."

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Digital thumb?