Discharge orders you'd LIKE to write!!!

[LoriAlabamaRN]

Hey, this quote from MLOS was in the middle of another thread:

"Maybe this is better suited to an ER thread, but here's a brief list of discharge instructions I would love to give some days:

1) ATVs & ETOH are bad.

2) Stop drinking a fifth of liquor each day - it's bad for you.

3) If you insist on OD-ing on your Klonopin, just take them all, DO NOT crush them & shoot them up w/your heroin.

4) If you go looking for a fight in a bar, you WILL find one.

:smackingf I could go on and on ..."

I think this is a great idea for a thread! I'd love to hear the responses from our ER nurses!!! :)

[Still Riding]

Drinking and guns don't mix, even if it is tradition to hunt and drink with the boys.

[grammyr]

That is hilarious...wish our docs had a sense of humor like that.

He's dead serious. 76 years old and still ticking. He actually writes this kind of DC instructions and has never been sued.

[sjt9721, BSN, RN]

For those pesky foreign bodies:

• Always wear pants when standing on a step-ladder to change a lightbulb.
  
• Put non-skid strips on the floor of your shower.
  
• Don't abuse produce

[nadja9]

For those pesky foreign bodies:

• Always wear pants when standing on a step-ladder to change a lightbulb.
  
• Put non-skid strips on the floor of your shower.
  
• Don't abuse produce

LOL!!!! Aren't the excuses funny and quite creative!!! Once had someone in ED with what I am assuming was like a large, marichino (sp?) jar lodged in an interesting area of the body. It had to be surgically removed. I wonder what the path report said......

[analee23]

This one I wish I could've written.

1. Don't run naked outside through cactus patch, it will hurt and the "lucky" student nurse will have to pull ALL those stickers out of you again!!!

[Nurse Valium]

What about:

"THERE IS NOTHING WRONG WITH YOU. GO HOME."

[nurse4theplanet, RN]

or please seek mental help

[MMARN, BSN, RN]

Or these:

1. When you start eating first thing in the morning and do not stop until you go to sleep, it's NOT considered one meal a day. Eat sensibly.

2. Doors are to be pushed open with hand not kicked with bare foot.

3. Never sit on a chair until all broken glass shards have been picked up.

4. Bring toilet paper on camping trips. Some funny looking leaves nearby can be poisonous (ouch).

:rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl: :rotfl:

[TennNurse]

Then it's just hilarous!!! :rotfl:

had a guy who had swallowed a large piece of meat that became lodged in his esophagus, needed an endoscopy to get it down. D/c instructions included "Chew Food":chuckle

I had the same guy! Except we pulled it out, and really, all I could think of to write was, "Cut your food into little pieces. Chew them really well."

At least a few times a month we have some hyper-alert brand-new parents (whose own parents have apparently recently gone back home and left them alone with the new baby) who come racing in with a perfectly normal baby doing that funny little hiccuppy breathing thing they do, or maybe sleeping through the night for the first time. Docs will write as discharge diagnosis: "Concerned parent" I have yet to think of a good d/c order for them that's not too patronizing. I mean, at least they care about their babies, and they're always really apologetic and grateful when we check them out and say nothing's wrong.

For my pts who present with weeks-old complaints that they just decided to have checked out now, in the ER, at 1100 at night, and $$$ worth of labs and exams show nothing: "Get a job with insurance. Find a doctor. Leave us alone."

For my pts who state they were in an MVA 2 weeks ago and are here on their lawyer's advice: "Get a job. Stop looking for new ways to spend taxpayers' money on your bull****."

For my 470-lb pt who presented with the desire to be cleared for the nursing home because she found it too taxing to move around on her own for anything (including frequent, liquid bowel movements) and spent the entire time barking orders at us and demanding food, I'd discharge with the following question: "How in the name of God did you allow yourself to get to this point in less than 50 years?"

For my pt who nearly sliced off his hand skinning a deer: "Leave the deer alone. This is obviously some bad karma you've got here."

For parents of toddler who presented with dog bite to the face following the toddler biting the dog: "This would be a good time to start teaching your child about limits, such as 'Do not bite anything that can bite back.' P.S. Considering who ended up needing sutures, score one for the dog!"

For patients who present with any c/o who are subsequently unwilling to a) take medicine b) receive Xrays c) submit to various procedures such as IVs and Foleys: "Return to ER when you are willing to listen and cooperate."

For the mom of my 4-year-old pt (several years ago, Easter Sunday, out west) with genital herpes contracted from her father: "Rip off this man's testicles slowly with dull instruments. Failing that, bring him to me." (Very sad, 6-year-old sister also had herpes from Dad, who was under investigation initiated by SANE. Still cry when I think about this kid.)

[JBudd, MSN]

Getting drunk is stupid.

Crossing high speed interstate highways on foot while drinking is stupid.

We cannot cure stupidity.

Cars traveling at high speeds will.

[Mama Val, ASN, RN]

I had a Doc at the ER write this on the discharge sheet of a male patient that we had received at the jail for a 12-hour Sleep-Off.

1. STOP drinking alcohol

2. Drink more water

3. Eat good food

4. BE KIND TO ALL WOMEN

Now that is what I call wishfulllll thinking

:roll

[nitenurse78]

If pt found smoking in the hospital room then discharge home.

If pt calls nurse "awful and ugly" because nurse says it's against the rules to smoke in the hospital then discharge home.

If patient leaves hospital to smoke AMA then she is well enough to leave and must then be discharged home.