Drama Queens/Kings in the ED

[Virgo_RN, BSN, RN]

I haven't been in the ED very long, but I have been there long enough to make a few observations. One of these observations is, I've seen several people come in making such a fuss, you'd think they were on their deathbed or something, and you think for sure, they've got to have a fracture, dislocation, or something seriously wrong. You work your tail off to keep them comfortable, assuming they must be in horrific, unimaginable pain. Often these folks have some friend or family member hovering and doting, catering to their every little whim. But when all the imaging studies and labs come back, there is nothing out of the ordinary at all. When they leave, they are quiet, and sometimes act embarrassed or apologize for their behavior.

Contrast this to the really ill person with cancer, CHF, or what have you, who quietly lays there, not asking for a thing, just wanting to rest quietly and try to feel better. It would be easy to forget about them in the shuffle, but you feel so much empathy for them and their distraught family members, that you make certain to poke your head in and offer warm blankets, assess their pain, and reassure the family. Or, they may be sick enough that they are your priority patient, and you spend all of your time in their room hanging fluids, giving medications, and monitoring their condition, all the while, you can hear the loud person down the hall calling out "NURSE! NURSE!" for another pillow or some juice.

As I ponder this phenomenon, it brings to mind the saying that there is an inverse relationship between how sick a person is and how much noise they make. I'm beginning to be convinced that there is a lot of truth to this, to the point where I'm integrating it into my nursing practice and making sure to peek in on those quiet ones as often as possible.

Thoughts?

[Lunah, MSN, RN]

Yep, the quiet patients are the ones to watch! But on the other hand, the noisemakers? Eventually they could have real problems, too. I've seen the noisemakers get ignored after too many noisy visits, and ... well, bad things can happen to everyone, eventually. The boy who cried wolf, and all that.

You are becoming most wise in the ways of the ED!

[morte, LPN, LVN]

yup, my EMT instructor said to always assess the quiet ones first....you know the ones yelling have an airway and are breathing

[MissERN]

This made me think of the last time I was in triage. A name popped up onto my tracker with the stated complaint of "lac", and as I looked out into the waiting room I assumed that it must be the young gentleman who was waving his bandaged hand in the air with a painful grimace on his face. I called him into my office and began his triage. He was telling me how he cut is hand , with an electric saw, at work and how "I could see the tendons poking out" and "ma'am I'm sorry, but I might cry." By the way he was acting I thought the poor guy must have done some serious damage. I put some gloves on and got 4x4's and gauze ready. I was ready for major bleeding and deformity as I began to remove his homemade splint. What did I find?? A very unimpressive 1 cm lac, no bleeding, no "tendons poking out". I sure hope he never gets a real laceration!!!

[classicdame, MSN, EdD]

this is why you have to be on your toes. Never make assumptions

[Virgo_RN, BSN, RN]

This made me think of the last time I was in triage. A name popped up onto my tracker with the stated complaint of "lac", and as I looked out into the waiting room I assumed that it must be the young gentleman who was waving his bandaged hand in the air with a painful grimace on his face. I called him into my office and began his triage. He was telling me how he cut is hand , with an electric saw, at work and how "I could see the tendons poking out" and "ma'am I'm sorry, but I might cry." By the way he was acting I thought the poor guy must have done some serious damage. I put some gloves on and got 4x4's and gauze ready. I was ready for major bleeding and deformity as I began to remove his homemade splint. What did I find?? A very unimpressive 1 cm lac, no bleeding, no "tendons poking out". I sure hope he never gets a real laceration!!!

LOL, too funny. Reminds me of the guy that came in, convinced he had some horrible fatal neurological condition, even endured a lumbar puncture....diagnosis, strep throat. Poor guy was so embarrassed, said "Wow, I feel like a total wuss." when I gave him his DC instructions. I actually felt bad for him.

[AngelfireRN, MSN, RN, APRN]

Well, you know what they say.... the squeaky wheel gets the grease, or just gets greased, however you want to look at it.

[PeachPie]

People like them made me think, "If you have the energy to whine, then you're going to be fine!"

[KY RN]

What about drama quens/kings from the family? When I ended up in the hospital, I couldn't talk. I just rolled around and moaned in my bed. My family, on the other hand, was complete idiots. They yelled at the Dr. and the nurses due to slow care, incompetent care, etc, . (Later on, I was really embarrassed how my family acted. At the time, I didn't even pay attention to them!)

[Virgo_RN, BSN, RN]

Well, yes, there are those. I tend to really focus on the patient and explain things to the family as I go, and most of the time that really helps, and I get a lot of "Thank yous" for it.

[Riley3]

When I first read the title of this thread I was thinking about the drama Queens/Kings..meaning other nurses. Ya know the ones where every patient they are taking care of is an emergency and they have the worst patients of the ED...The ones that go from 0-10 then ask questions

[Virgo_RN, BSN, RN]

Haven't run into any of those, though there are a couple I remember from my days on the floor.