This seems to be common, from what I have been reading. Some examples of what I mean are:
"Why is the trauma team undressing grandma when it's so cold in here?"
Patients who sign out AMA.
Patients who whine about their treatments ("I don't want an IV, DRE, EGD, etc.").
Is this just due to lack of knowledge? If so, does completing nursing school or becoming a paramedic cure this problem? Or do these people flunk out because they are unable to set priorities?
I am not talking about the failure to recognize the seriousness of your own condition, because we are often not able to accurately assess ourselves. However, once someone else is telling you that you need emergency treatment, I would consider it dysfunctional behavior to refuse.
I haven't graduated yet, but I'm a horrible patient. A few times in the past year I've been hospitalized for various things, and end up leaving early. I just call my doc at his office and tell him I'm ready to go, to please call in my d/c orders. He does, and knows better than to try and keep me. I'm a royal PITA, but am always, always nice to my caregivers. It's not THEIR fault I'm a jerk when I don't feel well, and I tell them that, and follow up with a thank you note.
Just wondering why you don't go to your doc in the first place instead of going to the ER? Many of the things they do in the ER can be done on an outpatient basis, even ordered STAT if necessary.
I know that patients with medical backgrounds are always the least favorite patients to take care of although I have found that sometimes they are the best to take care of. The pts that are legit medical; R.N., LPN/LVN, M.D's, EMT, etc. seem to know exactly what they want and how much. The nuts are the ones that have psych issues or are students i.e. Nursing students, Medical assistant trainees, or the unemployed nurse, doctor, or nursing asst. These are the ones that drive me crazy in aspects of the first thing they announce when you enter the room is that they have a medical background. Once you ask a few questions then usually they come clean and 1 + 1 (don't) = 2. As for families being crazy I 90% of the time chalk it up to they can't control the given situation so they control (complain) about: mother's room is always to hot/cold, they didn't get fresh ice this shift (even though mother is NPO), the linens weren't changed, this IV has been beeping for 10 minutes (really 3), things like this. Trivial crap!!!!! Usually that is when I kind of fib and say things like "I'm sorry I was taking care of a vomiting patient but I'll turn up the room temperature now". That usually seems to shut them up.
Just wondering why you don't go to your doc in the first place instead of going to the ER? Many of the things they do in the ER can be done on an outpatient basis, even ordered STAT if necessary.
I do go to my doc. He admits me, then I call and tell him when I'm ready to go home. That's it!
Specializes in Education, Acute, Med/Surg, Tele, etc.
Boy have I had my share in ALF and Hospital! Mostly in the ALF!
I had this pt, who fainted on her bed that had significant CHF history and HTN! The daughter was visiting and saw her faint...she is married to one of the biggest surgeons in the area. SHE FREAKED! She was running like a chicken with its head ripped off screaming orders at everyone! Man she really tripped out!
I got there and tried to get her feet elevated on the bed (she fainted and landed on the bed..whew!). I called 9-11 because she was unresponsive (but unlabored regular breathing and regular but fast pulse). The elevation of the feet helped and she came around very confused.
9-11 arrived and the daugher was in the way, barking orders at the paramedics and trying to give her mother a drink of water. Basically had to shove her away as she complained that her mother needed fluids stat. Then she tried to get her up to the bedside commode...it was insaine!
I finally was able to get room around all the equipment and furniture to excort her out and had a little talk with her! I told her although her efforts were understandable, that it is time for the medics to take over and they couldn't do that if they had to fight her in their treatments. I got her busy finding family phone numbers and making calls...that kept her busy so the paramedics could do their job!
The funniest thing was she insisted she knew what she was doing because she was married to "the top surgeon in the NW". Yeah..uh huh sure...I don't even think she knew CPR, let alone with her actions what she should have been doing, which was let the professionals do their job!
The pt died in the hospital from complete heart failure which was expected to a point, but still kind of shocking to us all, and ASPIRATION comlications...hmmmm guess that water wasn't a hot idea after all huh!?!?!?!. The Surgeon sent us a wonderful thank you card, including an appology for his wife..LOL! Good Man!
There have been so many incidents like this in my career...some worse, some better...and all crazy! I just stay calm...probelm solve families as quick as I can by giving them tasks so they feel helpful (and out of my way!) assuring my pt is safe first. ANd after it all...I vent with some humor to my fellow nurses or my hubby (who is paramedic)...of course leaving names and what not out of it for confidentiality!
Lots of times I just laugh..and say "guess that is why I am here huh? And with the way things are going...I have extreme job security! LOL!".
Gompers, BSN, RN
2,691 Posts
Just wondering why you don't go to your doc in the first place instead of going to the ER? Many of the things they do in the ER can be done on an outpatient basis, even ordered STAT if necessary.