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Whats your least favorite type of patient to take care of in the ER.....
Mine would have to be the drug over dose....had one on my last shift the treatment is pretty much the same What we normally get are the ones that havent done it right only taken enough to make them sleepy or beligerent so they dont end up intubated......Its pretty standard care....Large bore IV's monitor....foley....narcan/romazicon....charcoal...which always ends up all over the place........lol.....and sometimes NG tubes...they can be a real work out of your nursing skills....iv's, foley's, ng tubes...an of course restraints and the restraint paper work that goes with it.............Give me a lunger or MI any day.
How about this one. Had a cardiac arrest the other night. Pt. was DOA, we pronounced it upon her arrival. The ER doc and I walked over to the family room where there is 50 family members. The doctor gives the news and then quietly exits the room as I am left to try and calm the family and support them however I can. Now, also let me mention that due to renovations in our ER the family room that we were in is not actually in the ER, you have to walk down the hallway away from the ER to get to it. So I am in the room with the 50 family members crammed into this little family room and the daughter "passes out" So I am trying to get her out of the middle of the floor and put a cool cloth on her head when the next thing I know the son is having a seizure. So here I am by myself climbing over the "passed out" daughter to get to the son who is having a seizure and whose airway is becoming non patent very quickly from all of the secretions. Would have to say that was my least favorite in a long time. Needless to say after getting him stable for a second I ran to the phone, called the ER told them to send me another nurse and a stretcher. The other nurse and I lifted this 230 lb man off the floor and onto a stretcher. He then starts seizing again. We run back over to the ER, get a line give him some ativan and eventually find out that he is supposed to be taking dilantin but hasn't taken it in months. Dilantin level is next to nothing. Sad to say, this was only in the first couple hours of my shift, any guesses on how the rest of the night went.
i'm an urban er nurse...my faves have to be the ones who call ems for either a toothache, or the std's...i have 70 year old women who won't call ems and wait hours for a family member to come home and bring them in when they are having chest pain, yet these 20-somethings will call ems just because 'i don't feel good'...talk about a difference in mind-set...were we raised that differently? probably the best was a homeless man, on a cold night, called ems c/o chest pain, when he got to our place, and realized we weren't going to do anything for him (when he stated he had no complaints), stated that he was going to kill himself because he had no place to go (we also have a psychiatric er, the only one in the city) do they know how to play the system or what?!
Lee
I love the patient's that admit themselves voluntarily to psych for suicidal thoughts, and then refuse to take any meds, go to group, speak with the doctor because it's too early in the morning at 0900, and are rude to staff when they open the door while they are sleeping to do safety checks.
Another favorite are the ones who tried to OD on 3 amoxicillin and 10 Ibuprofen, called an ambulance to take them to ER for the whole OD protocol, (did I mention they were drunk), and are pissed off when they wake up that they are under a emergency detention on the psych ward. They are usually in their eary 20's, seeking attention from S.O.
Personality disorders suck, I'll take someone truly schizo any day.
I had alot of difficult patients when I worked for a Rehab facility here in Seattle... This one lady just irked me, though.
Her husband was a psycho and so was she. She was trying to sue the facility and she made no apologies regarding that. She had already been kicked out of numerous other facilities due to her (and her husband's) behavior. You'd think that people would learn!
She accused my male coworker of hitting her in order to garner sympathy and attention from her husband. She would threaten other residents and staff. She hit me one time and her husband said that it was my fault. She would repeatedly verbally and physically abuse CNAs. She and her husband would scream and yell about every facility policy they didn't agree with.
Finally, we were able to rid ourselves of the beast! She became rather ill one morning and I sent her to the hospital. They admitted her and she stayed for 3 days. She refused a bed hold before she left due to the 160/day cost. WoooooooooHoo!
It is unfortunate that the facility she currently resides at is the second job of one of the CNAs at my current place of employment. The CNA tells me that she hasn't changed a bit... SAD!
How does he get the EMS to bring him in when they know what its for? Home care not an option? Does he make a cmplaint that can't be ignored to get his foot in the door? Maybe take that money the EMS spends by taking him in and get the fire department to go by once a week and hose him down ...
ok ok.....that was mean but it really gets me mad to see people abuse the ER.
You hit the nail on the head z's playa, that is my exact favorite patient too. I just want to know how they LIVE at home? Who wipes their butt at home?
Or how about a nice, combative, carbueratior cleaner ingesting, listerine drinking fella. Can get a buzz just off their breath. Whatever ya do don't take off their shoes......[/quoteI learned this the hard way. We had an extemely combative man who managed to get two lacerations IN the ER from flinging himself on the floor. Then he alternated between crying and yelling for about 6 hours. What a trip. I was working as a nurse tech and trying to provide total pt. care. I wemt to remove his shoes to check for pedal pulses, etc. It was winter and cold outside, especially if you were homeless. The RN about took my head off.
As a transporter:) ,
You come across all types but mostly the ones that are drunk, throwing up some or even cussing at the staff and here I come along to take this person to 2nd flr xray for a CT scan of his head. Full bolus on Vitamin pak, EKG done, VSSq30, U/A,C7 or spectrum, and whining cause they are hungy and knowing its an NPO order.
And then it changes to a 1:1 by the afternoon he crashes and wants to kill everyone in the room -- i.e. security is nearby. Now the men who miss the urinal that is the funniest trying "REAL HARD" to assist standing up wobbling by the Stryker pee hitting the floor, patient curtin, shoes, pants, slurring loudly and flirting with me all at the same time while helping the ER staff make bio-collections.
But I always recieve back the patients I cared for up on the units so I know them all by name now. I like helping down in ER because you learn alot more there than actually working on a Nursing unit. I seen ABGs being drawn, how to do H.L.'s, foleys by watching never really put one in a female/male patient though. :stone
The one thing I want to do is go to Nursing School for LPN...yeah, yeah about the RN stuff its easier to move around than with an RN degree not as much school requirements but like the hands on with the patients. I care about my patients alot.
T:rotfl:hanks
Mine has to be the UTI obese female with 40 family members entourage along for the free ride. She expects food q1HR and they bring it and interrupt all aspects of the ER in the process. They ask for free bus passes, free lunch tickets, free parking passes even though they didn't drive you gather from the conversation. And she isn't in much pain, but is just a needy pain.People that work the system in general.
I hate the 20 yp male who is so wimpy with the flu that every time he coughs he gets diarrhea, and poops on himself. Then he wants us to clean him because he is to sick. And his fiancee is going on and on with her poor baby, I love you.She needs to look at what he is and run like hello
because he is such a whiny wimp
yeah but see ,it was her fiancee,the love still smells good you know give her a year or two and see if his **** smells good to her then.also why do adults waste the er 's time with colds take some damn nyquil and go to sleep.I guess their just hungry for attention. :lol_hitti
RAD72
14 Posts
Now that's rough.