Your least favorite patient.

[errn7]

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.

[getoverit, BSN, RN, EMT-P]

23 y.o. guy shows up at the ER wanting a script for Paxil because he has a job interview tomorrow and is afraid he "might" have a panic attack....and his girlfriend is with him who also wants a script for Paxil too. i'm not knocking a bona fide anxiety disorder but gimme a break!

or anyone who rolls around in "10/10" pain, excruciating, can't bear it anymore, hurts to palpate a radial pulse from their lumbar spine...but miraculously recovers when doctors order Toradol and then storm out of the ER in no apparent distress (other than anger).

people c/o herpes, lice, etc.

anyone saying that if they weren't (black, white, hispanic, gay, fat, etc...you name the social distinction, because i honestly don't see things that way) then we'd be taking their complaint more seriously. and then become even more upset when told "i'm sorry, but your knee pain for the past 15 years--which has left a trail of mystified doctors across 4 states-- unfortunately coincided with an elderly man's heart attack 15 minutes ago...bad timing"

[Lurksalot, BSN, RN]

My least favorite...the ones who say "my doctor called ahead for me to be seen right away," or "my doctor called and said I would go right to a room."

Sometimes they are really nice people, and I feel terrible having to explain that 'yes, your doc may have called, but he called to say he was sending you to the ER...to be seen by the ER. No, your doc did not call and arrange a room for you. YES, he could have called and arranged a room and a direct admission, but for some reason that is too much trouble for him. No, you can not just "go up to a room" for the abnormal lab work your doc already did two days ago, and YES, we do need to re-draw all the labs and have the ED docs dispo you.

I just hate the look on the face, and there is no way to make people understand as I send them (usually) back out to the waiting room moaning "but my doctor CALLED!"

Oh, and I also dislike the VIPS. I firmly believe we should treat them all exactly how we are forced to treat all of our patients every single day. Hours of waiting in the waiting room sitting next to a poor smelly homeless person with no where to go, then onto the only stretcher we have left in the triage hallway as the draft blows in, then maybe wheeled into a holding area in the ED with twelve others between curtains with monitors going off everywhere while you wait six hours(if you're lucky) for a floor bed. Oh, and once we HAVE a bed for you, pray it gets cleaned, the nurse can take report, and we can get transport to take you up there. 'Cause if you have chest pain and I need to take you up monitored, it will be even longer.

Maybe if the VIPs went through what everyone else did, then they would do something about it. So I guess they take the cake, they irk me most of all.

[loricatus]

#1- Drug seeker with phoney complaint. They take your time away from the truly ill patients with all their manipulation tricks & usually try to involve administration sometime near the end or middle of their stay. I could write a guide to their behavior patterns step by step for those just entering Emergency Nursing. It is starting to get really old since the pattern never changes, just the patients do.

#2- Parents who have never taken the time to educate themselves on their newborn/infant. You know the type I am referring to. Run to the ER for hiccups, BM that isn't the same as the previous one, one episode of spit-up... Then add those that do not speak English and refuse the translation phone.

#3- Pts or pt family member that comes in with THE NOTEBOOK to record everything & makes you waste your time repeating things over and over again so they can put it in the notebook. Reminds me of Rainman with his personal injury journal.

Got so frustrated with a patient's wife doing this that I reversed it and took out a small spiral and kept coming in the room and writing things down about her, just her, after I would look at her----boy, did she get mad at me. Anyway, all I did write was something like this "sitting with left leg crossed of right leg...head turned to left, giving me dirty look, coughed, blue shirt is nice but doesn't seem to fit her well". Just needed a harmless way of venting. Nothing written that divulged anything about patient or wife, for those thinking I might have done that by writing things down. It was just banter to make it appear like I was keeping notes about her. I just needed to tease the paranoid.

[smk1, LPN]

Patients with extremely active psych issues. Sorry just not my cup of tea, I feel for them though and hope I never have to go through what they go through, but I don't have the patience needed to deal with a 12 hour shift of psych issues 3 days/week.

[ThrowEdNurse, BSN, RN]

definitely the high drama mamas with abd pain. they fall out, screaming for 2 hours, "lord jesus help me, lord jesus help me." stick fingers down their throats, roll around on the floor, act as if we are devil people for ignoring them and the final diagnosis is always.....trich! never a surprise. your loud screaming doesn't make me think you are sick. it makes me think you are stupid, stupid enough to get an std. never an ounce of shame when 4 hours later they walk out of the ed standing straight up and looking as if nothing ever happened. also, if you happen to be 14 yoa, you don't get to squeal during the pelvic exam and jump off the table when the md inserts the speculum. and to all the men out there, if it smells like trout, keep your member out!!!

[northshore08]

definitely the high drama mamas with abd pain. they fall out, screaming for 2 hours, "lord jesus help me, lord jesus help me." stick fingers down their throats, roll around on the floor, act as if we are devil people for ignoring them and the final diagnosis is always.....trich! never a surprise. your loud screaming doesn't make me think you are sick. it makes me think you are stupid, stupid enough to get an std. never an ounce of shame when 4 hours later they walk out of the ed standing straight up and looking as if nothing ever happened. also, if you happen to be 14 yoa, you don't get to squeal during the pelvic exam and jump off the table when the md inserts the speculum. and to all the men out there, if it smells like trout, keep your member out!!!

exactly! so funny! i should post that one at work....and when i come in the room with your im injection (which i mixed with lido so it wouldn't hurt), do not jump off the stretcher and run to the corner, shrieking, "omg i hate needles!!" while covering your multiple tats with your gown. :chuckle

[ThrowEdNurse, BSN, RN]

Yes, please don't tell me that you hate needles as I have never had a pt who said, "yeah! a needle! I love shots!" You are wasting my time. You have exactly 3 seconds to drop your pants as this is 3rd time I have told you I need to stick your bottom since I have entered the room. If I don't see booty by the time I finish saying this I will document that the pt refused and I am leaving the room to care for sick patients who came to the ED for emergency reasons and who would like to receive the treatment they came here seeking, even if they "hate needles." Whatever that means. And if you move when I stick you, I will allow this needle to break off inside you as I care more about myself than you and I will not get stuck by a needle that just penetrated the skin of someone I know has an STD.

Also, you're really nice for using lidocaine.

[back2bRN]

Least favorite pts:

-LOL who are nice to your face but really demanding (I really hate to bother you, but... {insert multiple complaints/requests})

-Anyone who comes in starting at triage with "Well this really isn't urgent but I was in the neighborhood..."

-Those who in spite of educating that your "emergency"(sore knee for years, sore throat for minutes+ NVS,CTAS 5 )really isn't still insist on seeing a doctor b/c "I'm here anyways"

-Those who outright lie to me at triage or when I take them back

Actually anyone who has that "I'm entitled" attitude.

[AnnieOaklyRN, BSN, RN, EMT-P]

I dislike adult patients that are whiney and needy. I honestly had a 32 year old male the other night with a little belly ache that brought his whole adult family to the ER, including his mommy and he was crying!!! SUCK IT UP!!!!!!!!

[Rohan8]

.......

[NO50FRANNY]

Least favourite patients: The two patients whom I charged with assault this year while trying to look after them (I am 5"3 and weigh 50kg), the older narcotic seeking paedophile whom I triaged to the waiting room who got his father to ring the director of ED to make a formal complaint that I was sarcastic and judgemental (I was neither, and I have witnesses), the borderline pd pt. that called me a *&%$#ing mole when I asked her nicely to sit in the waiting room after she manipulated her way into a bed (I had a humeral # who needed it), the four naughty, needy, mean elderly men who made my new grad cry in short stay last week (boy did they cop a spray from me), the I have a cut finger and now that I've waited an hour I have chest pain pt., passive aggression, cultivated helplessness, patients who present because they are hungover, the doctor (from a different department) who phoned triage and told me to fast track her husband please because we have small children and both have to work in the morning- um, insulting, unethical and entitled much?, the guy who brought in his girlfriend wearing his volunteer paramedic cap and telling me she is tachycardic- it's not sunny at this time of night mate- why the hat?, the patient who pulled a gun on our respiratory consultant who we are still obliged to treat when he OD's (for the literally hundredth time) and requires intubation, anyone who says they are dizzy when they clearly aren't (I actually told one if they thought they were going to faint, give me a wave and lay down on the waiting room floor) that was a busy night, man flu and especially early 20's man flu with mum in tow, patients with the alert "not to be assessed / treated by a female", the patient (seeking) who attacked the ambulance officer when I asked him to take the pt. to the waiting room after giving him orals, then threw an IV trolley at another patient, the seeker that made loud and continuous racial slurs and foul comments to one of our loveliest (Korean) doctors (he was truly upset all night), patients who use the emergency department as "one stop shopping", dependent personalities, narcissistic personalities, the anti-social personality pt. who terrifies all the nannas with their behaviour, young people who think that 1 day of vomiting and diahrroea warrants a trip to an Emergency department, young people who get drunk, fall over, sustain a small laceration then call an ambulance with the excuse that they couldn't drink drive (heard of a taxi?), patients who swear in front of elderly people, patients who work in health care who should know better, pts with family that do the stand / stare / hover thing, patients who take absolutely no responsibility for themselves, their health or their actions hmmmmm how about.....

PATIENTS WHO ARE NOT SICK!!!!!! I feel better now, had a bad bad night.

[BostonTerrierLover, BSN, RN]

The patient that tells the Doctor what their diagnosis is,

What medications they will be needing,

Whether or not they will need an admission to the hospital(and how many days),

and "While I'm here, could you run these labs, I read that blah, blah, blah. . .,

Oh Yeah!!!, that's not what I read on WebMD!!!!!!!!!!