What are your favorite and least favorite diagnoses to work with?
My favorite is DKA. Not sure why, but I think it's because the s/s, pathophys, and treatment all dovetail so neatly together like a mathematical equation.
My least favorite is septic shock. Sitting on a hypotensive patient, prodding the ED doc to order adequate fluid resuscitation while wanting to avoid pressors if at all possible and waiting for the intensivist to come and take over is very anxiety provoking.
Love: STEMIs, SVT, rapid a-fib, sepsis, and kids whose mild fever only requires Tylenol & a popsicle.
Don't love: TIAs/complex migraines that require 5 hours of "I think my hand feels more numb again" induced repeated neuro checks, CT scans, and MRIs before disposition; GI bleeds that exsanguinate faster than you can get blood & plasma into them; heroin ODs that don't get immediately discharged after a lecture; man colds accompanied by a concerned female family member; abdominal pain that is not clearly an appy or perfed bowel; and new oncologic diagnoses and other Bad Things That Happen For No Good Reason.
Any patient who brings a family member who answers all the questions. Any family member who displays mindreading abilities. (PUNT!)
Patients that sip slowly on liquid meds that I've warned them taste like horse dung, and the drama.
Little old ladies that drop pills in the sheets and on the floor, and the five visitors who immediately jump in and start flapping bedclothes to help.
Patients that NEED a warm blanket and a sip of water before initial vitals...someday I'll just leave to go get them and never return.
I'm OK with most diagnoses, except constipation, because I could never get the knack of disimpaction. It's like picking up Jello with one finger, while the bowl screams.
Short of Air. I think someone got tired of calling patients SOBs :)
I really like cardiac stuff and we do a lot of it. I have a bias against cyclic vomiting. I just hate hearing someone continuously heaving no matter what I do.
Other than that I am up for almost anything. Look out sick people!
My Faves are a nice simple STEMI ( they are in the cath lab and no longer my problem within 45 minutes) and the female abd pains (suprise youre preggo) that just hang out with minimal interventions.
Least faves are the "unfixables" (insert name of regular patient here) that expect drugs and breakfast every time they show up.... I tell them that if I havent eaten, they don't eat. They time their visits by the time of day and the MD who is working. Over it no sympathy.
:lol2:
Altra, BSN, RN
6,255 Posts
Love: STEMIs, SVT, rapid a-fib, sepsis, and kids whose mild fever only requires Tylenol & a popsicle.
Don't love: TIAs/complex migraines that require 5 hours of "I think my hand feels more numb again" induced repeated neuro checks, CT scans, and MRIs before disposition; GI bleeds that exsanguinate faster than you can get blood & plasma into them; heroin ODs that don't get immediately discharged after a lecture; man colds accompanied by a concerned female family member; abdominal pain that is not clearly an appy or perfed bowel; and new oncologic diagnoses and other Bad Things That Happen For No Good Reason.