most and least favorite DX to care for? - page 4
In general, what is your favorite diagnosis to take care of? I liked Tricyclic OD's (cause they could really crash sneaky and fast); unstable GI bleeds, acute respiratory failure, acute asthmatics... Read More
Aug 16, '01Most Disliked Dx:
GI bleeds, Anything to do with activated charcoal(Yuck)
Anything cardiac (not my specialty)
and something i call "The Death Watchers"
(family members that are not close to the pts. that stand around the bed just waiting)
and family members that go out of their way to point out your shortcomings (however trivial it is)
Favorites are OB:
Precip. deliveries, stat sections, Mag. drips
I also get a charge out of getting a vein that no one else could.
oh yeah and has anyone had this experience:
(no offense intended to anyone)
An extremely overweight woman (fluffy) that tells you right before a pelvic exam that it MAY smell bad "down there".and it will knock you over,even the doc had tears in his eyes.
(that pt. also swore she was pregnant with twins and the uterus was nongravid on US) weird case.
Aug 16, '01Yeah, I also hate those women the ED rushes up to L&D because they 'appear' pregnant and have abdominal pain...only to discover they're just FAT and the only thing 'living' in their uterus is blood and air...
Or the ones the ED rushes up saying 'she's crowning!' only to check her and find she's long thick and closed...and no sign of a baby coming ANYTIME in the near future...this has happened to me TWICE. Grrrrrrrrrr.
Aug 16, '01My least favorite dx to work with are several: I hate dealing with the drunk going through DT's. I hate the drug seeker who comes into the ER weekly with a toothace, a headache or a pain in his big toe! I hate big open bed sores! The stench nearly kills me! And talking about stench, I hate GI bleeds. I pray that I never have one myself or my own smell will make me puke! Also, I hate uneducated family members who try to tell me what medical treatment is best for Mama or Daddy. And I despise a COPDer who insists on smoking and then getting all anxious when he can't breathe! HELLO!!!!!
Many of you hate dealing with psych patients. I do not mind that. I love trying to help someone who is depressed, suicical or anxious. I just want to take them in my arms and cradle them. I feel so sorry for them, having been severally depressed myself at one time. But, as many of you do, I love the adrenaline rush of a code, trauma etc.....Nothing compares to the feeling of "saving someone".
Aug 16, '01Originally posted by nurs4kids
Favorites: Anything Neurosurgical, I love the way they're fine one minute and crashed the next. Like the newly diagnosed brain tumors, family is very emotionally needy. Love big wounds and any abdominal surgeries, the more tubes the better.
Despise anything respiratory or renal. Psych just makes me realize how little I learned in school. Ohhhhh, HATE endocrine patients...don't say the word "insulin" in front of me, I freak!!!
Endocrine patients are quite / sad / and confused during the denial stage, we have to be very patient with them in this time.
During acceptace stage they will be nice/ co-operative/ understanding and participate in group discussion with the educator and with each others.
Aug 17, '01What I hate: MS patients who have been in institutions too long and complain about EVERY part of their body, very hard to make them happy, very manipulative.
Any pt under the age of 18.
What I love: Geri patients that are so patient and eventually overcome their problem ie; stroke, hip replacement.
Aug 18, '01The last two days have been an adrenalin junkie's dream. (Or nightmare, depending on your point of view!) I admitted a 12 year old from a regional hospital with a really bad rep for hanging on to critical peds patients way too long. She had been in a head-on MVA and had a classic seatbelt injury, intact skin but shredded everything else. Had been to OR twice and was now in DIC, hypotensive, two PEA arrests behind her, and developing pulmonary edema. We've had such bad experiences with transfers from this hospital, inotrope syringe pumps dying in the elevator, patients arresting in the hallway from the elevator to the unit and that sort, so I had dopamine, epi and norepi all running into the bed at the last reported rate so that we could switch her over without any profound drop in BP. The actual admission was great, it went downhill from there. I spent all day yesterday doing stat orders because she was determined to die, and we weren't going to let her. As I left last night she was on her way back to the OR, then if she made it out, onto dialysis. (Myoglobin was 49,500!!) Okay, I'm good for awhile, let me have the sedated, paralyzed, ventilated RSV baby for a few days!
Aug 21, '01Favorite: alert geriatric patients, they actually appreciate anything you do for them. Acute CHF, Pulmonary Edema, Sepsis, Pneumonia, Asthmatics...I like the respiratory patients alot
Least Favorites:The TSTL(too stupid to live) ones, "I didnt have a thermometer..I didnt give the baby tylenol(fever104.6R) any 30 year old with vomiting or diarrhea(whine whine whine) and the ones with a complaint over 3 months old(What made tonight different at 3am?)
Aug 21, '01Most Favorite:
Elderly, CHF, COPD, trach and vented patients: Can see a result of suctioning, nebs,treatments etc...same as client with wounds, puzzle to find most effective tx. Fecal impactions: Expect to see "have glove and lubricant, will travel" written on my tombstone. Endstage patients who've been thru the medical mill and need comfort care.....learned so much from my hospice patients re resilency of the human spirit and that there is an afterlife.
Renal Failure/Dialysis clients...no output, can't tell by looking at em whats wrong without labs....no urine freaks me out for some reason. Vomiting clients...hangup from my childhood.
No experience: Birthin babies beyond my own. Never wanted the experience, don't think I could handle the loss of one baby.
Aug 21, '01This is a fun topic!
Favorite: Cute little old people, Post heart transplants (very emotional and rewarding!), LVADs, Post OHS, Thoracotomies, epidurals, anything technically challenging, pleasantly confused patients, pleasant hallucinating pt's (that can be a lot of fun sometimes!), ambien (we call it the naked man drug, cuz some of the male pt's that take it just get naked and confused in a very funny way!), oh and the list goes on!
Least favorite: Emptying suction containers whether it be respiratory or GI... I gag all the time, Deep sternal wounds that gape and you can see into their chest, I hate caring for psych pt's...they just annoy me...callous, mean, insensitive I know but that's why I'm not in psych! Down syndrome pt's that are post OHS (frustrating), whiners, manipulative ESRD dialysis noncompliant pt's that think they should get a kidney transplant, LVAD or heart transplants that stoke (makes me very sad), and what burns me the most are condescending pts or family members and pt's that think they are entitled to the whole world!
Sep 17, '01Most favorite DX: anything that calls for me to "save" them....AAA (cool) love DKA, lots of gtt's and complications.
Least favorite.....G.I. bleeds...ick, always smell, unstable angina...(yawn...boring) and overdoses, who get mucomyst.....ick
Sep 17, '01fav: sepsis, copd, chf and im begining to like wound management.
least fav: psych pts with etoh/drug addictions.
now that many of our rehabs are closing their doors we are getting these patients. i think its dangerous and they have no business putting them on an open unit. especially with nurses like me, who are unqualified to care for them.
and then there are the ob patients who get transferred to the unit when the ob/gyn is full. im not an ob nurse. ive been out of school for six years. i can care for them yes, but they still scare me.
Sep 17, '01My favs are anything newly diagnosed. In home care, it's a great opportunity to see a person learn to take care of themselves and to do really well. I also seem to love my users. They're manipulative and cunning, but once you show them you're up front and wont' judge their way of life, they're all yours. I impressed the hell out of one by correctly diagnosing (oh! that word!) that her horrible lungs were from smoking crack. It's a distinctive sound that you never forget.
Least favorite? The anxious person who wont be calmed down because the family is hovering and enabling. Psych drives me nuts (no pun intended!), esp. schizophrenics. I also simply can NOT deal with burns. When I get a little burn, that's ok, but after it blisters, I'm done for, esp if it's something really bad... I have a friend who was burned badly as a child (her chest and arms) and I can't stand to look at her scars which are well healed...
Sep 18, '01My favorites are anybody that is really sick or injured in the ER that are true emergencies.
My least favorite are the frequent flyers that aren't sick but wish they were. The drug seekers who storm out, when they don't get what they want or rip up their script for Motrin as they storm out the door. And the old ladies who have to pee every 5min(usually ask for a bedpan before they come off the ambulance stretcher) and of course they haven't eaten all day(came in for abd pain and N/V)"don't you people feed anyone around here?"
Also I can't forget the people with nonurgent problems that got themselves to the ER but can't find a way home. "I need a cab slip" meanwhile they don't live anywhere near the hospital.
I think I'm done.