most and least favorite DX to care for?

IM_loopy · Sep 17, 2001

Most 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:rolleyes:

frustratedRN · Sep 17, 2001

fav: 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.

nicola · Sep 17, 2001

My 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...

kaycee · Sep 18, 2001

My 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.

frustratedRN · Sep 18, 2001

lol

thats one of my favs too....sick all day...n/v/d so badly thes pts must be admitted. they are. first thing they want is to eat...lol

and thats the kind of stuff they say too...dont you feed anybody around here? lolol

i love the ones who are absolutely indignant when we suggest they try things for themselves.

like the 23 year old who got all twisted because i suggested she migh want to wipe herself after she peed in the bedpan.

she couldnt walk to the bathroom herself, she couldnt wipe herself., couldnt stand, couldnt sit, couldnt wash. poor thing. all she was able to do was talk on the phone, feed herself, and press the call bell.

her diagnosis:

r/o appendicitis....lol

like my friend says...shes never coming back to that hotel again..

or how bout the ones that SCREAM when you draw a simple tube of blood...lololololololol

semstr · Sep 22, 2001

Wow, my heart is beating real fast now! What a show, not even ER is better!

My fav: children between 2 and 5 years old and the very old, demented Pat.

Least: chron. Lungs, bed sores, GI-Bleedings, Alks und suicides gone wrong (hurting others instead of killing themselves)

nilepoc · Sep 22, 2001

Favorites: Big pelvic fractures requiring large amounts of transfusions and the level one. If I have to go to angio for an embolization, that much the better. Any big goopy trauma is a favorite, especially if they have a head component.

I really like Necrotizing Fasciitis patients with rapidly advancing tissue necrosis and subsequent sepsis.

Opening a belly at bedside is always entertaining, and messy. For that matter any bedside surgery. One of the coolest was cracking a chest at bedside for a cardiac tamponade.

Any patient on CVVH and multiple pressors with a swan.

I really dislike all medicine overflow. Not because of the patients, but because being a surgical nurse, I really have a hard time with the time it takes medicine to act. I also hate that they tend to not wait and see if a therapy will work before they change their mind and do something else. Why is it that every time a medicine doctor touch's a chart, they have to write an order?

And I really hate "trauma" patients socially intubated who just need to wake up and calm down so we can extubate them and send them home. What a waste of an ICU bed.

Cool topic. I really like this one

Nytenurse · Sep 23, 2001

Favorite: I love anything ortho. Especially the elderly with a little dementia. I love the stories they tell. My desk was outside the room of an elderly woman who after a touch of haldol was talking to unseen people for hours. She was laughing and talking I wasn't about to disturb her good time. It was the first I'd heard her laugh like that. I love the elderly even the ones who aren't demented I love what they have to tell me, the stories they share.

Least fav: any male under the age of 40. I think its really pathetic when a young male gets into a car accident because he was drinking and driving (again) and has to have his mom sleep in the room with him. Every night, for two weeks. Refuses the psych consult for drug, etoh abuse. Says he doesn't have a problem. And of course they havent washed their crotch for a week and he won't let anyone touch him "down there' then there are the young males who sleep in the nude. Walk around their room in the nude etc. After being told several times how inappropriate it is you finally get the order for a psych consult. And regarding psych pts, hate to say this but the male psych pts I have had have always been polite. A little timid, sometimes wild eyed but always polite. Thank fully I don't have them long. I work with a nurse who used to be a psych nurse, now does she have some stories.

ChemoRN · Sep 23, 2001

I have to agree with Ted - anything Hem/Onc! Give me a bald patient any day

I trend towards the 30-50 year old man with a great family that keeps him motivated. It's bad when they don't make it, but they're a blast in between.

Least fav - anything medical. not so much the patients, although there are those... Our medical dept just is TOTALLY disorganized. Drives me nuts!!! Get together - figure it out - and then enter ONE order. it shouldn't be that hard:confused:

samrn32 · Sep 24, 2001

my LEAST favorite is noncardiac chest pain

although i'm happy for them they are not infarcting it is aggravating to me when they are on a ntg gtt a heparin gtt

grasping their chest screaming and then in the next breath

say "can i have some ice cream?"

I do like vents, and actual AMI's.

majic65 · Sep 24, 2001

Least favorite? A 35-year old mom of 8 currently treating her labor pains with crack. Eventually the crack wears off, there isn't any more, and then they get right nasty, for sure! They also often leave AMA (OK byme!) but WITHOUT the baby that was so uncareingly subjected to this abuse.

Favorite? Bikers!! Anywhere,any time--they are unfailingly polite, and so used to being discriminated against that anyone who shows average caring and treates them like human beings wins them over forever. Plus--if they are in pain, many nurses and docs refuse to give them adequate relief, since "they are all drugaddicts anyway." Try to clean up bad road rash without some pain meds and you turn a BIG, "dirty" biker into a very mad, hurting biker--not a good move! They also make great new daddies, most of the time. And are quite useful in intimidating those troublesome drunks who always seem to appear on the floor on Friday nights.

MRed94 · Sep 24, 2001

I love my "Geries" too, but NOT when they have Napoleon complexes......"I am the ONLY one who matters, so do it NOW!!" When there are 52 pts on the unit and it is 0400, and your lovely NG tube just pulled it out for the 4th time that night, you have 6 UAs that nobody remembered to tell you about, and you have just had 2 call ins for the day shift, it "AIN"T HAPPENING, LADY!!!"

Some days, I tell you....

Then there are the yucky, nasty, infected wounds.....gimme 6 or 10 of them, and no Napoleons, and I am a happy camper....

Forget the psych patients who are "out there" and you can't convince them that "naked" isn't proper attire for strolling down the avenue......

I don't much like psych when they are alert and somewhat oriented, and most of it is an act to get the meds.....

And then there are the ones who are just @$$es, and delight in telling you exactly how stupid you are, and fight you every step of the way no matter what you are doing to/for them......Cussing at me just raises my hackles....

Sorry, it's been a loooooooooooong night, and I need sleep.....

:)

Marla