Patients who don't know their med Hx or what meds they take?
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this is something i wrote on 12/4/1998.....that someone asked about. you can find it in any newspaper (dear abby archives). i'm not sure how good this will turn out? it's the only copy i have.
me
Last edit by CEN35 on Jun 30, '08
Dec 29, '01Joined: Oct '01; Posts: 974; Likes: 52its readable. if i can read it with my sorry eyes, anyone can read it...lol
pic of abby is interesting. never knew she was black..lol
this is important information for the public. maybe everyone read it because most of my patients can now give me a detailed hx...sometimes too detailed...including dates and doseages.
sure helps when delivering careDec 29, '01Occupation: ED staff nurse From: US ; Joined: Nov '01; Posts: 1,150; Likes: 232Pt's crack me on this subject.. I ask do you have any medical problems, the response will be no. I then ask if they take any medications, they say OMG, I take so many. Do you know what they are? no. Do you know what they are for? no, but this is my hospital, my doctor's office is here. When were you in the hospital last? 1997. Has your medication changed since then? yes. Then I don't have a record of what you're on now. Just get it from my doctor's office. Yeah, he/she leaves his/her door unlocked at 3 in the morning just so I can get YOUR medication list! (I don't really say that) I'm sorry I don't have access to your doctor's files. Oh. My wife knows (this one infuriates me), She will be in as soon as she parks the car. Wife comes in, do you know your husband's medications? Let's see..... he takes a little white pill and the blue one with breakfast and 20 units of insulin. What kind of insulin? Eli Lily I think. grrrrrrr. I do a lot of patient education on this subject, I tell them to make a list of their medications and their allergies and keep it in their wallet/pocketbook. If they get all of their prescriptions filled in the same place, the pharmacist can assist in this. If they are a cardiac patient, I make a copy of their EKG and shrink it down to where it will fit in their wallet, that way wherever they are the doc will have an old EKG to compare to.
Dec 29, '01Occupation: RN Joined: May '00; Posts: 252; Likes: 10I like the ECG idea, I will try that. My question is, how readable are they?
My favorite one is:
Me: have you ever had any problems with your heart?
Pt: no.
Me: What is that scar on your leg from?
Pt: Oh that is when they took the vein from my leg and attached it to my heart.
Me: So, you have never had any problems with you heart, but you have had surgery to your heart?
Pt: Yes.
Me: Have you ever had any problems with high blood pressure
Pt: No.
Me: What do you take the atenolol for?
Pt: Oh I take that so my blood pressure doesn't go high.
Me: Okay. Do you have any other medical problems?
Pt: No.
Me: So why do you take the glyburide?
Pt: Which one is that, what color is it?
Me: The big white pill.
Pt: Oh I take that for my diabetes (while looking at me like I am nuts).
Me: okay.Dec 29, '01Occupation: LTC Joined: Mar '01; Posts: 3,254; Likes: 54It truely amazes me just how ignorant the public can really be about their medical history and medications that go along with it!
I mean this is important stuff. I don't deal with alot of those things in LTC because they are admitted with a good medical history and meds that they're on. But it seems to me that there needs to be more pt education on these topics. Type of insulin? Eli Lilly... too much!
Rick, that's a very good article you wrote to Abby. A great reminder to those patients with alot of meds and what they're for.
LilgirlRN, keep up the good work with that pt ed. It sounds like the public can use all the education they can get! When it comes to delivering the care, the pt should be able to provide healthcare workers such vital info.Dec 29, '01Occupation: ED staff nurse From: US ; Joined: Nov '01; Posts: 1,150; Likes: 232The EKG thing works, if you have a copier, you can always increase the size of the EKG. Even if it's small you can tell the rhythm, see st segment depression etc, etc.
Dec 29, '01Occupation: Quality Nurse & Home Health Nurse Joined: Dec '99; Posts: 3,786; Likes: 129This is something ER nurses and Home Health nurses really have in common!!
I get a referral with a scribble in the med area that says "see attached" there is usually no attached.
Or, I get a referral with several meds on it, tne a discharge Instr sheet with different meds, then in the home, NONE of those meds are there NOR do they have an RX for the "new ones". I work every weekend, so you can imagine what it's like. Call the service, have doc paged, "I don't know this pt, this is dr so-n-so's pt, have them call the office on Monday." 99% of the time, I have to use my best judgement to tell them how to take their meds b/c no one wants to commit. 1% of the time, I get the doc who is the primary and happens to be the one on-call too, that is always a happy thing!!
Rick, very well-written, practical advice. Kudos to you!!
I do want you to know that several of my pt's DO have lists of meds.
The best list I ever saw a pt have was a little old man, who was learning the computer WP, and he had lists of every thing you could imagine, in tables. Systolic BP;s for everyday of the year, another table of diastolics, then at the bottom, he averaged all the bp'S. I didn't have the heart to tell him I have no use at all for averaged sys and distolic, averaged together, b/c he was sweet. How about those lists for every BS they have done for the last three years? They are too cute!Dec 29, '01Occupation: Clinical instructor Specialty: 13 year(s) of experience ; Joined: Dec '01; Posts: 781; Likes: 121LiligirlRN,
I've been giving ALL pts a copy of their EKG for 3-4 years now. I'm happy to hear that someone else is doing that. Every patient tells me that no one's ever suggested that to him/her before. I don't shrink it though. I figure it could be a lifesaver, and damn the pocketbook space saving!
Has anyone ever told you that carrying it ever came in handy for them? I haven't...Dec 29, '01Occupation: ED staff nurse From: US ; Joined: Nov '01; Posts: 1,150; Likes: 232I've seen a patient pull it out of his wallet and hand to the ER doc, the guy was from outta town...maybe one of your patients? It did help, the guy was having an MI.
Dec 29, '01Occupation: RN-i (RETIRED) Specialty: ORTHOPAEDICS-CERTIFIED SINCE 89 ; From: US ; Joined: May '00; Posts: 14,479; Likes: 2,298CEN we need to get Abby to print that one every 6 months or so.
Please forgive me if this is not what you wanted, but I did find it in the archives.
http://www.morningsun.net/stories/12...04980077.shtml
I can't tell you how many times I have gone through this exact exchange. But I will tell you I believe that "someone" (ME) knowing meds & hx of my husband's mother saved her life last Christmas. She was staying with her daughter about 100 mi away when she had a "falling out spell" you have all heard that one.
Well of course the daughter called 911 and called us. We made it down there at about the same time the EMS got her to the ER.... Hmmm
Anyway the ER doc was rolling his eyes at the "hysterical family member...." when I went back and told them she had already had a PE within the last month and wouldn't it be nice to get a Spiral CT or a VQ. Hmmmmmm.
Yep, PE and she went for a greenfield filter. Gosh a doc that LISTENED to a family member?
When she got to the ICU of course no one knew her meds.....except me....grrrrrrrr. Oh and the allergy to Sulfa that gave her anaphylaxis....grrrr.
My family all have the printouts etc.....and she had one too....left in her suitcase at the daughter's house.
BTW*I* take a half a white pill that is bigger than the white pill that the doctor gave me that replaced the funny looking pink pill.....except I don't always remember to take it.......Last edit by P_RN on Dec 29, '01
Dec 29, '01Occupation: RN Joined: May '99; Posts: 3,488; Likes: 119What a great letter! Wish more of my patients had seen and taken your advice. I ask if they have a list of their meds and they bring a basket of them from the kitchen. I write them down and then ask about things I saw on their H&P that aren't there and suddenly the spouse jumps up and brings another couple bottles from the bathroom cabinet. Then after a few more questions they remember some more. Arrrgh. When asked about allergies they say "well, they gave me a shot of something in the hospital once that gave me a rash." Very helpful. I agree that Abby should run this letter regularly.Dec 29, '01Occupation: Clinical instructor Specialty: 13 year(s) of experience ; Joined: Dec '01; Posts: 781; Likes: 121It comes down to the fact that people don't feel the need to take responsibility for their own health. It's the "you have my chart here" mentality. Or their feeling of entitlement when they whip out the health care card...With that card comes responsibility people!
I have asthma, and have 5 inhalers (car, bed, bicycle, motorcycle, and a spare in the bathroom) plus refills @ the pharmacy. How dare you come to me in triage and tell me that you or your child's inhaler ran out. And when I try to teach you how to tell if it's low, don't look at me like I'm offending you.
You offend me w/ your lack of concern for your own health!
Dec 29, '01Occupation: GN Joined: Jan '01; Posts: 426; Likes: 2Rick,
Very nice of you to give us the link to the letter. I am going to make copies for my friends. You are the Best.
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