Last night I had to take my 2 year old to the ER for croup. WE had tried everything from being outside (in 15 degree weather) to running the shower until it ran out of hot water. His cough was almost continuous and I just decided to take him in. This is his 3rd bout of croup in less than a year and the first 2 times I was able to wait it out until morning and take him to the doctor, but this time it was really bad.
I got in there and the doc says "does it seem better now?" I said yes. He starts with "well usually the cold air helps because it reduced the inflammation" I stopped him and said "I worked in a trauma center for over 5 years I understand the physiology of croup but he wasn't getting any better at home. I really think he needs steroids and a cool mist SVN." He said "well we can give him some Decadron.." to where I said "do you realize that the dose of Decadron for a child his age is 7 tsp. of medicine? I would rather you give him a shot of it." He was rather surprised that I was asking him for the shot but I explained that in the past he gets about 1/4 tsp down before he starts vomiting. So he followed my treatment plan to a T and we were d/c after 1 1/2 hours.
I'm really bad about this with my doc as well. Dd had a stomach bug a few weeks ago and vomited more than 35 times in 6 hours (it was every 10 minutes) . I called him and asked for a script for Tigan suppositories which he thankfully called in to the nearest pharmacy. What a guy!!!
I work in a busy busy ER, before this I have worked on PCU/ICU/CCU, and as Im sure many of you Nurses know when you get a pt. demanding TX before diagnostics or even after diagnostics it can be frustrating. It's people telling you how to do your job. I agree no one knows their body better themselves but its never proper to demand treatments or interventions as a healthcare person. There are ways to suggest and be diplomatic about what you want and then their are the ones that are demanding. Now when it comes to your child I completely understand, but instead of saying No Dr. he has to have this, say Dr. you know what worked well for him before, or Dr. you know he had trouble with that before. I see many Nurses as Pts. and even Physicians, and for the most part if you let them know the TX path your taking and the results of all diagnostics they are extremely happy. Nurses do not deserve special care, nor do physcians, (I do agree children do), I treat all of my pts. the same, as if they were family..........and sometimes family disagree. Just because you hav RN,MSN, or MD on your name badge is irrelavent to me. And as many of you ER nurses know when they are in the ER they basically post their badges on their forhead, so all can see that this some how makes them VIP. I understand there are bad nurses out there just like in any profession, so its always good to have some one that can understand and translate the medical interventions (hows and whys) to your family if they are being treated. But on the other hand a good nurse will do that for their pt.
As medical professionals, of course we're in a position to provide complete, relevant information which makes diagnosis & treatment decisions a little easier, and to participate in a meaningful dialog about treatment decisions for ourselves & our families. But ultimate responsibility for medical decision-making lies with the physicians & nurses providing the care. I'm a little uneasy with the underlying tone here (maybe I'm just being overly sensitive) that the ER is an adversarial place, where getting appropriate treatment is somehow a game of "gotcha."
Maybe I'm just making something out of nothing ...
Hey....I see alittle of Zach point, however...why waste time and money?
Heck at work we can call the doctor and practically diagnosis the UTI, heart failure etc, why shouldn't I be able to tell the doc, I have strep or a UTI again, can we save some time here and just reoder me X. Heck I just spent $200 on doc appts (not covered by insurance) last month for simple things that I could have easily taken care of over the phone if I was at work.
I work in a busy busy ER, before this I have worked on PCU/ICU/CCU, and as Im sure many of you Nurses know when you get a pt. demanding TX before diagnostics or even after diagnostics it can be frustrating. It's people telling you how to do your job. I agree no one knows their body better themselves but its never proper to demand treatments or interventions as a healthcare person. There are ways to suggest and be diplomatic about what you want and then their are the ones that are demanding. Now when it comes to your child I completely understand, but instead of saying No Dr. he has to have this, say Dr. you know what worked well for him before, or Dr. you know he had trouble with that before. I see many Nurses as Pts. and even Physicians, and for the most part if you let them know the TX path your taking and the results of all diagnostics they are extremely happy. Nurses do not deserve special care, nor do physcians, (I do agree children do), I treat all of my pts. the same, as if they were family..........and sometimes family disagree. Just because you hav RN,MSN, or MD on your name badge is irrelavent to me. And as many of you ER nurses know when they are in the ER they basically post their badges on their forhead, so all can see that this some how makes them VIP. I understand there are bad nurses out there just like in any profession, so its always good to have some one that can understand and translate the medical interventions (hows and whys) to your family if they are being treated. But on the other hand a good nurse will do that for their pt.
You're right. I probably did overstep my bounds a bit last night but it was 2:00 in the morning and I was a bit grumpy. We just got back from a long vacation and long plane flight on Monday and I still hadn't caught up on my sleep yet. And I did play the "nurse card" which I don't usually do.
I think I might make something nice for the staff and go in and apologize for being a bit "demanding". :chair:
i work in a busy busy er, before this i have worked on pcu/icu/ccu, and as im sure many of you nurses know when you get a pt. demanding tx before diagnostics or even after diagnostics it can be frustrating. it's people telling you how to do your job. i agree no one knows their body better themselves but its never proper to demand treatments or interventions as a healthcare person. there are ways to suggest and be diplomatic about what you want and then their are the ones that are demanding. now when it comes to your child i completely understand, but instead of saying no dr. he has to have this, say dr. you know what worked well for him before, or dr. you know he had trouble with that before. i see many nurses as pts. and even physicians, and for the most part if you let them know the tx path your taking and the results of all diagnostics they are extremely happy. nurses do not deserve special care, nor do physcians, (i do agree children do), i treat all of my pts. the same, as if they were family..........and sometimes family disagree. just because you hav rn,msn, or md on your name badge is irrelavent to me. and as many of you er nurses know when they are in the er they basically post their badges on their forhead, so all can see that this some how makes them vip. i understand there are bad nurses out there just like in any profession, so its always good to have some one that can understand and translate the medical interventions (hows and whys) to your family if they are being treated. but on the other hand a good nurse will do that for their pt.
:yeahthat: that's along the line of what i wanted to say, but you said it!!!
I don't know of an ER nurse who doesn't do this. When it's a problem I (or mine) have had before, such as my asthma, the docs usually ask me what's worked in the past. If it's a new problem (my 2-year-old had croup in December) the doc discussed it with me.
Only once have I ever had to insist on a treatment. Years ago my ex had a run of bad luck while we were camping. First he smashed his finger and dev a subungal hematoma, then the next morning he burned his other hand on the camp stove. We went to the local ER, which was a 2-bed ER run by a crochety old nurse and a doc who looked older than Methusalah. The nurse (I kid you not) had no idea what to do about the hematoma. The doc said it didn't look bad enough to drain but I insisted he at least try....the pressure was so great that he almost got hit in the face by the stream of blood.
My son needed tubes in his ears when he was ~ 2 1/2. His primary peds referred him to the ENT specialist, who carefully explained what they were, yada, yada. I listened politely and when he stopped talking, I said, "ok, fine. And as long as he's asleep, and you're in the neighborhood, I'd like you to bronch him, and here's why." I reviewed Juan's neonatal hx, numerous intubations, sick premie, and that I felt his voice was kinda hoorifice. He looked @ me as if I'd lost my mind, but said he would do it.
Post-op, he comes to talk to me--Juan had a subglottal cyst! "I thought you were one crazy mother, but you get points on this one!"
I am lucky, my primary doc is cool and listens to me about me and my kids..not so lucky if i end up w/ student the day we come in..had made irate calls to office later! I do try not to play nurse card when in er..its hard cause live in small area and i float to most of the hospitals and most of them know me anyway! I do multiple specialites...lesson learned there as I do IV therpy and ER nurse so nervous when she started my line she blew it three times! and I have garden hoses for veins, you couldnt miss with a 14 gauge!...lol I just smiled at her and told her it was fine, we all miss from time to time!
My guard instantly goes up when I have a nurse as a pt in the ER, especially when the first words out of their mouth are "I'm a nurse" or they have their badge practically pinned to their pt gown.
Please trust that I know my job and I really do know what I'm doing; that said, I have no problem whatsoever, and would encourage pts to tell me, "this happened to me before, and this is what helped.." But do not demand only certain meds/treatments, refuse others, etc., because you're a nurse. Each nurse/doctor does things differently, and as we all know, there is more than one way to solve a problem!
I do not tell people that I'm a nurse when I've been with family or friends in the hospital. I'd rather let the staff treat the pt without the added pressure/stress of feeling like I'm watching their every move.
I work in a busy busy ER, before this I have worked on PCU/ICU/CCU, and as Im sure many of you Nurses know when you get a pt. demanding TX before diagnostics or even after diagnostics it can be frustrating. It's people telling you how to do your job. I agree no one knows their body better themselves but its never proper to demand treatments or interventions as a healthcare person. There are ways to suggest and be diplomatic about what you want and then their are the ones that are demanding. Now when it comes to your child I completely understand, but instead of saying No Dr. he has to have this, say Dr. you know what worked well for him before, or Dr. you know he had trouble with that before. I see many Nurses as Pts. and even Physicians, and for the most part if you let them know the TX path your taking and the results of all diagnostics they are extremely happy. Nurses do not deserve special care, nor do physcians, (I do agree children do), I treat all of my pts. the same, as if they were family..........and sometimes family disagree. Just because you hav RN,MSN, or MD on your name badge is irrelavent to me. And as many of you ER nurses know when they are in the ER they basically post their badges on their forhead, so all can see that this some how makes them VIP. I understand there are bad nurses out there just like in any profession, so its always good to have some one that can understand and translate the medical interventions (hows and whys) to your family if they are being treated. But on the other hand a good nurse will do that for their pt.
I completely agree. I can not stand it when people think they know better than our doctors because they are a nurse, or they make some comment just to make sure I know they are in the medical field--which sometimes gives them the right to mess with all or our equipment, screwing up the monitors or turning up the 2nd Liter of fluids when it was ordered tko so now I have to get the pt out of bed every 5 minutes to pee.....I keep my mout shut when I go to the Dr.
Specializes in 6 years of ER fun, med/surg, blah, blah.
Agree completely with Zachary2011!
My guard instantly goes up when I have a nurse as a pt in the ER, especially when the first words out of their mouth are "I'm a nurse" or they have their badge practically pinned to their pt gown.
Please trust that I know my job and I really do know what I'm doing; that said, I have no problem whatsoever, and would encourage pts to tell me, "this happened to me before, and this is what helped.." But do not demand only certain meds/treatments, refuse others, etc., because you're a nurse. Each nurse/doctor does things differently, and as we all know, there is more than one way to solve a problem!
I do not tell people that I'm a nurse when I've been with family or friends in the hospital. I'd rather let the staff treat the pt without the added pressure/stress of feeling like I'm watching their every move.
When a family member or patient tells me they are a nurse, I always ask what their specialty is & it's interesting when the answer is that they are retired now or that the area of practice is Hospice. Not ED. A totally different outlook & orientation. So I never worry about that. I tell the "nurse" exactly what I am doing, size of angio gauge, etc until they can't take it anymore & shut up. Works for me.
. I called him and asked for a script for Tigan suppositories which he thankfully called in to the nearest pharmacy. What a guy!!!
Zachary2011
30 Posts
I work in a busy busy ER, before this I have worked on PCU/ICU/CCU, and as Im sure many of you Nurses know when you get a pt. demanding TX before diagnostics or even after diagnostics it can be frustrating. It's people telling you how to do your job. I agree no one knows their body better themselves but its never proper to demand treatments or interventions as a healthcare person. There are ways to suggest and be diplomatic about what you want and then their are the ones that are demanding. Now when it comes to your child I completely understand, but instead of saying No Dr. he has to have this, say Dr. you know what worked well for him before, or Dr. you know he had trouble with that before. I see many Nurses as Pts. and even Physicians, and for the most part if you let them know the TX path your taking and the results of all diagnostics they are extremely happy. Nurses do not deserve special care, nor do physcians, (I do agree children do), I treat all of my pts. the same, as if they were family..........and sometimes family disagree. Just because you hav RN,MSN, or MD on your name badge is irrelavent to me. And as many of you ER nurses know when they are in the ER they basically post their badges on their forhead, so all can see that this some how makes them VIP. I understand there are bad nurses out there just like in any profession, so its always good to have some one that can understand and translate the medical interventions (hows and whys) to your family if they are being treated. But on the other hand a good nurse will do that for their pt.