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 went to my regular dr after my sore throat and stinky breath just wouldnt go away. I had a negative strep screen but my doctor ordered a PCN shot anyways. The nurse that gave me my shot first dropped the uncapped needle on the floor and was going to stick me with it until I protested and after changing the needle - the IM injection was so high on my GM that I had shooting pains down my leg for a week. I have never had a problem before with shots! I was soo mad. She acted like I was an idiot when I told her that her site was a tad bit too high (like in my lower back!!!). She was snotty when she asked how I would know and i hated to throw the ER Nurse Card out there - but dang - I was upset. She then apologized and said I might be right! Might be?
I always go to my mom's doctors appts with her. She recently had a major surgery so my sisters went with us as well. I felt bad for the doctor because I am an ER nurse, my sister is a flight nurse, and my other sister is a nurse is CVOR. The doc was way cool and said that it was nice to know he had to be on his best behavior! We immediately said we werent there to check up on him - we were there for her. I trusted this doctor completely or she wouldnt have had him do the surgery. Its nice to have the inside track on docs, facilities, and what not.
All the posters here have for the most part gotten what they asked for from the ER docs and primaries.
However,
I know of a person who tried this with his primary and received a certified letter in the mail telling him that his doc would no longer attend him.
He found another primary and true to his nature and background found he needed to instruct again only to receive a second cerified letter.
Apparently the two docs communicated with each other...hence the second letter....or their staff/office managers did.
Docs are no different from lawyers in this regard. They will tell you they cannot attend you anymore but you will play heck finding someone who will after that as the next one will call the first one and get the low-down.
It is one thing to ask for certain kinds of treatment for another person who you are escorting/accompanying but when it comes to asking for yourself the playing field becomes a little tricky....especially if you are asking for any kind of med for pain. The first suspicion pretty automatic and is that you are drug-seeking....then immediately discounted.
anyway............
This was the experience of my friend and a true story.
Last summer, I started waking up in the middle of the night with laryngospasms and the feeling that my throat was closing. This was accompanied by a sound very much like stridor... but weirdly enough, I never felt shortness of breath at all. Then one night, while I was working in the ER-writing nurses notes and eating a bagel-the symptoms started. My co-worker sitting next to me, and the ER attending were very startled. They grabbed my chair and rolled me into the nearest room, slapped an oxygen mask on me, and ordered a stat portable xray of the soft tissues of my neck. The whole time, my lungs were clear and the xray was normal. The doctor gave me a script for a nebulizer/albuteral/MDI. This also happened at a friend's house (he is an EMT), and he threw me in the shower, thinking I was having some kind of croup attack. Needless to say, the more anxious I became from "having a pinhole to breathe out of", the less i seemed to be able to breathe. The next day, I called an ENT specialist, and asked if he could look into my throat and help me figure out what was wrong with me. He inserted a flexible endoscopic tube down my throat, immediately withdrew the scope, and said "you have the worst case of GERD I have ever seen!" He asked me if I had experienced any heartburn or chest pain because the entire back of my throat/epiglottis was swollen and reddened. (I had no pain at all!) He told me that the acid reflux from my stomach was backing back up into my esophagus, and the epiglottis was closing in an attempt to protect my lungs from stomach acid! He agreed that what I was feeling-the "sensation that I had only a pinhole to breathe out of" was exactly what was going on! I was started on Nexium, and that was the last of the terrifying larngospasms. My point in the story is that sometimes a dr will misdiagnose because of very atypical presentation of symptoms! For three months, I actually went along with the diagnosis of "asthma" even though I truly did not feel that was the answer. Oftentimes, a patient presents with mysterious/weird symptoms and it is like a mystery or puzzle for healthcare practitioners to solve.
I awoke with a sore throat and was going on vacation the doctor asked me if I had any other symptoms and I said no but I know I have strep throat. The doctor told me she thought all I had was a viral illness and I kept asking for a rapid strep she finally gave in knowing I was a nurse then came back telling me guess what you have a sore throat:rotfl: . I got my antibiotic and off I went on vacation.(I was sick as a dog by the night)
This reminds me.....when I went in for my surgery a while back the nurse anest. was starting my IV.....I did not have glasses on and could not see very well. I commented that I hardly felt it, saw some orange, and told him he must be using an insulin needle. He asked if I was a nurse, I said yes but in peds not adults. There was a big pause, then I said he should probably give me a whopper dose of Versed to start off with.......since I didn't have ANY toys or stuffed animals :roll We had a nice chucke, and I don't remember a darn thing until I woke up in recovery. :chuckle
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--
Oh, God, do I hear you!!! I know that I am not the only nurse in the world, that there are also MDs and NPs and CNMs that occasionally need medical help, and if you are one of these, just say so politely during initial how-do-you-do/what-brings-you-here conversation. But these people who say nothing, observe with their sharp, critical eyes, then just as I am about to stick, startle me by blurting out, "What gauge is that IV?" or "Did he tell you he has rebound tenderness?" or "Her last urine output was at 0600 today", they just irritate the living h*ll out of me.
Why do so many medical professionals choose this passive-aggressive line of attack? Why is it assumed that they must attack at all? I tell you now, that if I had a pt come in and say to me, "I have gained 6 pounds since yesterday and noticed pitting edema this morning and would like to have my BNP checked" I would appreciate that person's forthrightness. Not that I need them to tell me how to do my job, or point out things that I will assess for myself, but when I take care of another medical professional whose attitude is "We are in the same line of work but different specialties, which is why I have come here for your help", I enjoy the nurse-pt rapport all the more.
Can we maybe put signs on buses or something? I think I can safely say that this irriates all nurses everywhere.
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!
When I went to ER w/?appy (it was), all the nurses knew me, so I didn't have to tell them anything. But the 3rd resident to come and examine me started to do the rebound thing, I put my hand on his and told him I had rebound tenderness, he didn't have to check it! Twice was enough for me. OUCH!
And when the RN started my IV (she didn't know me), she mentioned how she didn't see how I started IVs on babies, I told her I couldn't do her job, either. When you're really sick, it's behooves you to be nice to the people taking care of you.
One of my patients tonight was staff from radiology, day shift. She came in her pajamas, with her badge pinned to the front. Because telling us she was staff wouldn't suffice I guess.
As a phone triage nurse with an ER background, not only do I do this for myself, I coach my callers that I send to the ER as to what they might expect or how to present their symptoms to the ER staff. I don't show up telling everyone that I'm a nurse, but I know that accurately describing the situatation and the home interventions that I've done will usually result in the expected treatment. If not, I engage in (hopefully) constructive dialog.
. I called him and asked for a script for Tigan suppositories which he thankfully called in to the nearest pharmacy. What a guy!!!
LuvDaTrauma, BSN, RN
12 Posts
I went to my regular dr after my sore throat and stinky breath just wouldnt go away. I had a negative strep screen but my doctor ordered a PCN shot anyways. The nurse that gave me my shot first dropped the uncapped needle on the floor and was going to stick me with it until I protested and after changing the needle - the IM injection was so high on my GM that I had shooting pains down my leg for a week. I have never had a problem before with shots! I was soo mad. She acted like I was an idiot when I told her that her site was a tad bit too high (like in my lower back!!!). She was snotty when she asked how I would know and i hated to throw the ER Nurse Card out there - but dang - I was upset. She then apologized and said I might be right! Might be?
I always go to my mom's doctors appts with her. She recently had a major surgery so my sisters went with us as well. I felt bad for the doctor because I am an ER nurse, my sister is a flight nurse, and my other sister is a nurse is CVOR. The doc was way cool and said that it was nice to know he had to be on his best behavior! We immediately said we werent there to check up on him - we were there for her. I trusted this doctor completely or she wouldnt have had him do the surgery. Its nice to have the inside track on docs, facilities, and what not.