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!!!
Specializes in Peds ED, Peds Stem Cell Transplant, Peds.
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
Are you the one that sends parents with their babies in that has copious amounts of tears and drool and demand an IV because their baby vomited all day long, and hasn't ate, but you see cheeto stains on their chin and fingers?
Specializes in Peds ED, Peds Stem Cell Transplant, Peds.
Last summer my ten year old was smashed in the head with a flying baseball bat. The doctor said ok let's suture her up, no CTscan no nothing.
I demanded first a CTScan, then a plastic surgery to repair the damage, it was a 7 cm lac on her forehead, she is a girl, plastic needed to fix her up, then I requested she either get LAT, LET or sedated because there is no way on this side of heaven my daughter could tolerate being sutured without it. there wouldn't be enough staff to hold her down.
The Doc grumbled about how she really didn't need the scan and we were radiating our kids way too much, but did, after no fracture or bleed, but the radiologist was highly impressed by the LAC. The Doc grouched about finding a plastic surgeon, I refused to let him fix her. He was like there may not be one around then I said send me to Chicago, about 15 minutes away, Then a plastic surgeon appeared . Plastics came up asked me how I wanted it fixed, I said I don't care but she needs sedation (they had no LAT, or LET). He got the ball rolling and in 20 minutes she was in the or getting it fixed.
Yes, I am pushy, but for the sake of my childs wellbeing and I make no apology for it:clown:
I have only been "pushy" once, and that was when my throat started bleeding on post op day 10 following tonsil removal. I was working ER at the time, so I used my code and came through the back door at the ER (my doc who did the surgery was located about an hour away). The ER doc looked at me and yelled "get in a room now!"-I guess it was all the blood coming out of my mouth-who knows? He tried to ice it down (which I had already done at home, but hey, I would have done anything to get it to stop), holding epi soaked gauze on it, nothing would stop it. Finally they ended up sending me to the hospital where the surgery was done to have it fixed-the funny part was right before surgery, the nurse told me not to worry everything would be ok-you know the bit. None of them at this facility knew me, and at that point-I really was not caring that I was a nurse-I just wanted the bleeding to stop. I looked at the nurse and said "I'm not worried, all bleeding eventually stops". She busted out laughing and asked where I worked, I told here, and we all had a good laugh, despite what was going on.
I have never HAD to be pushy, because my PMD is sooooo great. He takes one look at me and asks me what my diagnosis is, symptoms later. He knows that I know what works for me, and that I know s/s probably as well as he does (for the minor things - thank God I've never been majorly ill since highschool). Most of the time he'll call in an rx from a phone call. But if the situation presented itself, you bet I'd want a full detail rundown of what is going on, from exact lab results to the guage of my IV. In addition, I will mention my healthcare background. I always like knowing if my patients are healthcare professionals. It means I don't have to say things in lay terms and explain everything I do as simply as possible. And, that way when I draw blood or what not, they don't surprise me right before I stick by saying "you should be doing ____" instead. It lets me know I need to be on my best behavior (not that I'm not always with every patient, but I really want to watch my step w/ a nurse or doctor as a patient) and do things by the book. I actually like the challenge of having to try and satisfy the most picky customers (which, I believe are other healthcare professionals!). When I'm the patient, I let people know my position, but I also don't want to come across w/ my badge pinned to the front of my pjs. LOL, that had me laughing. Can't believe that actually happened!!! :roll
I went to my own ER and told the doc what I had, and very politely treated me for it, although he didn't agree, because he knows me. turns out I was right. I told him we would both save time if he would just assume that during our shifts together too.
I always like knowing if my patients are healthcare professionals. It means I don't have to say things in lay terms and explain everything I do as simply as possible. And, that way when I draw blood or what not, they don't surprise me right before I stick by saying "you should be doing ____" instead. It lets me know I need to be on my best behavior (not that I'm not always with every patient, but I really want to watch my step w/ a nurse or doctor as a patient) and do things by the book. I actually like the challenge of having to try and satisfy the most picky customers (which, I believe are other healthcare professionals!). When I'm the patient, I let people know my position, but I also don't want to come across w/ my badge pinned to the front of my pjs. LOL, that had me laughing. Can't believe that actually happened!!! :roll
I love to know when I'm treating other healthcare professionals, for all the same reasons above. There is no satisfaction quite like having another nurse tell you, "Thanks, you did a great job". I do like to find this out in a normal way, though, as opposed to people remaining silent as they stare at me gathering equipment, then suddenly blurt out some missive designed to alert me that they might know something about what I'm doing. Just say, "I'm a nurse, so I'm interested" and definitely, that makes explaining everything much quicker, not to mention more enjoyable.
And yes, patients do come in with name tags attached. Several months ago I had a young lady come in who works up in CT and both she and her SO were incensed that they did not receive preferential treatment. They told me several times that they wanted to be taken to CT, and it better happen immediately because they "know people here!" I also had a family member come in who worked at another hospital, and she made sure not only to wear her name tag, but her stethoscope as well. I did think that was a bit over the top.
And yes, patients do come in with name tags attached. Several months ago I had a young lady come in who works up in CT and both she and her SO were incensed that they did not receive preferential treatment. They told me several times that they wanted to be taken to CT, and it better happen immediately because they "know people here!" I also had a family member come in who worked at another hospital, and she made sure not only to wear her name tag, but her stethoscope as well. I did think that was a bit over the top.
The only time I've ever worn my uniform and name tag to the ER was when I was mid-shift and had a major kidney stone situation going on. It was 3am and my charge nurse sent me to the ER, and I was in so much pain that I didn't bother to change into my street clothes. I actually hoped wearing hospital scrubs (work in NICU where we were the surgical ones) would get me seen faster, but no dice. I literally rolled around the waiting room (doing the "kidney stone dance") for like a half hour before they called me back. And they were empty when I got back there, except for one patient. :angryfire
They did treat me well though, once I got back there. And 24 hours later when I turned up in their ER again (this time from home), they took me back almost immediately and I was admitted less than 2 hours later.
Specializes in Peds ED, Peds Stem Cell Transplant, Peds.
I had taken care of a child of a Neurologist and Cardiologist. It was RSV. Anyway, they never expected special treatment and listened to everything I had to teach. The showed the uptmost diginity in learning how to care for their sick baby.
Not to cut on LPN or CNA, but in my experience it is those two groups the give me the biggest fuss.
I feel we all need to be our own advocate (in a polite way) and sometimes we also need that reminder that even those that present without medical background can do a darn nice job of predicting what their problem is. Had a 95 year old in LTC - tiny women, crippled body, mind as sharp as a pin. Suddenly kept losing weight 2-3 pounds/week. Kept adding supplements, extra calories, extra favorite foods etc, etc. Nothing worked. Finally went and simply asked "Mrs Smith got in idea why we can't put a single pound on you even tho you seem to be eating pretty good." Her response.. "I think you had better check my thyroid, my medicine probably needs adjusted". Sure enough, that was her problem. From that point on the Dr. and I always asked HER opinion on HER care.
last week I went to the doctors and told them I had bronchitis they said no I don't and I had a viral illness gave me cough syrup. This week I went back and guess what I have bronchitis :rotfl: what a waste
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.
Thats pretty funny. I would be embarrassed to do that! I just keep my mouth shut and never tell anyone I am a nurse unless I am asked what I do for a living.
. I called him and asked for a script for Tigan suppositories which he thankfully called in to the nearest pharmacy. What a guy!!!
She busted out laughing and asked where I worked, I told here, and we all had a good laugh, despite what was going on.
I did think that was a bit over the top.
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Kidrn911
331 Posts
:angryfire