If you could speak your mind...

Fiona59 · Jul 18, 2016

Borderline diabetic. You are or you aren't. Taking insulin? Pretty sure you are

GSDlvrRN, MSN · Jul 18, 2016

I had a patient say she was having a diabetic attack. I brought in the glucometer and explained that I needed to take her blood sugar. She wouldn't give me her finger and I explained that I needed to do a finger stick to check her blood sugar because she felt like she was having a diabetic attack. She said she doesn't have blood sugar problems, she said I need to check her diabetes. Oh you have diabetes but not blood sugar problems? Makes perfect sense.

Pangea Reunited, ASN, RN · Jul 18, 2016

The grandiose lies some patients' family members tell me make me want to say, "Doubt it!". I had one "medical doctor" ask me what I was giving his mother. When I told him it was penicillin, he asked me if that was for pain.

KatieMI, BSN, MSN, RN · Jul 18, 2016

Well, the thing is, the patient is someone's mom, dad, sister, brother, etc. It would be awkward to name your own mother "Mrs. Jones", don't you think so?

And actually there is "prediabetes", officialy:

Diagnosing Diabetes and Learning About Prediabetes: American Diabetes Association®

some providers treat it with insulin, although it is VERY much off-label. But, of course when someone's blood glucose is in 200th range all the time and the diagnosis is still "borderline", then :roflmao:

What makes me silently crying inside is denial. Total, irreversible, persistent and cold as a stone denial. I am pretty sure that it is not "belief" or "hope". It is conceivable how family can hold for the last straw for comatose patient who is young, strong and just was at the wrong place and at the wrong time. But 97 y/o terminally demented, blind, double AKA and suffering from intractable pain... full code, and the family requested sedation and pain meds withdrawal so that Mother Dear could be aware of their presence and love and could "participate" in PT so that she "got stronger, fitted with protheses and walk out of the hospital"? GCS of 5 for the last 10 years attempted to be enrolled in university (of Michigan, not less) because of his periodical grimaces and seizure-like movements are seen by family as "the way he communicates"?

KatieMI, BSN, MSN, RN · Jul 18, 2016

I had a patient say she was having a diabetic attack. I brought in the glucometer and explained that I needed to take her blood sugar. She wouldn't give me her finger and I explained that I needed to do a finger stick to check her blood sugar because she felt like she was having a diabetic attack. She said she doesn't have blood sugar problems, she said I need to check her diabetes. Oh you have diabetes but not blood sugar problems? Makes perfect sense.

- do you have diabetes?

- no

- ok, I see you take metformin, gliburide, Invocana and Januvia. Do you know why do you take them?

- my doc said these are for my sugar.

- well, "sugar" or "sugar problem" means that you have diabetes.

- WHAT??? I DO NOT have diabetes, I JUST have SUGAR! Nobody ever told me I have diabetes!

:down:

TheCommuter, BSN, RN · Jul 18, 2016

Patient's wife said, "You don't know what you're doing!"

I wanted to respond, "Oh, really? If you and your husband knew what y'all were doing, why were you unable to manage this health issue at home? If you know what you're doing, why are you even here?"

Kitiger, RN · Jul 18, 2016

- do you have diabetes?
- no
- ok, I see you take metformin, gliburide, Invocana and Januvia. Do you know why do you take them?
- my doc said these are for my sugar.
- well, "sugar" or "sugar problem" means that you have diabetes.
- WHAT??? I DO NOT have diabetes, I JUST have SUGAR! Nobody ever told me I have diabetes!

I like how you handled that. This lady needs some more teaching!

Kitiger, RN · Jul 18, 2016

Father: - as I'm reaching for my stethoscope - "Have you checked his lungs yet?"

Me: (And why do you think I have the stethoscope in my hand?)

Father: "The head of his bed needs to be up 30 degrees."

Me: (It is up 30 degrees ...)

Father: "He can choke if the head of his bed isn't elevated to 30 degrees!"

Me: (You're looking right at it.) "The top of the mattress matches the mark you put on the wall to show us see how high to put it."

Father: "Well, I just want to make sure you're doing it right."

Me: (Sigh :rolleyes: )

calivianya, BSN, RN · Jul 18, 2016

There's a reason why the intubated, sedated, restrained ward of the state is the holy grail of patients!

My personal favorite recently was when a daughter who lived a grand total of three hours away called to check on her mom, who came to us from the nursing home for severe sepsis. Intubated, several pressors, trips to CT, etc., just a crazy busy patient. Daughter makes sure to mention she'll be up in a couple of weeks to see her mom, because she was "just" there and couldn't justify coming back so soon. Oh, and told me that I *HAD* to brush her hair because her hair got tangled so easily that it was just a total emergency if her hair didn't get brushed right away.

The first thing that almost leaped off my tongue was, "Want to make Mom a DNR and withdraw care? I'll be perfectly happy to brush her hair while I'm getting her ready for the morgue. I'll even use some detangler and make it smell good for the funeral home people."

The second thing was, "If you care so much about her hair, how about you come and brush it yourself?"

What I actually said was, "I'll do the best I can, but managing these machines and medications is taking up a lot of my time. If I have time, I will try to brush her hair."

Oh, and the patient family members who fired one of our awesome 40 year nurses because she said the word poop when discussing the substance that came out of their father's butt. Apparently calling it "poop" is disrespectful. :banghead: I would have liked to ask, "Oh, do you prefer the S word instead? That's what I usually say!"

KatieMI, BSN, MSN, RN · Jul 18, 2016

I saw family member "firing" an attending for using the word "borborgymus" ( a rare term used for clearly heard hyperactive "wave" of peristaltics which stops suddenly at a point that can be localized, usually in case of SBO). He just did not like the word, that was his single complain. I asked him how he would like to name the bowel sounds since they need to be documented; the answer was an angry "a fart" and I sure was complained about "not knowing even THAT much of English".

Also, during my ObGyn clinicals there was a noise about disciplining a very experienced nurse who could not hold herself from discouraging a new mom from naming her newborn girl "Latrina". The nurse visited Italy not long ago before that and so knew the meaning of the word ("a communal toilet room").

KatieMI, BSN, MSN, RN · Jul 18, 2016

There's a reason why the intubated, sedated, restrained ward of the state is the holy grail of patients!
My personal favorite recently was when a daughter who lived a grand total of three hours away called to check on her mom, who came to us from the nursing home for severe sepsis. Intubated, several pressors, trips to CT, etc., just a crazy busy patient. Daughter makes sure to mention she'll be up in a couple of weeks to see her mom, because she was "just" there and couldn't justify coming back so soon. Oh, and told me that I *HAD* to brush her hair because her hair got tangled so easily that it was just a total emergency if her hair didn't get brushed right away.
The first thing that almost leaped off my tongue was, "Want to make Mom a DNR and withdraw care? I'll be perfectly happy to brush her hair while I'm getting her ready for the morgue. I'll even use some detangler and make it smell good for the funeral home people."
The second thing was, "If you care so much about her hair, how about you come and brush it yourself?"
What I actually said was, "I'll do the best I can, but managing these machines and medications is taking up a lot of my time. If I have time, I will try to brush her hair."
Oh, and the patient family members who fired one of our awesome 40 year nurses because she said the word poop when discussing the substance that came out of their father's butt. Apparently calling it "poop" is disrespectful. I would have liked to ask, "Oh, do you prefer the S word instead? That's what I usually say!"

I found such "holding for that one thing" extremely common. It doesn't matter how important, non-important or clearly absurd the thing is; if it remains the last vestige the family/patient still able to control, they will hold on it to the crazy point. I'd seen insisting on turning the patient every 2 hours with time measured by sport seconds clock (i.e. turn has to be done sharp at 13.59.59); on playing gospel music very loudly at all times of the day and night; on keeping TV on one particular channel; on using only lotions and shampoos brought from home, and tons of others.

I usually assure people that, although we cannot guarantee anything, we will do whatever we can according to their wishes as long as they do not cross the borders of safety/common sense, and if they come to that, we think about accomodations whenever possible. The lover of gospel music got headphones, for example. If you give them even some small semblance of control, however idiotic it might look for us, they often become more open and trustful sooner, and after a little while they can be spoken with about real business, like DNR.

P.S. I will be thankful to the end of my life to the nurse who did not let other staff to cut off my beautiful long tresses and combed and braided them every her shift while I was in ICU. Much later, she told me that, while I was out and hooked to ECMO machine, she thought at least keeping me, as she put it, "presentable" should the worst thing happened. It did not happen, and it made things at least a little bit easier for me :)