Lame admit Dx's

jurbyjunk · May 17, 2002

I worked for several years on a mat/gyne unit. We used to get "Squirrely Shirley" admitted by her GP for "hyperemesis gravidarum". Shirley had no weight loss and no emesis, but we would have to start an IV on her.

She always started out in a 4 bed ward, but would 1) sleep all day and be awake all night, talking on the telephone, reading, ordering in pizza (!), 2) showering at all hours of the night, and 3) passing wind, if you know what I mean. Eventually her roomates couldn't stand her anymore and they would ask to have her moved to a private room, which is EXACTLY what Shirley had wanted to begin with.

One night, a friend of mine heard the shower running in Shirley's 4 bed ward. Dorothy opened the door and saw Shirley, lying on her back in the shower, legs up against the wall, sound asleep.

When her husband would visit, he would bring her flowers and "real food" from an expensive restaurant. Her "hyperemesis" would clear up and she would get discharged home. Several weeks later, she would be admitted again. This went on right through 3 pregnancies.

Finally, I had the "bed utilization" doc confront Squirrely Shirley's GP, who admitted that he would admit her for HG when she have a fight with her husband (!!!). The bed utilization doc told him that this was an acute care hospital not a social services agency. Fortunately, Shirley had her tubes tied after her 3rd baby.

jurbyjunk · May 17, 2002

Many years ago, I thought that I might try my hand at psych nursing. One night shift, I had to admit a late - 40s woman, committed by her GP. Her diagnosis: inability to sleep all night, hot flashes, irritability. I said, do you still have your periods? "Once in a while". After I finished admitting her, I said to the charge nurse "it sounds to me as if this lady needs a D&C and put on hormones. I'd say that she was menopausal". "Oh no" said the charge nurse, "menopause is a psychiatric condition according to the DSM". When I came to work the next night, the woman had gone to the OR for a D&C and then gone home with a prescription for HRT. So, is the DSM written by men?

jurbyjunk · May 17, 2002

Once had a patient tell me "my cookie hurts".

mother/babyRN, RN · May 17, 2002

Well, not long after graduation, I was working in a small community hospital-kind of a satellite unit to a larger facility and I noticed there were quite a few people coming in with the diagnosis of situational anxiety to pregnancy....Had no idea until a more seasoned nurse mentioned that was the code for abortion....Then we have threatened vs r/o spontaneous abortion...Hello??? And, even while doing critical care I did always have to chuckle at near syncope...We are ALL near syncope....

Nurse_Bonita · May 17, 2002

About two weeks ago we had a guy brought into our ER complaining of a belly ache and flatulance. I don't know who his MD is or what the MD was thinking, but they admitted this guy to CCU.

Ok, if I go to ER complaing of a belly ache and flatulance and perhaps throw belching in for good measure, are they gonna admit me too? :devil:

RNinICU · May 18, 2002

Several weeks ago we had a 42 year old admitted through the ED to our ICU with epiglotittis. According to the ENT guy who saw him on consult, it was strep throat.

mother/babyRN, RN · May 18, 2002

Ok, I am exhausted and what do I get for that????MANDATORY OVERTIME....Just can't win...

We induce because of all the reasons described above BUT GOD FORBID a pt comes in on the night shift with contx q 3 min as high as the reading will allow and huffing and puffing IF the damn cervix doesn't ripen to at LEAST 80 percent....OH yes, thats THIS week!

jevans · May 18, 2002

Hi

I've got one of my staff on long term sick with TATT

Took myself and many colleaques days to work out

j

kids · May 18, 2002

Originally posted by jevans
Hi
I've got one of my staff on long term sick with TATT
Took myself and many colleaques days to work out
j

NO FAIR!

I'm too tired to figure it out.

My plane leaves for Oklahoma in 60 hours and 38 minutes (but whos counting) and won't have any net access when I get there.

PLEASE....

what is TATT?

good grief! I cant believe I miscounted the time left!

okihusker · May 18, 2002

Admit ICU: DX Physical Exhaustion

(Guess I should have been admitted on some days too)

Transfer to Inpatient Mental Health Unit: DX: Major Depressive Episode, Partner Relational Distress, Suicide Gesture, and Bilateral Ingroing Toe Nail.

Admit General Medical Ward: DX: Social Admission

Admit ICU: DX Rule Out MI (the patient's symptom were electrical shock feelings that started in the chest and rushed to her head. Three to four of these 1-2 second episodes in 24 hours) Should have read Admit to Inpatient Psychiatric Unit: Axis II, Conversion Disorder.

Admit ICU: Palpatations, Rule Out Dysrhythmias (yes she was having frequent unifocal PVCs. After further enquiry by this RN, we discovered that she consumed 15-16 Mountain Dews a day and 2 to 3 liters of ice tea a day as well).

Pediatric Critical Care Columnist · May 19, 2002

I work in a pediatric ICU to which we are often required to admit patients inappropriately. We admit a significant number of post-op T&As, and we discharge an inordinately high number of patients directly home... We record all of our admits/transfers on an index card kept at the desk with the date, time and source of admission, patient's name, hospital number, diagnosis, physician, where they went from us and when they left. Recently I came back from a short vacation, and as is my habit, I checked the card to see what I missed. I nearly fainted when I saw, under "reason for admission" "ingrown toenail". Just when I think I've seen everything... :roll

jevans · May 21, 2002

TATT

Simple really TIRED ALL THE TIME