Most annoying reason for admission?

gonzo1, ASN, RN · Mar 1, 2015

It seems like a great number of our patients shouldn't be admitted. But I have decided to embrace the crazyness and just be happy I have a good job. If only the patients that really needed us got admitted most of us would be laid off.

RN_2012, BSN, RN · Mar 1, 2015

I work at a rural hospital and I feel like we admit patients for just about anything...
(Ex.- patient with COPD c/o being out of breath when walking long distances up an incline [sats are WDL otherwise and while in ER])
While I can rationalize a patient being admitted for SOB or something r/t a chronic illness if it is r/t ABCs in any way (regardless if it is a chronic or expected issue) there are some reasons for admissions that drive me CRAZY!
For example "malaise". Really?
The MOST frustrating admitting dx to me is constipation. I mean really? You haven't gone poo in 3 days? Wow, me neither!...(yea probably TMI but working 4 12s and not eating healthy can do that to ya...) But i'm not going to the damn ER am I?
So you're being admitted and i'm going to give you mineral oil/ an enema/ whatever (stuff you can do at HOME) while I have other patients that need actually medical nursing care....
Maybe after drinking a bottle of milk of magnesia for a week and still having trouble i can take you seriously...But really, being admitted as an inpatient for CONSTIPATION just drives me crazy....
(this is regarding average people who do not have any other illness/are not taking opiates or other drugs that can cause constipation)
Am I the only one that is bothered by this?
Am I a horrible nurse for being annoyed by this?
Is there any admitting dx that irks you??

Sure there are some that irk me, but they are what keep me working...small rural hospitals can't be too picky and keep census.

UnbrokenRN09, BSN · Mar 1, 2015

AMS on a pt with known dementia. "Well, it just seemed worse today". Then the family member coming up with 50 different ways to ask why the pt is confused. (after a negative CT scan, negative for UTI, etc). And they're usually 80-90 something and FULL CODE.

NurseSpeedy, ADN, LPN, RN · Mar 1, 2015

I worked for a facility with this "rule" too (every fall is an ER visit-forgot to quote earlier post). What they failed to tell the residents and their POA is that they can refuse and there's not a darn thing the facility can do about it, except document the heck out of what happened and that they were urged to go to ER, that they also refused the ambulance that the facility called (yes, they made us waste their time too),etc. very few people knew that they couldn't be forced to seek medical attention

kgoode0919 · Mar 1, 2015

I had one for "fever". Her temp was 100.0 Also had another for "weakness and diarrhea" for a 60yo. Really? Take some Imodium and drink fluids! He wasn't even dehydrated...

wanderlustnurse88, RN · Mar 1, 2015

Pre-syncope. Normal BPs. We get a lot of transfers of waiting for LTC from other hospitals. We just had someone over a year on our floor before finally being able to go to LTC. It's frustrating when most of the medical floor is filled with these people and we cannot admit people from ER with acute medical conditions.

allnurses Guide · Mar 1, 2015

Worst admission I ever had was a patient with advanced Alzheimer's who had a fall. Patient was a DNR and had the kind of dementia that resulted in extreme fear/terror and violent combativeness as a result. The patient's workup was negative. Doc admitted the patient "to give her a liter of fluid". I kid you not. One liter. The patient pulled out every IV and was terrified, dangerously combative, a huge fall risk and, as is typical, strong as an ox. The daughter was crying and begging them not to admit her. The ER nurse was stuck with this patient for ten hours awaiting a bed, which made her day a living nightmare as well as the patient's day. I continue to wonder (seethe?) why we admitted her and why they didn't just give the liter in the ER and send her back to her memory care assisted living. She never did get that liter of fluid. Could not keep a line in her long enough and no orders granted for restraints. She would not take anything PO (though apparently she would where she lived). IM meds just seemed to agitate her more. It was all so dramatically, ethically, morally wrong. It still bothers me thinking about it. They discharged her early the next morning after a horrible, horrible night.

allnurses Guide · Mar 1, 2015

I work on a certified stroke unit and get admits for UTIs on 80 y/o people all the time. MRI is negative, no deficits except confusion, CT scan negative, etc. After a few rounds of IV antibiotics they improve. It is exasperating.

This one I at least understand due to how quickly they go into urosespsis.

imintrouble, BSN, RN · Mar 1, 2015

Rural hospitals have to be creative with admits in order to keep us open and employed.

I just wish they'd staff us well enough to take care of all those unnecessary admits.

N/V/D with no N/V/D the entire time they're inpatient. Just because the patient said so.

malamud69, BSN, RN · Mar 1, 2015

Our system is Broken!

MD and hospital are afraid of lawsuits

Of course this is absurd!

Once again the USA rears its head as a toddler when it comes to healthcare.

sistrmoon, BSN, RN · Mar 1, 2015

The ones that annoy me are the transfers from smaller hospitals for IV antibiotics for like UTI or pneumonia. Really? You don't do IV antibiotics?

Abdominal pain is one I dread. Seems to often be someone with multiple abdominal surgeries and/or inflammatory bowel disorder, long list and big plastic bag full of home meds to count and lock up, demanding, particular, runs you all night, sent from ED with no pain or nausea meds given or ordered.

JMCP · Mar 1, 2015

as an aside: you sn is hakunamatata and here you are ranting and annoyed

anyway! the hospital needs to make money. i worked at a hospital where for any reason they could justify using the ct scan, they would! omg, everyone knew about that...but hey... the radiologists would say, thats the hospital's money maker.

I'm sure the hospital just wants the census to go up.... constipation lol