a rant (pts come to hospital for the littlest of things)

Morning-glory · Jun 9, 2005

I think a vacation is in order. When they start getting under my skin, it's time for me to go. I get what you're saying though. I had a lap chole last year and I was home before I had a chance to wake up. Went home, slept some more, woke up feeling great. Post op day 3-4 were tough but I kept going.

I had one overnight for a wrist fracture. Let's just cast it and send him home. Or appy's that hang around because they are having so much pain. Look buddy, you had your operation a week ago and your mom and girlfriend are fluffing your pillows, emptying your urinal (???) you're 19 years old, get out of here already. Of course your having pain, you haven't moved all week. I sent his family home after telling them that any other patient would be doing all this stuff for themselves the day after surgery, and he could certainly get up to use the bathroom without making a big production out of it. He was gone the next day because he didn't want me getting him out of bed again that night. Why the docs let him stay so long is beyond me.

A shift or 2 off will do you wonders!!

Enjoy!

1Tulip · Jun 9, 2005

Yeah, this day surgery thing seems strange.

I had jaw surgery and it was pretty painful, but opiates are opiates. I don't think they work better just because a nurse hands them to you. Problem with me was they had to put me under pretty deep to get some muscle relaxation. One doctor pulled the jaw out while the other rebuilt the TMJ using a muscle flap from my forehead. I managed to get home, but then couldn't pee for four days.

(Wanna know how much the ER charges to put in a foley and send you home?)

Having said that... I wouldn't have wanted to be in the hospital (where I could get cystitis with the REALLY bad bugs.) Nor would I have wanted to have my liquid meals prepared by hospital dietary. So... why are these folks being admitted? What is the attraction?

pricklypear · Jun 9, 2005

This is exactly why I would never work ER (at least the one at my hospital!). I would lose it after the 3rd "I've had this cough for about 6 weeks, and tonight I coughed up some green stuff." Yes, but why did you come to the ER? "Because of the green stuff." Do you have any pain? "No" Have you had a fever? "A fever? I don't think so." and so on... I love the ones who come in on the Monday night of a long weekend with "a stomach ache and a headache. Oh, and I need a note from the doctor to my boss, I'll never make it to work tomorrow." AGGGGGGGGGGGGGG!!!

Tulip - 1) to get out of work, taking care of kids, etc

2) attention

SmilingBluEyes · Jun 9, 2005

Well I can relate. We see all kinds of things in OB that could really be taken care of at home IF a person had any common sense and self-control. I also noticed it's the ones who have little to no means to pay their bills who seem to come in the most for the pettiest things. It really gets on my last nerve.....ah well, I won't expand on that, hijacking the thread. I do understand what you are saying, however. Maybe you DO need a vacation. These things can get to anyone.

amber1142 · Jun 10, 2005

Low and behold they are getting big pain meds and need help every single time they get out of bed cause the PAIN...oh my gosh the PAIN. I find now I can't take care of them because I just find it too much to deal with...lol. I want to say look sister....I was home 2 1/2 hours after my surgery and I had to make do...you can too. But, that is me.

I feel that way when I see a woman who is 2-cm dilated, early labor, carrying on about the PAIN. I had all four of mine naturally, and yeah, it hurt, but I survived (more than survived, I TRIUMPHED). So I just want to tell them, "Oh, don't be so dramatic!" or "Snap out of it!" (But that wouldn't be "therapeutic".) I guess this should go in the thread about speaking our minds for one day.

:chuckle

Luv2BAnurse · Jun 10, 2005

I get that too. Even when all labs, scans, etc are normal, the patient c/o such awful pain, and says that we better find out what's wrong and fix it. When the patient is being discharged because the doctor found nothing wrong with them, and offers otc tylenol or motrin for pain, the patient gets hysterical and refuses to be discharged. Try telling the patient that insurance won't pay does no good.

After a few hours of battling a patient that way, I called the doctor who said:

Fine, tell her if she does insist on staying, that there are no more orders. If she gets hungry, she may want her family to bring in some food. If she thinks she might start hurting, they should also bring in the tylenol or motrin.

Needless to say, after telling the patient what the doctor had to say, she managed to "allow" a discharge within 20 minutes.

....never did find anything wrong with her....

tryingtomakeit, RN · Jun 10, 2005

I had a patient (23 weeks pregnant) come in the other night because her "bellybutton is sore" !!!!!!!!

FarmgrrlRN · Jun 10, 2005

Have you noticed that people can't be sick anymore? Lately I have noticed that folks come to the hospital for the littlest of things. I threw up twice today, I have a headache...did you take anything...no....when I raise my arm like this it hurts...and of course you want to say so bad...well don't do that. I see this increasing in pregnant women. They come in at all hours with minor stuff...or with stuff that has been going on for WEEKS and then decide to come in.
We get overflow med/surg in our women's health area, and there has been an increase in admissions for abdominal pain, short term observation. They have a stomach ache!!! No white count, every scan imaginable has been ordered and negative, but they stay overnight with dilaudid ordered for their pain. I tell you, I could be bleeding from my eyes and I would not get admitted to the hospital. The other thorn for me is lap chole's. I had one last year. My surgery was at 0830 and I was HOME by noon. I was waking up from anesthesia and they were putting on my underwear giving me instructions to go home. Now I see this influx of short term observ. lap choles that stay cause PACU isn't open after whatever time and well...instead of just recovering them and sending them home...they stay. Low and behold they are getting big pain meds and need help every single time they get out of bed cause the PAIN...oh my gosh the PAIN. I find now I can't take care of them because I just find it too much to deal with...lol. I want to say look sister....I was home 2 1/2 hours after my surgery and I had to make do...you can too. But, that is me.
This is just a rant. I know somewhere I can rationalize everything I mentioned. It just really gets to me sometimes. ARGH. Double ARGH.
Anyone else get this way? Or am I just really in dire need of a vacation?
Thanks for listening

Unfortunately you had to "make do" d/t insurance.... I personally feel its ridiculous to make 4 incisions (though small, they are painful) in a pt's abdomen, remove an organ and send them on their way out the door. I had one 2 years ago...stayed as an outpt b/c my surgeon was 5 hours behind schedule, at which point my mom was refusing to take me home that night (imagine driving home at 7:30pm, 25 minute drive, get me in the door, then to Eckerd to drop off the Rx and back before the pain really kicks in)...got my self a second night in the hospital (not my choice) b/c of nausea & vomiting issues...

ZASHAGALKA, RN · Jun 10, 2005

ER triage: 'my back hurts', 'how long has it hurt', 'six months', 'does it hurt worse tonight', 'no', 'what made you decide to seek treatment at 330 am tonight', 'I thought maybe I should get it checked out . . .'

Or suicide watches when little girl took 5 xanax cause bf broke up with her and can't figure out why she's only sleepy. Have to bite your tongue to keep from saying either 'grow up', or worse, 'next time dearie, take a bunch of your granny's beta blockers. . .'

there you go.

~faith

Katnip, RN · Jun 10, 2005

"I'm six weeks pregnant. I threw up twice today."

ZASHAGALKA, RN · Jun 10, 2005

Cybercat:

Oh wow, I hope your stomach settles.

Where are you going to nursing school? I went to nursing school in MD.

~faith