Of your patient load..

TheCommuter, BSN, RN · Mar 28, 2015

I work at a specialty post-acute rehabilitation hospital. The majority of our patients are there to obtain intensive rehab after having had major CVAs, orthopedic surgeries, COPD exacerbation, pneumonia, etc.

Many of our patients are frequent flyers who are constantly being readmitted. And other than the patients whose disease processes are hereditary or due to accidents, a large percentage of our patients end up in our beds due to lifestyle issues.

Libby1987 · Mar 28, 2015

There used to be a 50-60 yr gap between me and a majority of my patients. That gap has pretty much closed, and I'm not 80.

anon456, BSN, RN · Mar 29, 2015

I work peds and it's a whole different ballgame.

Gooselady, BSN, RN · Mar 29, 2015

..how would you divide your patients between the kind of patients you went to school for, the unreasonable and rude, the poor self care and not going to change, and the hopeless but family are in denial types? (Am I missing a major category?)

I think I understand what you mean :) but in the final analysis, we went to school to deal with ALL of them

When we opine about what we were 'meant' to do from nursing school is another one of those 'Welcome to Real Life in Nursing' wake-up calls every nurse just has to get used to. If a doctor calls them a patient, then we went to school to be their nurse. I'm not defending the scoundrels, malingerers and non-compliants at all. Just noting they are there and ain't goin' away any time soon.

Nursing school inadequately prepares us to deal with the social, emotional and interpersonal complexities. It can't really be expected to. "Nursing school" never really ends, if you ask me :)

dirtyhippiegirl, BSN, RN · Mar 29, 2015

There's a neat biography called The Horse and Buggy Doctor that I stumbled across a few years ago by a country physician who worked from the late 1800s into the 1930s.

Everything that we whine about today - malingerers, non-compliant patients, sicker patients surviving longer, bedside time decreasing - all get a healthy mentioning. He talks quite a bit about the new generation of patients being more whiny and needy than the last. And this was over 100 years ago. Some things really don't change.

(I also like to bring up this book when physicians get all misty eyed thinking about ye Libertian utopia of ole where everyone paid in cash for services rendered.)

Libby1987 · Mar 29, 2015

I think I understand what you mean :) but in the final analysis, we went to school to deal with ALL of them
When we opine about what we were 'meant' to do from nursing school is another one of those 'Welcome to Real Life in Nursing' wake-up calls every nurse just has to get used to. If a doctor calls them a patient, then we went to school to be their nurse. I'm not defending the scoundrels, malingerers and non-compliants at all. Just noting they are there and ain't goin' away any time soon.
Nursing school inadequately prepares us to deal with the social, emotional and interpersonal complexities. It can't really be expected to. "Nursing school" never really ends, if you ask me :)

I realize all of that and don't disagree at all, but really wasn't what my question was about. Am I understanding that you don't think I should ask the question?

The question comes reading posts that hinge on the type of patients being assigned that have me wondering just what the ratio actually is, roughly speaking. Maybe one drug seeker feels like "most" patients after a tough shift. Or the ICU having so many cases being strung along that have no hope. Or being hand maiden to entitled patients and family. Or maybe "most" isn't an exaggeration. That's why I'm asking. I'd like to know what it's like outside of my patient population.

(The patients we thought about in nursing school being the ones with whom we perceive we're making a difference.)

Anna Flaxis, BSN, RN · Mar 29, 2015

I guess I wasn't under any illusions in nursing school about the types of people I'd be providing care for. There is a huge diversity in the human population, and each person and their circumstances and life experience are unique. People end up in front of me for a variety of reasons, from what we call "non-compliance", to lifestyle choices, to just plain ol bad luck.

I work in an ER, so I see a little bit of everything.

Libby1987 · Mar 29, 2015

I guess I wasn't under any illusions in nursing school about the types of people I'd be providing care for. There is a huge diversity in the human population, and each person and their circumstances and life experience are unique. People end up in front of me for a variety of reasons, from what we call "non-compliance", to lifestyle choices, to just plain ol bad luck.
I work in an ER, so I see a little bit of everything.

My question wasn't intended to make it about who nurses went to school for but to provide a simple broad definition of a patient group.

Anna Flaxis, BSN, RN · Mar 29, 2015

My question wasn't intended to make it about who nurses went to school for but to provide a simple broad definition of a patient group.

That's the thing. We see sick and injured people from all walks of life, and each has a unique individual set of circumstances. I couldn't give you a simple broad definition for something so varied and complex.

I could tell you that most of our patients are ESI Level 3 and 4, that most of them are members of the small community where our hospital is located, and that many use our ER for convenience because of the limited hours of operation of the one Urgent Care center in town, or that they can't get in to see a PCP in a timely fashion, or that they just don't know the difference between sick and not sick.

As far as judging whether the person is sick because of their own choices, well, much of the chronic illness in the US is related to lifestyle, and yes, we see that reflected in the ED.

Libby1987 · Mar 29, 2015

That's the thing. We see sick and injured people from all walks of life, and each has a unique individual set of circumstances. I couldn't give you a simple broad definition for something so varied and complex.
I could tell you that most of our patients are ESI Level 3 and 4, that most of them are members of the small community where our hospital is located, and that many use our ER for convenience because of the limited hours of operation of the one Urgent Care center in town, or that they can't get in to see a PCP in a timely fashion, or that they just don't know the difference between sick and not sick.
As far as judging whether the person is sick because of their own choices, well, much of the chronic illness in the US is related to lifestyle, and yes, we see that reflected in the ED.

That's similar to our community.

The majority of my patient population is receptive to teaching. Lifestyle might have gotten them there but most IME don't blow off their end of responsibility. I haven't yet got to the point that most of my work is futile as it's very much in the minority, from the venting posts here, that doesn't seem to be everyone's experience.

JoseQuinones · Mar 29, 2015

The ones that really puzzle me are the patients who come to chat about politics. I am not kidding. There's a knot of old gents who sit in the waiting room of my ER on Friday evenings to watch the TV and chat about politics. If we ask them to leave, one of them will show a foot ulcer or a "suspicious" mole he's come to get checked out and of course the rest are just there to support him as family. (Everyone repeat after me: "The client's family is whoever they say their family is.") Last week they brought dominoes.