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OK, don't sweat small stuff about patients, especially from glasshouse

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by Emergent Emergent (Member)

Emergent has 25 years experience .

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Ok, this is a vent. At the end of my really, really long shift with OT, finally got the Locum ER to drag her slowpoke fanny in to see an 11 yr old patient.  The patient happened to be the child of one of the housekeepers, the humblest and nicest guy in the world. 

So, she (ER doc) comes out of the room asking if we have chewable Ibuprofen. I tell her no, but we have liquid. Then she goes on a rant that this 11 yr old doesn't know how to swallow pills as if her parents have committed a crime. I said, why not just give the liquid? Then she wants me to crush a pill because "this child is adult sized and would need 20 ml of the liquid!" 😱

OMG. I told her that that doesn't sound like very much. She continued to agonize over the fact that the nicest people in the world hadn't taught their child to swallow pills. When I left she still hadn't ordered anything. 

Why do doctors and nurses think they have to reform patients or their families over every little thing? What a waste of energy. Just give the poor kid the liquid Ibuprofen! 

End of rant.

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Pixie.RN has 18 years experience as a MSN, RN, EMT-P and specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN.

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Been there, done that. I have had adult patients who are terrible pill takers, too. I tell them to practice with M&Ms, but in the meantime, we have liquid. 20ml is not huge, that is just four of those little 5ml individual Motrin cups. Someone needs to get some perspective! 

I hope you have some days off, @Emergent

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Daisy4RN has 20 years experience and specializes in Travel, Home Health, Med-Surg.

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Agree, what's the big deal, give the kid the liquid and be done with it. And, how does that Doc know the parents havent tried anyway. I couldn't swallow pills as a kid either, and believe me my Mom tried because it was a pain to smash them. And believe me I tried also because it was gross/nasty tasting to take pills smashed up on a spoon with a little water on it. I tried and eventually taught myself but think I gagged myself in the process until I was about 17yo or so. Yea, give the kid a break!

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Davey Do has 35 years experience and specializes in Psych, CD, HH, Admin, LTC, OR, ER, Med Surge.

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12 hours ago, Emergent said:

 (ER doc) goes on a rant that this 11 yr old doesn't know how to swallow pills as if her parents have committed a crime.

Perhaps you need to post this in the ER, Emergent, so all are aware.

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Davey Do has 35 years experience and specializes in Psych, CD, HH, Admin, LTC, OR, ER, Med Surge.

14 Followers; 1 Article; 75,365 Visitors; 6,081 Posts

12 hours ago, Emergent said:

"this child is adult sized and would need 20 ml of the liquid!"

You know, we all could learn from this ER doc...

584629246_20ml2.jpg.b591d6180a83e7293a53e37eb3147dd8.jpg

 

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1 Follower; 44,513 Visitors; 3,043 Posts

It's the reason behind the saying to walk a mile in someone's shoes before you judge them. Even small stuff like this.

Especially when it comes to parenting and children.

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CelticGoddess has 6 years experience as a BSN, RN and specializes in Palliative, Onc, Med-Surg, Home Hospice.

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On 6/1/2019 at 2:25 PM, Emergent said:

Ok, this is a vent. At the end of my really, really long shift with OT, finally got the Locum ER to drag her slowpoke fanny in to see an 11 yr old patient.  The patient happened to be the child of one of the housekeepers, the humblest and nicest guy in the world. 

So, she (ER doc) comes out of the room asking if we have chewable Ibuprofen. I tell her no, but we have liquid. Then she goes on a rant that this 11 yr old doesn't know how to swallow pills as if her parents have committed a crime. I said, why not just give the liquid? Then she wants me to crush a pill because "this child is adult sized and would need 20 ml of the liquid!" 😱

OMG. I told her that that doesn't sound like very much. She continued to agonize over the fact that the nicest people in the world hadn't taught their child to swallow pills. When I left she still hadn't ordered anything. 

Why do doctors and nurses think they have to reform patients or their families over every little thing? What a waste of energy. Just give the poor kid the liquid Ibuprofen! 

End of rant.

That ED doc would really freak out over my nephew.  He was an adult (like 20 or so) before he was able to swallow pills.  He had been on liquid metoprolol since he was 8yo.  Until he was able to successfully swallow pills.  trust me, his mother and father both tried to teach home how to swallow pills.  This is also the same child who struggled with straws until he was a teen.  

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9 Followers; 22,974 Visitors; 3,036 Posts

Often enough these are simply healthy kids who have had to take very little medication in their lives.

Geez. If that is upsetting....welcome to someone's miserable life, I guess!

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VivaLasViejas has 20 years experience as a ASN, RN and specializes in LTC, assisted living, med-surg, psych.

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4 hours ago, JKL33 said:

 

Geez. If that is upsetting....welcome to someone's miserable life, I guess!

I know, right? I have a 30-year-old who STILL can't swallow pills very well. I can imagine what that doctor's reaction would have been if he showed up in her ER.

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Davey Do has 35 years experience and specializes in Psych, CD, HH, Admin, LTC, OR, ER, Med Surge.

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5 hours ago, JKL33 said:

Geez. If that is upsetting....welcome to someone's miserable life, I guess!

Very astute of you, JKL.

There's probably something else going on in this ER doc's life and her coping mechanisms are sub-par.

It's amazing how people with high intellectual function can have the ability to cope with stress akin to that of a two year old prone to temper tantrums.

It seems that often when someone who has experienced intense stress relive that experience with lesser stressors.

Case in point: Years ago, an intelligent, hard-working fella, Mitch, who was a really nice guy worked in the Intake Center at WRMC. Mitch was a Viet Nam Vet who had to deal with some horrible situations during his  tour of duty. He was very capable, but would spaz out in stressful situations, and had to be  put on a benzodiazepine anti-anxiety while working at Wrongway so he could fruitfully function.

It was almost like a relatively minor stressful experience caused him to react like he would to an intensely stressful one. 

Anyway, concepts like this one help me to have empathy for others in such situations. You know- "There for the grace of God go I"?

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Not only was I a bad pill taker as a child but I had been known to take off out of the room, and out the door if I could make it if the word "injection" came up when I was a kid.

Anyhow, somewhere in my travels, a nurse once told me to take the pill with some water, lean my head toward my chest downward (which seems counter- intuative) but the pill floats to the top of the water in the back of your throat and then just swallow. I also think it helps to take a drink of water first so your mouth isn't so dry. It actually works quite well and I have taught some other reluctant pill takers to do the same.

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BiscuitRN has 4 years experience as a BSN, RN.

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As a school nurse I can say that only about half of my 11 year olds can swallow pills.  I don't mind having to give larger amounts of liquid medication.  I do mind when they don't tell me they can't swallow pills then try and shoot the pill and water across the room and spent 5 minutes coughing.

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