End of the day, lots of things going on and its time to pass meds.
Pt. calls me in his room to ask me a question. Scene: Pt. standing at bedside, hand out with paper wadded up in it, face innocent and childlike, very casual mannerisms. Tells me: "I put this in my butt, and now when I poop there is a little blood."
OK
Ummmmm............
Well.................
Checked for rectal bleeding, nothing active. Inform attending and get the H/H order I want. Go through all the formal things (document etc) AND SPEND SOME TIME DOING PT EDUCATION ON WHY WE DON'T PUT FOREIGN OBJECTS IN OUR BUTTS.
Pt calls me in the room to ask me a question again. This time it is "I know I can't put things in my butt.............and I won't, but does my finger count?"
OK
Ummmm............
Well............
More education provided ON WHY WE DON'T PUT FOREIGN OBJECTS, INCLUDING OUR FINGER, IN OUR BUTTS.
Passing meds. I have gotten everything under control, everyone else if fine. Yes, I know I know, I am such an intolerant nurse. I saved this guys meds for last.
What does he say to me? That he want to take all his meds as suppositories. ALL of them.
If you think that is made up...no way...I totally believe it....I have seen some doozies coming in from the ER...."Removal of Foreign Body..." under Anesthesia...people are sick, sick, sick....
When my wife was a young, innocent ER nurse, a dude came into her ER with an, um...a sex toy...stuck in his rectum.
She asked the ER doc..."How are we going to get it out?"
He replied? "Get it out? Why would we do that? He just wants the batteries changed!"
Yes. All kidding aside, as I mentioned before, although it is a funny story to laugh at, it is tragic at the same time.
This may all be a cry for help. More than likely he has some disorder (eh, well, duh.............YA THINK) that makes him act this way. He has no insurance though and tends to be a needy pt. He is the type of pt. that is given the minimal help then pushed out the door VERY quickly by case management and the manager............and the nurses too. So, this personality/mental disorder continues to have "the other check" turned to it as we place profit and our desire to be rid of his behavior above the need to do something for him.
I'm afraid to say, on this level, I failed my pt. I could have advocated for a psych. consult at least. It would have done him a world of good I am sure. If not, who knows, maybe it might have been the beginning of his recovery at least. But, instead, I'm afraid he will be pushed out the door quickly only to return in another month with a new medical condition and the same behavior.
Specializes in multispecialty ICU, SICU including CV.
Yes. All kidding aside, as I mentioned before, although it is a funny story to laugh at, it is tragic at the same time.
This may all be a cry for help. More than likely he has some disorder (eh, well, duh.............YA THINK) that makes him act this way. He has no insurance though and tends to be a needy pt. He is the type of pt. that is given the minimal help then pushed out the door VERY quickly by case management and the manager............and the nurses too. So, this personality/mental disorder continues to have "the other check" turned to it as we place profit and our desire to be rid of his behavior above the need to do something for him.
I'm afraid to say, on this level, I failed my pt. I could have advocated for a psych. consult at least. It would have done him a world of good I am sure. If not, who knows, maybe it might have been the beginning of his recovery at least. But, instead, I'm afraid he will be pushed out the door quickly only to return in another month with a new medical condition and the same behavior.
Don't beat yourself up over this. Hindsight is 20/20. Some days it is all we can do to provide safe care. Getting psych on board for this guy probably would have taken X amount of time out of your day, and some days, we just don't have it. Remember, hospitals are a 24 hour operation. You were not the only one involved in his care. Someone else could have done this, too.
Myself personally -- I would have told the guy that NO, you can't put your oral meds up your butt, because they don't absorb that way -- and then I would have told him that he can put whatever he wants up his butt on his own time, but not his pills, on my watch. (Yes, I know I shouldn't work in psych.) You spent a lot longer with this guy than I would have.
whichone'spink, BSN, RN
1,473 Posts
Hey remember the SNL sketch "Appalachian Emergency Room". There would always be one guy who would have something up his rectum.