Patients who want to be admitted for minor things

[Emergent, RN]

We had a patient the other day whose ankle was still hurting after a minor accident the day before. He has already been seen, the splint that was put on bothered him so he removed it. History of previous ankle problems. Our most generous doc was on, he first prescribed percs. Pt refused, he said dilaudid that he got the day before worked the best. He got IM dilauded. He got another x-ray, no fracture. Somewhere along the way, I mentioned about discharge. He said that, oh no, he didn't see how he could manage at home, he expected to be admitted. Middle class, retired guy, by the way, in his 60s, brought in by family member who lives a few blocks away.

He insisted, then, that IV dilaudid is the only thing that would kill his pain. He got an IV, got several doses of dilaudid. Sent family member home saying that he would likely be admitted. I spoke to him of the fact that he doesn't meet criteria, he argued and whined. Doc came and reiterated. He argued and whined. Finally he demanded to speak to administration (3 AM in morning) Nursing Supervisor sent in, 15 minute session with her.

Finally got him out the door, I was amazed! I cooed and sympathized all the way to the lobby where he waited for his BIL. Was so happy to be rid of the unrealistic pest.

Would love to hear your stories!

[TheGooch]

People think a hospital stay is like staying at the Hilton until they actually need to be admitted for some reason. Then they see just how un-Hilton like it really is with the noise and not being waited on like king/queen because there is always someone else who is worse than you and requires more attention.

[BabyRN2Be]

There was a time in which physicians were fairly liberal in their admissions. I'd guess that some of the older generations still think that a very minor ailment will score an admission. I'm referring to the days where hospitals were more like Hiltons.

[llg, PhD, RN]

Older man, retired, living alone ... may just have needed to feel "cared for." Perhaps he was a widower not accustomed to having to fend for himself when sick or lonely. Feeling alone, mobility impaired, and in pain might have intensified his feelings of grief and loneliness to the point that he wanted admitted so that someone -- anyone -- would care for him.

He might not have needed admitted for his physical ailments, but he needed to TLC for his psycho-social needs.

I feel sorry for the guy -- just wanted someone to care about him enough to take care of him when he was alone and hurt.

[iluvgusgus]

llg, Psh he just wanted dilaudid.

[Emergent, RN]

The fellow lived 4 blocks away from his sister, with whom he was "very close". Was brought in by his very kind and patient appearing brother-in-law.

This fellow had a whiny, needy personality. He was a successful retired fellow with a nice motorhome, boat, and two failed marriages. Maybe they failed for a reason.

[psu_213, BSN, RN]

I had a healthy man in his early 20s with N/V. + relief with Zofran. Passed PO challenge. Went in to discharge him. He tells me, "I was thinking about what the doctor said about being discharged, but I think I should be admitted. I mean, what happens if I go home and vomit again later?" I so wanted to tell him "well then, I guess you better have a basin nearby just in case." Thankfully the doctor did not cave on the discharge.

[ChristineN, BSN, RN]

I had a healthy man in his early 20s with N/V. + relief with Zofran. Passed PO challenge. Went in to discharge him. He tells me, "I was thinking about what the doctor said about being discharged, but I think I should be admitted. I mean, what happens if I go home and vomit again later?" I so wanted to tell him "well then, I guess you better have a basin nearby just in case." Thankfully the doctor did not cave on the discharge.

That's what a script for Zofran is for.

[sissiesmama, ASN, RN]

I had a healthy man in his early 20s with N/V. + relief with Zofran. Passed PO challenge. Went in to discharge him. He tells me, "I was thinking about what the doctor said about being discharged, but I think I should be admitted. I mean, what happens if I go home and vomit again later?" I so wanted to tell him "well then, I guess you better have a basin nearby just in case." Thankfully the doctor did not cave on the discharge.

Oh yeah! We'll even send u home with a new emesis basin for when u get home - just in case. That's what I finally had to tell one patient when they were trying not to go home - said their emesis basin was "contaminated" after using it twice in the ER that day.

Anne, RNC

[TheGooch]

The fellow lived 4 blocks away from his sister, with whom he was "very close". Was brought in by his very kind and patient appearing brother-in-law.

This fellow had a whiny, needy personality. He was a successful retired fellow with a nice motorhome, boat, and two failed marriages. Maybe they failed for a reason.

With a sense of entitlement too.

[llg, PhD, RN]

llg, Psh he just wanted dilaudid.

Maybe ... but how did he get to that point?

I'm not saying that he should be admitted -- just that there might be a lot going on with him that the OP did not share -- or did not know.

[Ruby Vee, BSN]

I'm just remembering having my boobs lopped off as an outpatient. I knew I wasn't being admitted. Hard for me to have even a little sympathy for a guy who wants to be admitted for a sore ankle!