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.
