1. If you are on a zillion medications, write them all down on a piece of paper and give the triage nurse the list instead of sitting there trying to remember what all you take. And no, "this little white pill" does not help, or "it is a medicine for hight blood pressure".
2. Know what your allergic too. Telling me "some antibiotic" is not a good answer.
3. Telling me you are allergic to tylenol, ibuprofen, ultram, toradol, all NSAIDS, and telling me only dilaudid works for your hangnail pain will not fly with me. Or the doctor.
4. If you think your cough you had for three weeks is now an emergency at 2am, PLEASE leave your 5 kids at home so they are not ripping and tearing through all the cupboards and playing in the garbage cans.
5. If you come to the ED with any complaint pertaining to your lady parts ex: itchy, discharge, rash, lumps, bleeding etc, or c/o abd pain PLEASE FOR GOD'S SAKE WASH THAT THING! Is it to much to ask to put a little soap on a wash cloth and clean down there!
6. If when I ask you in my primary nursing exam "any illicit drug use"? Be honest. Because if you tell me "no" and your UDS lights up like a christmas tree I am going to be really Pi&&ed. Just be honest. I will find out the truth anyhow.
7. If when I ask you "do you take any medications?" or "did you take anything for pain?" and you reply "No" and the UDS comes back positive for oxycodone and or opiates, I am going to be pi$$ed you lied to me. Just tell me.
8. Please for the sake of everyone around you, get a shower! I understand we all don't feel like dressing up in our Sunday's best when we are sick but for goodness sake when the bottoms of your feet are so crusty black from DIRT and there is lice the size of cotton balls jumping around in your hair and I am sure your skin hasn't had contact with a bar of soap in MONTHS make me want to barf.
9. If your motives are clearly to score narcotics for the simple fact to get high, at least be smart about it. If you are going to prick your finger with a safety pin to drip blood in your ua to make it positive for blood to help your kidney stone act, please at least make sure your finger is done bleeding before you hand me the cup with your tampered specimen.
10. Please don't lie to me when I ask you if you drove before medicating you with narcotics. Then when you lie to me and say "my friend dropped me off" don't get mad when I call the police and have them sit in your driveway and wait for you after you pulled your iv out and sneaked out of the er, into your car and leave after you got what you were looking for. I was outside smoking and saw you. And I got your license plate number.
If you come WALKING into the ER don't be surprised when you are half-falling out of bed that I ask you to move yourself up in the stretcher...do NOT ask me to find a male nurse to LIFT YOU and move you up the bed...or I will laugh at you...and forgive me if I laugh harder when you ask for me to get the doctor to come help you!
Please do NOT come up to the desk in a huff when you find your elderly mom/dad/grandma/grandpa/etc. in 4-point restraints and tell me that I must be LAZY and that I should be sitting at their bedside at all times watching them instead of having them in restraints! Truth is, I found them standing with their legs stuck in the siderail pulling out their IV, telling me to 'get the hell out of my house'. This is an emergency department...I probably have 2 other patients doing the same thing and I can't be in 3 places at once!
Similarly, do not get upset with me if your 'angel' of a 14-year old is in 4-point restraints! Telling me they are a straight-A student does not negate the fact that they punched, kicked, or spit at the staff! You're probably not going to believe me...so you probably will also not believe that they are high on drugs or drunk or both!
Hmmmmm, must be a pretty small community that will send an officer to wait for an AMA patient to come home so the confirmation of drug use/driving can be confirmed.
My DH is a police officer. He has never been asked, nor does he have the time to stake-out someone's driveway in this manner. Just sayin...
unfortunately, in my facility many of the patients get away with saying they are allergic to every narcotic except Dilaudid. Then I have a patient just the other day that gets pis**** because I am not in his room exactly at 4 hours when his Dilaudid is "due". Excuse me, but #1, the medication is prn and NOT scheduled therefore I will not be in your room at the 4 hour mark...#2, even if it was scheduled, dont forget I have 5 other patients that also need me...and #3, when you are sitting there smiling and calm but are rating your pain a 10, doesnt look like you are in severe pain to me!
I had a patient recently in the ED, a 20 something young woman with c/o abdominal pain. She walked in, and clearly was capable of washing. When getting her ready for a pelvic, she said, "my thang is kinda ripe, I haven't had time to wash it lately". REALLY?? If I have time to eat, I have time to wash that thang!!!
L&D in one hospital required all patients to shower before they did anything else. It always cracked me up when we would take a labor patient to OB from ED, and the nurse was waiting with a smile on her face and pointed to the bathroom, asked the patient to shower, put on this nice clean gown and then she would be glad to help her get settled. I really wish we could do that in the ED!!
Due for an outpatient procedure, among the instructions - - "Please shower the night before if your procedure is scheduled in the morning, or in the morning if you are scheduled for afternoon. Use an anti-bacterial soap, and put on clean underwear and clothing."
And there is nothing wrong with handing someone a few wipes or washcloths and telling them to wash that 'thang'.
Further, I used to ask people if they took any meds that were not prescribed for them, or, if male, if they took any male-enhancement meds.
If they drank any EtOH, I started with 2 cases of beer/day, or 2quarts of whatever else. I usually got better answers than simply asking 'how much'. Few people will say they drink more than a 6-pack or a single bottle. I wanted to be prepared for the DT's.
unfortunately, in my facility many of the patients get away with saying they are allergic to every narcotic except Dilaudid. Then I have a patient just the other day that gets pis**** because I am not in his room exactly at 4 hours when his Dilaudid is "due". Excuse me, but #1, the medication is prn and NOT scheduled therefore I will not be in your room at the 4 hour mark...#2, even if it was scheduled, dont forget I have 5 other patients that also need me...and #3, when you are sitting there smiling and calm but are rating your pain a 10, doesnt look like you are in severe pain to me!
They are all lying. Plain and simple.
Anybody who claims this should be hooked to a cardiac monitor, have two large bore iv started, iv benedry, solumedrol and pepcid ready to go as well as sub q epi.
Then, give them a motrin. Assuming they don't go into anaphylaxis, give them a tylenol.
NOBODY is allergic to all non-narcotic pain releivers.
Specializes in Gerontology, Med surg, Home Health.
They are all lying. Plain and simple.
Anybody who claims this should be hooked to a cardiac monitor, have two large bore iv started, iv benedry, solumedrol and pepcid ready to go as well as sub q epi.
Then, give them a motrin. Assuming they don't go into anaphylaxis, give them a tylenol.
NOBODY is allergic to all non-narcotic pain releivers.
Not to change the subject, but there ARE people allergic to most if not all non narcotic pain meds....my mother was and she was not a drug seeker.
I remember one Halloween I had a patient who had altered mental status due to an acute onset of a disease process, and wow did I feel sorry for him ... Raggedy Ann put a Foley in him, his doctor was one of the Seven Dwarves, a guy dressed in prison garb put in his IV, and his nurse (me) was dressed in a bellydance costume .... I'm sure this did NOTHING for his tenuous grasp of reality! How bizarre.
This town isn't exactly "small" but not a large city either. We have a pretty good relationship with pd. This case was actually a rare occasion. This pt is a FF and often a trouble maker and is well known to us and PD. It wasn't only the case where he was looking for a fix (and unfortunatly got it) but then snuck out and drove on a suspended license. The officer was more than happy to go find this guy. Just so happens (I found out later) they didn't "camp out waiting for him" they busted him pulling into a local bar. Go figure.
I remember one Halloween I had a patient who had altered mental status due to an acute onset of a disease process, and wow did I feel sorry for him ... Raggedy Ann put a Foley in him, his doctor was one of the Seven Dwarves, a guy dressed in prison garb put in his IV, and his nurse (me) was dressed in a bellydance costume .... I'm sure this did NOTHING for his tenuous grasp of reality! How bizarre.
Thanks for sharing!
:yeah:
darkangel83
38 Posts
If you come WALKING into the ER don't be surprised when you are half-falling out of bed that I ask you to move yourself up in the stretcher...do NOT ask me to find a male nurse to LIFT YOU and move you up the bed...or I will laugh at you...and forgive me if I laugh harder when you ask for me to get the doctor to come help you!
Please do NOT come up to the desk in a huff when you find your elderly mom/dad/grandma/grandpa/etc. in 4-point restraints and tell me that I must be LAZY and that I should be sitting at their bedside at all times watching them instead of having them in restraints! Truth is, I found them standing with their legs stuck in the siderail pulling out their IV, telling me to 'get the hell out of my house'. This is an emergency department...I probably have 2 other patients doing the same thing and I can't be in 3 places at once!
Similarly, do not get upset with me if your 'angel' of a 14-year old is in 4-point restraints! Telling me they are a straight-A student does not negate the fact that they punched, kicked, or spit at the staff! You're probably not going to believe me...so you probably will also not believe that they are high on drugs or drunk or both!