JWaldron

Pretty sad. I hated it when those frequent fliers wold come in, the ones who really knew how to make you look bad. Would complain dramatically of chest pain at the doorway on their third visit of the day, exhibit severe symptoms of Dying Swan Syndrome, always when the place was jammed, and would make a loud fuss when you more or less ignored them to take care of the REAL emergencies. The other patients always look at you like you have no compassion and no judgment but they have no idea what the real problems are w/ these patients. "I'm dying! I'm dying! Won't nobody take care of me? I'm having a heart attack, I can't breathe, I'll be dead before I even see the doctor...' Why is it that they always have such carrying voices? I want to be one of them when I grow up! That or a circus clown. come to think of it, maybe they're one and the same? Right now I work on a unit which has the highest patient satisfaction scores for similar units (P M & R) in the entire state; we have plenty of difficult patients too, and plenty w/ DSS symptoms, but the other patients get to see that that's the problem and how difficult it is to deal effectively w/ some of these people. We do have our own psychologist, and that helps. We sure could have used one in the ER! Savvy

bet she really wanted her brows plucked, or a bikini wax! savvy

Oh, yeah, I remember on of those. Most expensive manicure she ever had when the doc cut her fake nail off. I'm quite sure her insurer rejected that claim! Came by ambulance, too! Savvy

Your post reminded me of the time I got 'corrected' for a data entry I DIDN'T make - and it would have been pretty strange if I had. I had a patient who was a left BKA and a right AKA, and I didn't enter a height for him! Should I have entered his current height? On his right side or on his left? Or his reported height before the first surgery, or before the second? (I just got a dirty look when I asked ) Savvy

She came to my ER too! >laugh Savvy

Oh-Oh! That's dangerous. You should have done something! Many years ago when I still worked in the ED, we had a young guy come into the dept. several days running, w/ that complaint. The doc told him each time that we weren't there to treat his pimples, and sent him on his way. On about the 5th day, he went into a local store, took a hostage, walked the guy down the street to the local church, held him there for a couple of hours, then shot him in the face, and then killed himself in front of the alter. We really should have squeezed his pimple. (The guy he shot had a through and through GSW of the maxillary sinuses, eventually recovered, and did very well, though it took a long while.) Savvy

And I love the 'balony amputation' I've seen a couple of times. It fits right in w/ Eurospesis. Gotta love those folks in Admitting. Oh, that's right, it's called 'Patient Access' now, whatever that means. Savvy

Awful. When I still worked in the ED, we had a self-castration too. Guy felt that sexual thoughts were the work of the devil, and he was going to see to it that the devil couldn't drive him to sin. Extremely religions man, by all accounts. Somehow, I don't think this is what God wanted him to do... I was not on that day, but he apparently did a pretty nice clean surgical job! It's hard to imagine what kind of inner voices drive someone to do such a thing. I have a schizophrenic family member and have a great deal of sympathy, but sure can't say I understand! Savvy

These are the same ones who want to know when meals are, and how soon the TV can be turned on as soon as they get to their rooms, too.http://images.allnurses.com/smilies/angryfire.gif --- And then there was the guy who arrived by ambulance, got off the stretcher and walked into the waiting room to the vending machine for a sandwich - his whole reason for coming was to get a sandwich from the machine, and he didn't have the $$ for a cab and didn't want to walk! And THEN he wanted the ambulance to take him back home! And the teenage girl who came in on...guess...Christmas Day, wanting her earlobe sewn back together - more than a year after she caught her earring with her hairbrush and pulled it thru the lobe, ripping it. She was not happy when the doc told her that was an unrealistic expectation... Savvy

I've seen adm. Dx like this too, and they make me laugh. how about Eurosepsis, or Baloney Amputation, two of my favorites! Savvy

I work in an IRF in a hospital, a 32-bed unit. Occasionally we have 33 patients overnight. The RNS and LPNs work 12 hr shifts and the aids work 8 hour shifts. usually we have 8 or 9 patients on the 7A-7P shift and the 7P-7A shift will have about 10 or 11 patients each. Nurses and aids usually each have about the same number of patients. If there is a charge who has a lighter assignment, that's the only time the nurses and aids may not have the same numbers. We just recently went from 8 hrs to 12 hrs for the nurses; I was working the 3-11 shift, and I have to say that I experienced much more teamwork between the aids and the nurses on that shift than I do working with the day aids. Just a cultural difference between shifts, maybe, but I spend much more time toileting patients, etc, when I need to be doing meds, dressings, treatments, etc, and it is frustrating. 15 patients for one CNA is a lot if the patients need a lot of care, and you are toileting them, showering many of them, dressing many of them in the AM before therapy, etc. Rehab patients are all sicker and sicker, just like all in-patients, but if these are SNF-level, maybe this is a pretty normal level. That I don't know about. For acute care, it's a very heavy load. Can you file an unsafe staffing report? Some facilities (union, mostly) have those, many don't. Savvy

Well, I DID have a patient come back from the OR w/ an order for foley to intermittent wall suction...and an NGT to bedside gravity drainage! Maybe the doc's mind and fingers weren't working at the same speed? Savvy

Haven't you heard people say they have to go so bad their eyeballs are turning yellow? This is one way of dealing w/ the situation! Savvy

Just last night at work I checked an H&P - the admitting Dx was CVA, but the history stated that the patient tripped and fell at home, hit his head, had a subdural hematoma, a subarachnoid hemorrhage, a non-displace occipital fx...and NO mention of a CVA anywhere in the history. TBI or CHI alone would have been good enough to get this guy into RHB, where I work - the doc didn't have to find some Dx that wasn't substantiated by the hx! The surgical history, Item 2. was "Awake, alert and oriented repaired in 2003." Maybe a lobotomy?? It must have worked, whatever it was, because this poor guy has no retention of anything, and can't seem to remember much of the past either. Savvy

BUT: ERs have to treat all, regardless of ability to pay. Urgicenters don't. Sounds to me like a job for a social worker in conjunction w/ ER staff, maybe a PA. But there will always be abusers like this. And they are very good at making big scenes so that everyone around can hear and see and think "Oh, those heartless hospital people..." and not recognise the abuse for what it is. Savvy