Have you noticed that people can't be sick anymore? Lately I have noticed that folks come to the hospital for the littlest of things. I threw up twice today, I have a headache...did you take anything...no....when I raise my arm like this it hurts...and of course you want to say so bad...well don't do that. I see this increasing in pregnant women. They come in at all hours with minor stuff...or with stuff that has been going on for WEEKS and then decide to come in.
We get overflow med/surg in our women's health area, and there has been an increase in admissions for abdominal pain, short term observation. They have a stomach ache!!! No white count, every scan imaginable has been ordered and negative, but they stay overnight with dilaudid ordered for their pain. I tell you, I could be bleeding from my eyes and I would not get admitted to the hospital. The other thorn for me is lap chole's. I had one last year. My surgery was at 0830 and I was HOME by noon. I was waking up from anesthesia and they were putting on my underwear giving me instructions to go home. Now I see this influx of short term observ. lap choles that stay cause PACU isn't open after whatever time and well...instead of just recovering them and sending them home...they stay. Low and behold they are getting big pain meds and need help every single time they get out of bed cause the PAIN...oh my gosh the PAIN. I find now I can't take care of them because I just find it too much to deal with...lol. I want to say look sister....I was home 2 1/2 hours after my surgery and I had to make do...you can too. But, that is me.
This is just a rant. I know somewhere I can rationalize everything I mentioned. It just really gets to me sometimes. ARGH. Double ARGH.
Anyone else get this way? Or am I just really in dire need of a vacation?
I get that too. Even when all labs, scans, etc are normal, the patient c/o such awful pain, and says that we better find out what's wrong and fix it. When the patient is being discharged because the doctor found nothing wrong with them, and offers otc tylenol or motrin for pain, the patient gets hysterical and refuses to be discharged. Try telling the patient that insurance won't pay does no good.
After a few hours of battling a patient that way, I called the doctor who said:
Fine, tell her if she does insist on staying, that there are no more orders. If she gets hungry, she may want her family to bring in some food. If she thinks she might start hurting, they should also bring in the tylenol or motrin.
Needless to say, after telling the patient what the doctor had to say, she managed to "allow" a discharge within 20 minutes.
....never did find anything wrong with her....
It does happen that things are missed..sometimes for years even if a pt gets the million dollar work up. What if the pt was genuinly fearful of any more pain and actually really panicked because of it? If she were in real pain regardless of the docs not finding anything concrete..how would the staff feel about the way she was treated in the end?
How does ayone know if nothing was ever found? Why would she go back to your hospital where she was tossed out after nothing was found?
Unless she was known for hystrionics. It isn't mentioned in your post though.
well not to hijack the thread, but Howard Community College in Columbia.
But on the thread: my favorite ER triage: 2 yr old boy, hoping around, into this, into that, completely negative assessment, 2:30 am: 'what's the matter with your son?', 'he threw up', 'how many times?', 'once.', 'what was he doing before he threw up', 'sleeping', 'what was he doing before he went to sleep', 'oh, he was fine then', 'so, let me understand, your son was fine before bed, woke up, threw up once, is fine now, and you brought him to the ER', 'yes, and who gets this' - as she hands me her Medicaid card.
You know I had to bite my tongue from saying, 'we all do'.
I'm a big hearted person, our gov't has the means to make sure that nobody goes hungry or uncared for - but if my tax dollars is paying for your food (don't get me started on the corporate welfare that is foodstamps), or your healthcare, then you shouldn't get it better than me.
AND I WOULD HAVE TO PAY 100 DOLLAR DEDUCTIBLE ON MY INSURANCE FOR THE ABOVE ENCOUNTER!!!!!!! Which of course is why I wouldn't have brought my child in -- evaluating the cost for your actions eliminates alot of stupidity.
And removing the cost for stupidity is ummmmm STUPID!
As an ER doc I know would say: proof positive why we need lifeguards at the gene pool. . .
All these examples are why I'm getting ready to take a week of vacation, then I start a new job in a new specialty, then I'm going on another two weeks of "real" vacation in FL!!!
It does happen that things are missed..sometimes for years even if a pt gets the million dollar work up. What if the pt was genuinly fearful of any more pain and actually really panicked because of it? If she were in real pain regardless of the docs not finding anything concrete..how would the staff feel about the way she was treated in the end?
This is exactly what I thought when I read that post. Many times doctors do not pinpoint what the problem is, especially ER docs. When I was in my teens, I ended up in the ER with very heavy lady partsl bleeding. ER doc checked me out, said he couldn't tell where the blood was coming from. That's it, sorry we couldn't help you, have a good life. I lost so much blood that I lost consciousness. To this day I still wonder about what happened. I guess if there was no objective data to back up my claims of cramping, I would have been labeled a drug-seeker, drama queen, attention-seeker, or worse.
I can see that you other night nurses share my frustration with those who don't seem to know why they are there at 3:30 am for something that has been going on for hours or days or forever. "What made you come in tonight? Right now?" I actually have them tell me, "I don't know." OK, I have to spend time taking care of you to rule out valid reasons why you should be here when I should be helping people who are here FOR A REASON and then call your doc and wake him up at 4am to tell him you are here, there is nothing wrong with you, can I send you home.
I also love the ones who come in repeatedly FOR NOTHING. They're 25 weeks pregnant and we already recognize them by sight. Bad Omen.
This is exactly what I thought when I read that post. Many times doctors do not pinpoint what the problem is, especially ER docs. When I was in my teens, I ended up in the ER with very heavy lady partsl bleeding. ER doc checked me out, said he couldn't tell where the blood was coming from. That's it, sorry we couldn't help you, have a good life. I lost so much blood that I lost consciousness. To this day I still wonder about what happened. I guess if there was no objective data to back up my claims of cramping, I would have been labeled a drug-seeker, drama queen, attention-seeker, or worse.
I don't claim to to know the details of your particular situation, but wanted to add some food for thought...
It isn't uncommon to leave the ED without a specific diagnosis. I've admitted and discharged many a patient with "Abd Pain, Etiology Unk" listed as their diagnosis. I realize it's frustrating...you have a problem, you want to know what it is and have it fixed. Often times the ED is the place to have things ruled out or excluded rather than pinpointed!
1. All recieve medicaid (not a slam 'cause I'm about 1 paycheck away from that myself) but it really creates an attitude where the person doesn't have to worry or even think about how to pay for this ER (or whatever) run. No, with my kiddos I have to really evaluate things before I spend the $$, it can usually wait until a Dr appt the next day.
2. Drama, drama, drama. All these people are drama queens/kings, addicted to it and the attention.
Such empathy....I hope I never have to visit the ER for what you think are the "wrong reasons".
You have to realize that the ER is the MOST expensive Dr's visit. It is very frustrating for people (who work hard and pay out of pocket for medical insurance and only utilize the system if it is truly necessary) to take care of someone who abuses the EMS/ER system.
One patient, who I knew on site from 24 weeks gestation, would come in by ambulance every time. Her mother would follow her in her car and sit with her, so it is not like she didn't have a ride. One night she came by ambulance at 2230 C/O abdominal pain. When did it start? "Oh, I've had it off and on since 0630 and while I was at the casino tonight I decided I better come in to have it checked out. :angryfire
Don't get down on us about empathy. We are ranting here because we are professionals and can't actually say all that we would like to the actual patient.
That's it, sorry we couldn't help you, have a good life. I lost so much blood that I lost consciousness. To this day I still wonder about what happened. I guess if there was no objective data to back up my claims of cramping, I would have been labeled a drug-seeker, drama queen, attention-seeker, or worse.
z's playa
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It does happen that things are missed..sometimes for years even if a pt gets the million dollar work up. What if the pt was genuinly fearful of any more pain and actually really panicked because of it? If she were in real pain regardless of the docs not finding anything concrete..how would the staff feel about the way she was treated in the end?
How does ayone know if nothing was ever found? Why would she go back to your hospital where she was tossed out after nothing was found?
Unless she was known for hystrionics. It isn't mentioned in your post though.
Back to regular programming. :)