a rant (pts come to hospital for the littlest of things)

[babyktchr]

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?

Thanks for listening

[RNKitty]

I really like the concept posted that my empathy is a comodity! :)

[SmilingBluEyes]

The header says "A Rant".

Which means that we will be reading a rant.

Not a well thoughtout, both sides of the story...reasoning out, of a situation. But a diatribe on a bad night/week/month of someone's job. One of those things that we do to eleviate burning out due to the stupidity of the job.

We all have horror stories of the person that nearly or did die from a misdiagnosis from the ER/MD/Clinic. Why does that occur? Because the ER is a lousy place to get continuity of care..it is for acute emergencies only...your PCP is the best person for continuity of care.

I come from a military family where you do not see an MD unless you are projectile vomiting/bleeding out a liter or more/have a temp>103. This philosophy nearly killed me during chemo, when anything over a temp of 100.5 is sign of a lifethreatening infection.

Later in life, I got bitten by a raccoon in area with a known rabies outbreak...I actually called the Insurance company/ER to see if it rated as an emergency to go to the ER or could wait to see my MD. Yes, it did, yet the ER did not start rabies prophylaxis..they wanted to wait 10 days to see if animal control found a raccoon!!!!! (Yes, I just know I can personally ID the exact raccoon that bit me....NOT). They prescribed a pain med that was not available in a 3 county radius and an antibiotic that was not readily available. I also developed sepsis within 18 hours of the bite..scarring from the infection was later found by CT on my lungs, spleen, liver.

Some people use the ER responsibly...some do not. The fallout harms all of us.

But we still all need to vent ocasionally. I doubt if any of us are utterly heartless..we just need to vent ocasionally.

I agree. I think it stinks we can't rant about our frustrations w/o someone trying to teach us a lesson about compassion/empathy or a lecture. :uhoh21:

[pattymwrn]

I agree. I think it stinks we can't rant about our frustrations w/o someone trying to teach us a lesson about compassion/empathy or a lecture. :uhoh21:

After reading over most of the posts, I think you are right. The title of the thread being a rant, I now wish I would have kept my "two cents" out of it. The last thing any of us need when we feel the need to rant is a lecture...Guess I let my personal experiences get the best of me....Rant on, undisturbed...we all have the right...:)

[Mulan]

I never did find out! The ER doctor did at least rule out pregnancy/ miscarriage. When I saw my GYN, she said that it would be very difficult to determine a cause after the incident. I guess it was nothing serious (hopefully) as I've had 3 pregnancies since then and no abnormal tests or anything. Actually I was wondering if it might have been caused by an allergy to latex.:imbar

That's interesting. I never would have thought about latex.

[babyktchr, BSN, RN]

You know...I posted cause I needed to vent frustations....with the "system", with patients...with everything. It distresses me to see that some take it so personally and feel the need to cut down any attempt to detatch from the job. I would find it hard to believe that anyone..and I mean ANYONE, can say they don't feel frustration and/or anger towards anything mentioned here. If you can, then I commend you on your mental health and your ablility to let things slide. It certainly has NOTHING to do with the ability to empathize and be compassionate...and I for one do not need or desire a lecture in how to be either. There are those out there who use the system...as well as those who don't use the brains God gave them. I am certainly guilty of not using my head from time to time. I posted a "rant" for just that reason. For one moment, I wanted to ventilate and see how many out there may feel the same way. There are many out there that do, I surmise. This site gives us the opportunity to do so...and with a broad spectrum of experiences, locations, specialties and expertise.

I really thought it would be a cool thing to give the community a chance to rant away. For those that don't agree..just move on..and let those who feel the need...do it.

By the by...I am still looking for vacation plans. Perhaps that is a thread unto itself!!!!!

[bluesky, BSN, RN]

I never said anyone was not being compassionate. A few weeks ago, before this Dr. died, I wouldn't have even posted to this thread and I haven't to similar threads in the past. In fact, I probably ranted myself with the best of them in the past. This one experience has changed me however and I am just as entitled to express my opinion on the subject as you are to rant in the first place... it's that whole freedom of speech thing, remember?

[UM Review RN, ASN, RN]

The header says "A Rant".

Which means that we will be reading a rant.

But we still all need to vent ocasionally. I doubt if any of us are utterly heartless..we just need to vent ocasionally.

For my part, I understand that it's a rant.

Years ago, we used to get frustrated and rant about patients being on the call light all the time for symptoms we could do little about. It helped to find out that the patients' symptoms were a real indication that something was indeed wrong.

In other words, the need to rant might be taken away if we could all actually be able to believe that people are not drug- or attention-seeking when they come to the ER.

Wasn't trying to lecture. Just trying to open your mind to the fact that sometimes the dx is missed. Sometimes I really wish I could call the ER nurse back a day or two later and give them some kind of follow-up, because some of the things that we've found coincidentally have shocked the most seasoned of us. Meanwhile, without the update, the ER nurse is going to stick by her original assumption that nothing was wrong in the first place.

This is not a blame-placing thing. It's not about "what got missed," or who to blame. It's about teaching ourselves about how fragile and how fallible our system can be for some people sometimes.

Instead of allowing myself to get frustrated and rant away (which actually increases stress sometimes, rather than relieving it), I simply tell myself--and the patient--that we weren't able to find the cause this time, but that doesn't mean "it was nothing."

Especially regarding the patients with potential TIAs or MIs.

[Dayray, RN]

I can jump on this band wagon. Sometimes it is frustrating.

the other day 23 weeker comes in by ambulance complaining of leakeing fluid. Nitrozine negative so we do a spec exam when the doc puts in the spec guess what comes gushign out? sperm. "umm when was the last time you had intercourse?", "just before I saw the fluid come out" this was just about the time her FOC shows up. He had drove himself in after helping her into the ambulance. What can you do?

Sometimes I feel bad for them becuse they really dont know any better and this kind of stuff can be embarrasing I just wish they woudlent take the ambulance.

Anotehr funny one. I can actualy see why this lady came in she was 36 weeks and had intense upper right quaderant pain. I put her on the monitor and palpated her belly. Upper right quatederant was tempanic when percussed. "what did you for lunch?" "baked beans and hot dogs" "please turn on your right side". I rubbed her belly a littel and did some light taping after which she very loudly passed gas and was ready to go home. Poor thing was quite embarrased. Lol

[SmilingBluEyes]

I think I feel like many others here: I have no problem whatsoever with people coming and getting seen. People have every right to expect compassionate, empathetic and competent care when they need it. No one here disputes that.

I do have a HUGE problem w/those who abuse the system constantly or refuse to accept the education we try and provide them----or are criminally non-participative in their own care. THAT infuriates me.......

And I agree with the point someone made; ED is NOT the place to get routine care, but emergent. The abuse of our ED's is epidemic and costing all of us dearly. The ED is not the place to get small things cared for but that is just what it's being used for due to non-access to routine preventive care. But that is another thread, is it not?

Anyhooo....if someone wants to rake me over the coals for that, so be it. I can take it. (grin) This thread was not started to slam on people needing legitimate care or as a request to be reminded we are to be patient advocates. It was just a rant.....and well-taken, at least, by me. :)

[babyktchr, BSN, RN]

I think I feel like many others here: I have no problem whatsoever with people coming and getting seen. People have every right to expect compassionate, empathetic and competent care when they need it. No one here disputes that.

I do have a HUGE problem w/those who abuse the system constantly or refuse to accept the education we try and provide them----or are criminally non-participative in their own care. THAT infuriates me.......

And I agree with the point someone made; ED is NOT the place to get routine care, but emergent. The abuse of our ED's is epidemic and costing all of us dearly. The ED is not the place to get small things cared for but that is just what it's being used for due to non-access to routine preventive care. But that is another thread, is it not?

Anyhooo....if someone wants to rake me over the coals for that, so be it. I can take it. (grin) This thread was not started to slam on people needing legitimate care or as a request to be reminded we are to be patient advocates. It was just a rant.....and well-taken, at least, by me. :)

Why why why do they call an ambulance for that????

[nurse_wannabe]

the other day 23 weeker comes in by ambulance complaining of leakeing fluid. Nitrozine negative so we do a spec exam when the doc puts in the spec guess what comes gushign out? sperm. "umm when was the last time you had intercourse?", "just before I saw the fluid come out"

Un-freakin'-believable.

[pricklypear]

Why why why do they call an ambulance for that????

Shoot...we had a guy come in by ambulance with friction burns on his...umm...organ. He "had no idea" how they got there, just that it hurt! Real bad.