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

redwinggirlie · Jun 13, 2005

I hear Kauai is nice this time of year....

lol..

schoona · Jun 13, 2005

Just as I was reading your rant, one turned up at triage!!. Is it we're not breeding them tough enough these days?But be consoled they're here in Oz as well.

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

SmilingBluEyes · Jun 13, 2005

We have had 'em come in time and again in ambulances for minor non-emergent complaints. They have no means of transportation, no bus passes, no money for a cab---and no one to call for a ride (You mean to say you have no friends or family with a car?!).

But what they do have are several kids already, and one on the way--and a real good firm understanding of how to "use the system" w/o being equally-aware of their responsibilities. Yanno, that makes me crazy, too. :rolleyes:

z's playa · Jun 13, 2005

I have no problems with coming to the ER for migraines, unless you want to tell me, and people have, 'I'm allergic to all non-narcotic pain relievers'.
Actually, if you have a true migraine, 10mg of IV reglan is a miracle worker. I've seen it time and time again. It doesn't work po or im, so you have to have an IV to get it. Even if you need pain management for migraine, it's cool so long as it's not your 5th time this week. (if you're having them that badly, you need to see YOUR doc sometime in there, yeah??).
As far as the sick ER doc - that's BS to say that because a doc chose not to get care, it's our fault cause 'we have an attitude'. Docs are more likely than anyone to think that nothing can go wrong with them. That is such a bad example.
~faith,
Timothy.

Actually, if you have a true migraine, 10mg of IV reglan is a miracle worker.

But...doesn't work for everyone. True migraine or not.

I agree if you're in the ER 5x in one week you need to see your doc. Pronto. :)

Z

z's playa · Jun 13, 2005

I totally agree that a rant's a rant. I'm sorry if it sounds like I'm not recognizing that. It's too darn easy to get drawn into a debate though. Am I right? I'll watch it. Bad Z.

Rant away. I'm all 'eyes'.

Z

babyktchr, BSN, RN · Jun 14, 2005

Makes me think of a time I went to the ED for the migraine of all migraines. I lived right across the street from the hospital and I walked over there and announced my presence to the triage nurse and rather quickly told her that I was indeed drug seeking...and any narcotic would do...any route she cared to give it to me...just get rid of this pain. I was seen by ED doc who reminded me of Joe Pesci...and he proceeded to look in my eyes with the bright light, to which I grabbed his arm and said..don't do that. Covering his bases he ordered a CT scan to rule out that pesky aneurysm. Well...they WALKED me to CT and when I was done, they asked me if I could find my way back and there I went, walking thru the ED looking for my cubby. I guess I was safe in assuming they found no aneurysm. I ended up with two percocet. As I left, I asked DR. Pesci about my BP which was 190/89...(which is waaaaaaaay high for me) and he told me it was because I had a sweater on. :uhoh3: I know I know... it is not keeping with the topic....but I will keep the reglan thing in mind.

z's playa · Jun 14, 2005

Makes me think of a time I went to the ED for the migraine of all migraines. I lived right across the street from the hospital and I walked over there and announced my presence to the triage nurse and rather quickly told her that I was indeed drug seeking...and any narcotic would do...any route she cared to give it to me...just get rid of this pain. I was seen by ED doc who reminded me of Joe Pesci...and he proceeded to look in my eyes with the bright light, to which I grabbed his arm and said..don't do that. Covering his bases he ordered a CT scan to rule out that pesky aneurysm. Well...they WALKED me to CT and when I was done, they asked me if I could find my way back and there I went, walking thru the ED looking for my cubby. I guess I was safe in assuming they found no aneurysm. I ended up with two percocet. As I left, I asked DR. Pesci about my BP which was 190/89...(which is waaaaaaaay high for me) and he told me it was because I had a sweater on. I know I know... it is not keeping with the topic....but I will keep the reglan thing in mind.

rather quickly told her that I was indeed drug seeking...and any narcotic would do...any route she cared to give it to me...just get rid of this pain

Nothing like being up front about it. Kudos to you. I would never have the guts to say that. :) Although I hope it wasn't the reason you got treated like caca.

So...how'd those 2 percocet work for you or do I need to ask? :rolleyes: I can't believe that. 2 percocet. Your BP is high because you're HOT? Doctors really don't like to have anything pointed out to them do they? They'll skirt around it and pretend it's no biggie even if it has the potential.

Ok ok.....we gotta get back on topic. We're sorry to the OP and others. :)

Z

babyktchr, BSN, RN · Jun 14, 2005

rather quickly told her that I was indeed drug seeking...and any narcotic would do...any route she cared to give it to me...just get rid of this pain
Nothing like being up front about it. Kudos to you. I would never have the guts to say that. :) Although I hope it wasn't the reason you got treated like caca.
So...how'd those 2 percocet work for you or do I need to ask? I can't believe that. 2 percocet. Your BP is high because you're HOT? Doctors really don't like to have anything pointed out to them do they? They'll skirt around it and pretend it's no biggie even if it has the potential.
Ok ok.....we gotta get back on topic. We're sorry to the OP and others. :)
Z

No problem z's...I am the OP

SmilingBluEyes · Jun 14, 2005

Migraines, yep I know em. There are times I would pay the Devil himself to help me get rid of em......I can sympathize totally. And treatments are borderline helpful at most. The only OTC I find that helps Benedryl, 50mg. Sucks cause they totally knock me on my tush.

ZASHAGALKA, RN · Jun 14, 2005

Regarding: 'I'm drug-seeking!' for a migraine: I'm a believer. 1st law of ICU (my main work unit): if in doubt, gork 'em out.

The ER rants in this OB thread (OK, it WAS a rant about inappropriate use of the system, and the ER is KING) were about misusing the ER.

a migraine isn't misusing the ER. The people we 'tag' as migraine 'drug-seekers' have a long proven history of being drug-seeking. These are the ones that have a horrible migraine until they get their meds, and then 5 minutes later, they are looking for a way to get away. A true migraine patient isn't cured in 5 minutes, regardless how powerful the dope. And once the pain recedes, a true migraine is soooo thankful, they want to shake everybody's hand, not slink out the ambulance bay doors. Know what I mean? Just because you come to the ER for a migraine doesn't mean we think you're a junky. It's when you start to act like a junky that we think you're a junky.

Another thing: a true migraine sufferer with a long history of it has a FP trying everything to find a fix. In other words, If I see Ms. X for a migraine, and we give her demerol and send her home cause her imitrex didn't work, then the next time she comes, there is at least evidence she's doing something else to try to head them off, "my doc is trying drug Y, and it worked a few times, but isn't working anymore" -- You can bet the drug seekers haven't seen a FP in the 27 hrs since the last time they were here.

There ARE some drug seekers that pretend migraines for med: that make all true migraines suffererers feel like nobody believes they are really hurting. But in my experience, we give the benefit of the doubt until there is no doubt. It's unfair to have to feel that way, but hey, I pay my child support faithfully, the kids are with me half time, I pay for xmas, eyeglasses, dentists, 1/2 of clothes, 1/2 school lunches, 1/2 musical intruments, etc., and the deadbeats still give ME a bad name. So I can relate.

But I just want to point out one more time - nobody in here was ranting about coming to the ER for migraines. I don't have migraines, but I did have viral meningitis once - and I'd of given my first born for pain relief - that's something I DO have empathy about.

~faith,

Timothy.

z's playa · Jun 14, 2005

No problem z's...I am the OP

Doh !!!!! :smackingf

Z

elizabells, BSN, RN · Jun 14, 2005

Hey y'all-

Yay ranting! Just wanted to point one leetle thing out. I imagine I would be utterly frustrated by the "well, it's hurt for months but I thought I'd come in tonight..." issue, but on the flip side, I've had chronic pain from RA for a long time, and sometimes you just emotionally break down, and then going to the ER seems legit in your panicked "oh my god am I going to be like this forever I'm only X years old I don't want to live like this oh god make it better or just kill me now please" frame of mind. I've never personally hit the ER in that state, but I imagine someone might. Please keep in mind that I'm NOT saying this as a rant buzzkill, I'm only butting in bc sometimes people w/o chronic pain don't have a frame of reference for this seemingly bizarre behavior. I also know the real chronic pain sufferers are the exception, and you guys deal with the seekers mostly.

Carry on. :chuckle