Jump to content

Same patient's over and over again

Posted

Specializes in med-tele/ER. Has 39 years experience.

Do you ever get to work, look at your assignment and have your heart sink because you know the patient's by name?

My last few shifts I have had the same alcoholic on my assignment :banghead:. A person I have detoxed so many times . I know alcoholism is a disease, but sometimes I consider becoming a traveling nurse to get away from taking care of the same people for years on end.

Dixielee, BSN, RN

Specializes in ER. Has 38 years experience.

That's a great advantage of working in the ED! Yes, you may see the same person from time to time, but chances are, they will come back in someone else's room :yeah:

MattNurse, MSN, RN

Specializes in med-tele/ER. Has 39 years experience.

That's a great advantage of working in the ED! Yes, you may see the same person from time to time, but chances are, they will come back in someone else's room :yeah:

I work in the ED from time to time and not kidding I had one guy come back 3 times in one 12 hour shift. He kept walking out AMA and calling 911 from the corner. He was mad that EMS was putting him in the waiting room for his non-emergent head lac.

I work on a unit and have found that we have ones that seem to keep coming back over and over again. So often that we don't even find the humor in it anymore. You do your best to educate them and their families but really feel it falls on deaf ears and in a week or two they'll be back in with the same problem. Not sure how much plainer we can make it. You might love the high sodium foods but your CHF doesn't.:nono:

So true, my ER co-pay is $325.00,I'd have to be a millionaire to beable to come into the ER as much as these people do. I see some ofthe same patients who make 20 to30 visits a year alone in our ER. During that year you have towonder what other ER's they visitas well.

Dixielee, BSN, RN

Specializes in ER. Has 38 years experience.

I work in the ED from time to time and not kidding I had one guy come back 3 times in one 12 hour shift. He kept walking out AMA and calling 911 from the corner. He was mad that EMS was putting him in the waiting room for his non-emergent head lac.

Yep, I know that guy too!! I have had them go straight back to the triage line from the discharge area because they didn't get the drugs they wanted, so they start over hoping they can get a sympathetic doc. These folks don't plan on paying their bills anyway, so it's like playing the lottery to them!

MattNurse, MSN, RN

Specializes in med-tele/ER. Has 39 years experience.

There should be some sort of consequence, otherwise why would they modify their behaviors. Yet I never hear the lawmakers complain about chronic abusers of the system and the general population probably has no idea who their taxes support.

Sun0408, ASN, RN

Specializes in Trauma Surgical ICU. Has 4 years experience.

One of the main reasons I left my renal floor.. same pts month after month. I moved to the ICU.. We rarely see the same pt twice :)

Dixielee, BSN, RN

Specializes in ER. Has 38 years experience.

There should be some sort of consequence, otherwise why would they modify their behaviors. Yet I never hear the lawmakers complain about chronic abusers of the system and the general population probably has no idea who their taxes support.

We (society and the system) have removed personal responsibility from the equation, but that is another whole debate!! :)

MattNurse, MSN, RN

Specializes in med-tele/ER. Has 39 years experience.

One of the main reasons I left my renal floor.. same pts month after month. I moved to the ICU.. We rarely see the same pt twice :)

Good suggestion, I was considering moving into the NICU, they never come back.

amoLucia

Specializes in LTC.

I hear you Matt. Frequent flyer syndrome is so disheartening to the staff esp. when we look at our tax $$$ at work. You have a lot of supporters out here.

GitanoRN, BSN, MSN, RN

Specializes in Trauma, ER, ICU, CCU, PACU, GI, Cardiology, OR. Has 52 years experience.

most hospitals have been hesitant to address the situation of repeated patients, in part because federal law requires doctors to treat anyone who turns up at ed. consequently, a small fraction of people who visit the ed each year account for a huge percentage of the costs in emergency care. having said that, this is true of healthcare in general and it's known colloquially as frequent fliers, these individuals visit the er repeatedly throughout the year, because they’re chronically ill, uninsured or alone or a combination of all three. furthermore, often these patients visit ed several times a day because they know how to work the system, and don't give up until they are admitted to their choice of unit. in conclusion, i recall seeing one pt. in particular that visited ed with all different ailments over a period of 6 times within 48hrs. just to get admitted :uhoh21:

Edited by GitanoRN

MattNurse, MSN, RN

Specializes in med-tele/ER. Has 39 years experience.

It gets worse every year and the patient's are getting younger.

nerdtonurse?, BSN, RN

Specializes in ICU, Telemetry.

Same here. We get the same redneck DKA patients who have no intention of ever changing their behaviors when we can "fix" them every 2-3 weeks. And when we start chopping off their feet, or putting them on dialysis, that's okay, too, because everyone else in their family has amputations and dialysis -- it's their norm. And they make your life living you-know-what on shift, because they treat you like a maid/waitress.

Or the chronic DT patients, who come in, get put on a vent so they don't beat us to death, we dry them out, they leave AMA once the vent's gone, never do any follow up with mental health, wouldn't go to an AA meeting if you held a gun to their head, but sure enough, here they come again with their tale of woe once a month (when the money/drugs/booze runs out). I had one AMA out on me at 5 am, and he was sitting beside the ABC store as I drove past on the way home, waiting for them to open.

I hate getting anyone as a patient under 50, because unless they're post-op/MVA, they are usually either DKA, OD, or DTs. They suck the soul out of you. It really depresses me when I have a bunch of those in a row -- these are people that you can't help, don't want help, actively avoid help, but show up for their free stay like clockwork and treat you like dirt. But when it's my turn for medicare, there won't be any, because we'll have spent the money on these folks. And then they'll want to kill the rest of us because they don't get their freebies anymore....

PeepnBiscuitsRN

Specializes in OB (with a history of cardiac).

Yes yes yes! We have had people get discharged, go outside, have a smoke and come back in howling that they're in 10/10 pain- wait, no- THEY CAN'T BREATHE...actually, it's more like, um...CHEST PAIN! All over, pain all over, they can't point out a specific place, but they're in PAIN! And the doctors and nurses are so CRUEL! They're withholding pain medicine from them, why?!! *SOB* it hurts so much...I-I can't bear it....I need a boxed lunch too... make sure there's Oreo's in there this time! Ooooooooooo!

Ever see those little computer generated cartoons on YouTube? They must have been created by real nurses and doctors because they're so spot on, I seriously spent 2 hours watching them and laughing so hard I nearly wet myself.

Dixielee, BSN, RN

Specializes in ER. Has 38 years experience.

We had a guy yesterday who was a gunshot wound "victim" (once you met him, you understood why), who was admitted 3 days prior to trauma ICU on a vent. Extubated quickly, went to floor where he signed out AMA as soon as he could ambulate. He went back to the same place he was shot in the first place, was assaulted by someone using a metal pipe, and came back to the ED, intubated, with a skull fracture. Of course, he will survive this and return again and again. He has come in as a code trauma 3 times in the past 18 months. Sigh.....yes, our tax dollars at work! I'm certain he is just delightful when he is not intubated!

amoLucia

Specializes in LTC.

I too spent hours watching those little cartoons (I need oxycontin, I need oxycontin, do you have any oxycontin?) They should be mandatory viewing for all! This would be all too funny if it wasn't so serious.

AgentBeast, BSN, RN

Specializes in Cardiology and ER Nursing. Has 7 years experience.

Try working geri psych. The patients come in, get probated, get forced meds, get well enough to be discharged, go off their meds, and the whole cycle repeats itself over and over and over and over and over and over ect.