Ok here is another thread we can hopefully get going for nurse veterans and young nurses to see what's to come. What are some of the craziest chief complaints or diagnosis you have seen. I don't want to limit it to chief complaint because that tends to be associated with only emergency.
I could name so many but to start the 2 that made me roll my eyes and say Seriously??
Pt came in with a complaint of "excessive anal sweating" stated that his butt crack had profuse sweating and it was impeding his life. Even after D/C came back hours later for same thing. I can not tell you how hard it was to keep a straight face during that triage.
Another patient came in OFTEN with complaints of feeling faint after excessive masturbation. :| His last D/C he was instructed to cut back on masturbation but apparently it was still an issue and he would come in for near syncope.
Actually have heard about the patient who got tired of sitting in the waiting room, stepped outside and called 911 for an ambulance. It was a short trip!
I work in telephone triage - I've had patients call who were in the car driving on there way to the ER, sitting in the parking lot of the ER, called because they were waiting too long in the ER, wanted to know since their PCP referred them to the ER if they had to wait like everyone else, argued because they had crushing chest pain and DIDN'T want to go to the ER, called with a serious problem but had no transportation and refused to call 911, or had called from an inpatient admission (hospital, SNF, rehab) to complain about X, Y & Z.
Not sure how I could intervene in any of these scenarios - but, yes you must wait just like everyone else, no I cannot resolve your medical problems over the phone, I am not a cab service … (and these I think in my head: if you are already on your way to the ER or outside the ER, then why did you call me obligating me to have to generate a triage note/document?).
My favorite though is the call at 2345 (when the shift ends at MN) …
after a long, meandering, circular story ensues - citing at least 10 vague symptoms (all unrelated) they then invariably ask me what is wrong with them? I call these: "Oracle! Tell me!" triage calls.
Contrary to the belief … I am not a Seer, a Prophet, or even Clairvoyant - and I certainly do not have crystal ball. You still need an appointment with a provider to evaluate you - in person. Dirty, no … they cannot diagnose you over the phone either.
Specializes in Emergency Dept. Trauma. Pediatrics.
I think daily in triage I have said at least once, "We don't take reservations."
Except some hospitals do now. BLEW MY MIND driving across county and seeing billboards to basically reserve your spot. Like call ahead seating or something. Ummmmm if you're issue is one that you can make a reservation for, it's not an emergency!!! So crazy.
Except some hospitals do now. BLEW MY MIND driving across county and seeing billboards to basically reserve your spot. Like call ahead seating or something. Ummmmm if you're issue is one that you can make a reservation for, it's not an emergency!!! So crazy.
They are basically making an urgent care appointment, but yeah. :-/
Specializes in OR, Nursing Professional Development.
They are basically making an urgent care appointment, but yeah. :-/
But that's what the urgent care centers are for! There are about 15 within 20 miles of me. THere's no reason for any ER to be taking "reservations", yet all 4 hospitals do.
Specializes in Emergency Dept. Trauma. Pediatrics.
But that's what the urgent care centers are for! There are about 15 within 20 miles of me. THere's no reason for any ER to be taking "reservations", yet all 4 hospitals do.
Exactly, the ER should not be encouraging this. I mean there are literally urgent cares now that offer their own almost "care credit" plans that aren't even based off your credit. So many options. In fact I just popped into an UC this week. I needed abx and I knew I needed them. I had tried to hope the issue would resolve even though I had a feeling it would. I tried some home therapies. My best friend told me I better stop being stubborn and go get abx. She would have called me some in but they are really cracking down on that when there is no chart associated with the RX. So I called primary and appointment was weeks out. So I caved and went to one of the fast med urgent cares or something like that. They state on there they can pretty much function as a same day clinic as well. I was in and out. Saw the PA, he was wonderful and gave me what I told him I needed because I knew what worked in the past. I was literally there for less than 45 minutes. They also treat at least 50% (if not more) of the things we see come into the ER.
Just imagine how less bogged down the ER's would be if people utilized their options. But shoot why bother when the hospital billboards are encouraging you to reserve your spot in the ER.
But that's what the urgent care centers are for! There are about 15 within 20 miles of me. THere's no reason for any ER to be taking "reservations", yet all 4 hospitals do.
I know, and I agree — the concept is nuts. But my point was that you can't make a reservation for anything that is a true emergency — if you state your complaint as "chest pain" or anything else that triggers concern, it won't let you make your "reservation." So these are low-level, fast track complaints. But yes, an actual urgent care would be more appropriate, or hey! How about a primary care provider? But when these things happen after hours or on weekends, or in locations without urgent cares, this is how the ERs sort their low-acuity patients in a way that helps keep the main ER from being overrun while making patients happy. I guess it's a win-win, though it may seem to us that it's eroding the concept of "emergency."
Had a homeless guy on the floor in mid winter, there for hypotension. Lots of history of substances and so on. The hospitalist kept him because he kept having intermittent low BPs... That is, until I pocketed his nitro tablets during bedside report while he was busy making demands of the other nurse. We immediately went and labeled his nitro and placed it securely in his bin in the med room to be given back when he left. No more hypotension!
Same patient, still there because it was the weekend, was caught the next night removing a bottle of hand sanitizer from a dispenser and placing it under his gown to take back to his room, presumably to mix with the endless sodas he called out for constantly. After that I ended up telling my manager that it seemed that he fully intended to camp in that room until spring with self inflicted issues and that we had to turn away patients that night with actual cardiac issues because we had no beds. The patient was discharged that day.
So this one was used as a teaching moment while i was still in nursing school, but has stuck with me. We would get a readout for the day on our own pts. along with 1 case study pt. of someone who had been recently admitted. This day the case study pt diagnosis says "Maggots." That is it and nothing else, just maggots. Of course we don't quite know what to think of this and proceed to discuss with our clinical instructor. Turns out a man had been admitted for an infestation of maggots throughout most of his posterior. Very sad case actually and involved some sad abuse in the form of neglect, but you would not have known that by his simple dx of maggots!
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3ringnursing, BSN
543 Posts
At least it wasn't from the patient's rectum, lady parts, or urethra.
None of the above are clown cars!