Sometimes you just can't bite your tongue.....

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Not too long ago, I had an assignment in our fast track area, working with a notoriously slow provider. Folks were waiting longer than usual for their non-emergent and often not-even-urgent complaints, and getting more upset than usual. I had one family start to carry on:

"Is there only one doctor in the ER??"

"OMG, this hospital sucks, someone could be dying and they'd be waiting for hours!"

Well, the second one did it. I turned to the family and said "There's one doctor in this section, so that more doctors can get to the dying patients in the other section quickly, so that they do not have to wait. Are you worried that your child might be dying? Because I can assure you, he is not."

Of course it didn't quiet them down, they kept going on and on about what the "poor dying people" in the ER must be doing waiting all this time. I told them not to worry about those other patients, and what exactly I could do right now to help them. Surprisingly, that actually got them to quiet down.

I think the hard part about this time was that the provider really WAS moving slowly, despite my efforts to speed things along. And in keeping with my nightly theme of not biting my tongue, I actually told the provider that he needed to work more quickly and multitask better in the fast track area. You can probably guess how that went over.

Do you work in Missouri? Because this sounds an awful lot like my FT area and the doc down there. :p

But yeah, I definitely get that. Sometimes it's hard to bite your tongue, especially when you're in Fast Track where you tend to have whiny patients that think their chronic knee pain warrants a visit to the emergency room. I think the hardest ones to not say something to are the ones that have 10/10 pain, yet are talking and laughing on their cell phone. Then, amazingly, when you walk in, they are back to grimacing and having out-of-this-world pain. Sigh.

Specializes in ER.

Sorry. Had to laugh. Been there done that. Drama queens are the same everywhere you go I guess. Just to remain mysterious... I would have added, "our provider in this area is very methodical and thorough." and let them chew on a response to that.

Specializes in Emergency, Case Management, Informatics.

I'm usually pretty calm, cool and collected. 99% of the time, I meet angry outbursts and nonsensical complaining with a smile and a quick explanation of why this lab or that treatment has to be done, or why things are taking so long. But, there's always that 1% that just takes the p*ss out of me and I have to let them have it. It usually doesn't help the situation, because the recipient is too stupid to understand what's going on, but I feel better for doing it.

Had a really drunk guy that came in the other day. Chief complaint was an abscess. First of all, who the heck gets drunk and says, "Hey, ya know what'd be really awesome to do while drunk? Going to the ER for something stupid!"?? Anyway, the ER was busy and he wasn't satisfied with the wait, so after an hour in the lobby he says he has chest pain.

He gets taken back, gets a chest pain workup, and then his O2 sat starts alarming because he's moving around too much (I'm watching him on the monitor when it goes off). He hits the call light.

Me: "Can I help you?"

Him: "Hey, this machine's beeping in here!"

Me: "It's fine. We have a monitor out here and it beeps whenever your machine beeps in your room. We're keeping an eye on everything."

Him: "Well, you need to send someone in here because I can't handle all this d*mn beeping!"

... So, I go into the room. As SOON as I open the door:

Him: "Hey, man! This d*mn machine keeps beeping! You need to do something about it!"

Me: "It's fine" (walking toward the monitor)

Him: "Well, I can't handle it!"

Me: "Can't handle what?"

Him: "All this d*mn beeping! I can't handle it!"

Me: "You can't handle a machine beeping? You're supposed to be a grown man and you can't handle beeping?"

Him: "Well... I... it's unnecessary! I can't handle all this unnecessary beeping!"

I turn the alarm off on the monitor (it will still alarm at the nurse's station) and as I'm walking out the door, I say, "Well, if you can't handle that, you're going to have a looooonnnng day today".

What's even more funny is that his friend (who was such a belligerent drunk that he almost had the police called on him in the ER prior to my shift) came back into the ER about 4 hours after he was discharged, complaining that he had back pain. He changed his clothes while he was gone, hoping that we wouldn't recognize him.

There are some really... special people out there.

There are some really... special people out there.

Isn't that the truth. It never ceases to amaze me just how special they can be.

We were coding a patient the other day and we had a frequent flyer in a room near the nurses' station. I ran to the station to grab something and lo and behold the frequent flyer is sitting up in the bed with her neck stretched as far as possible to get a bird's eye view of the "show". I glanced over at her and I'm sure my look more than got my point across of "don't even try it...", she sat back in the bed quickly. Funny how back pain and SOB can make a person move so fast. I don't know if I could have bit my tongue if she so much of even made a peep at that moment.

Yeah, despite the fact that the provider, um, did not take my constructive criticism well, it honestly felt really good to say something. And I'm a big girl- I can handle a little loudness ;)

Many many years ago, you were sometimes allowed to speak your mind without getting fired. I will never forget that obnoxious man who yelled and screamed at everyone about the horrible care his wife was receiving at our nursing home. He had been yelling at us everyday for a month. One night, I let him have it. I said "Well if your wife is receiving such horrible care here then why do you allow her to stay here? Since she is receiving such horrible care here why don't you take her home and you take care of her yourself." He was shocked and speechless. I repeated that same message to him over and over. He finally walked away without a word. He never yelled at me again.

Specializes in med/surg.

Well, you see, I am a little more passive-aggressive in my dealings with patients. To the ones who have surgery or whatever and refuse PT, ambulation, suppositories, lovenox, TED hose, SCD's, and their IS, for DAYS because "it huurrrts!" I simply sit down and very empathetically talk to them about their choices for nursing homes after they suffer pneumonia, DVT's, and general deconditioning. It's amazing how many of them begin to comply with treatment soon after that conversation. We have private rooms, but oh how sweet it would be to put a young, noncompliant diabetic on their 3rd admission in 6 months with DKA in the same room with the blind bilateral amputee on dialysis. Or the one with the stinky, gangrenous foot wound...

Specializes in Oncology; medical specialty website.

my favorite obnoxious patient was the one who came to the ed seeking. he didn't get what he wanted, and he stomped off to the waiting room. we thought he'd left. several minutes later, the med-command phone rang. i answered it, and the dispatcher sounded like she was trying not to laugh. she said there was a man in our waiting room who had called 911 because he needed to go to an ed. she gave the name, and i told her he had just been here and discharged. it was decided that he didn't need an ambulance. security was called to help him "move along."

Once had a seeker calling 911 from the phone in her room *in the ED*.

Specializes in Trauma, ER, ICU, CCU, PACU, GI, Cardiology, OR.

there are days that, no matter what you do while working at ed... you just can't please everyone. therefore, i applaud you for stepping up and letting the doctor on hand be aware of the situation, even though you obviously weren't backed-up by your managers or administration. certainly, they will be the first ones to tell you other ways on how you should've handled the situation. however, it's always easy for them to give advise because they weren't present... oh! wait they are never present. my apologies, i just couldn't hold my tongue :D

We had a resident in a long-term care facility that called 911 because we wouldn't let her go outside to smoke.

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