The revolving door

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Specializes in med-surg, psych, ER, school nurse-CRNP.

OK, I'm at work. I have had an influx lately of what I call "the revolving door". I work occupational, but I have noticed this in the hospital, and in my days as a school nurse as well. Here's the scenario.

A very large gentleman comes into Medical (large in size, not obese, this guy had to be 6'7 and well over 200 pounds, he was BUILT!) and states "Yeah, they told me to come in here and get checked. I cut myself last night"

I don't see a bandage, nor do I see a cut that would necessitate a recheck, but there's more to the story, as I later find out.

"Who told you to come back?"

He sighs. "That girl, whoever was here last night, I gues she ain't here, she told me to come back. I think I cut a ligament. I can't move my finger." (This as he is wiggling said finger to demonstrate)

I ask him to show me the cut and he points to this 1/ cm lac on his knuckle that looks near healed. I swear, I've had paper cuts that looked worse than this.

"Sir, I can assure you, there's probably no way you cut a ligament there."

"Whaddaya you mean? It was DEEP, man! It bled all over. Why won't it move?"

"Well, sometimes cuts swell. That may be why you're having difficulty moving it." (As he continues to move the finger to show me he can't move it)

"Well, I want to know if there's any metal in it." (Sure, let me get my trusty X-ray machine out of my purse)

I palpate around the cut gently with my nails and feel nothing. "Sir, other than digging to see or an x-ray, there's no way to know. The doctor is not here, and without you having any difficulty, I am not authorized to send you out."

He gets even madder by this time and storms out. I found out later that the nurse refused to send him out to the ER last night, because HE DID NOT NEED IT! He called to try to go around her and try to see the plant doc, who spoke to the nurse and then told the man he did not think a simple lac warranted a visit. So now he was trying it on a fresh face, lol. Lucky me.

I'm noticing this happen more and more. Our plant is closing, and people are coming out of the woodwork claiming workman's comp. If their minor stubbed toe is not made a fuss over, the come up with various and sundry other complaints, trying to find something they can get paid for. Hence the"revolving door" , it just goes round and round.

Saw the same thing in school nursing when kids did not want to go back to class. Sore throat would turn into headache would turn into bellyache, etc.

Anyone else have this phenomenon?

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My agency provided the occupational health function for a major employer. We were required to attend a presentation where we were shown the media tv footage of the trial of a former employee who got jail time for fraud because the company got our on site nurses to document that this man was bilking the system. I think a carefully worded warning would be in order for anyone who gets seen for something that is suspicious.

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Specializes in Adult Stem Cell/Oncology.

You could have told him, "Looks like a bad case of necrotizing fasciitis! I'll call the surgeon right away. If he can get you in the OR in the next couple of hours, they may just need to amputate the finger, not your whole hand!" Hahahah!

I wonder how he would have reacted to that..... :chuckle

And of course I'm joking! ....seems like some people get a hangnail and think they ned to go to the ER for it!

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Specializes in Case Management, Corrections, Home Care.

I work as a Correctional Nurse with male inmates(patients), and I get this, "but I have to go to the hospital!" at least once a week for injuries that are not even worthy of my time to look at. It's the part of the job I love believe it or not. I love to say "no!" than tell them to go away... I can do that with inmates, but not so sure with the general poulation. I really like my job and always treat the inmates with complete honesty and respect even if they don't like what I have to say. Thanks.

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As the plant is closing you are probably going to see more and more of this until it locks it's doors. Some dishonest people are going to try and bilk the system as much as they can while they still can. Frustrating as it's a waste of time.

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Specializes in Medical and general practice now LTC.

When I worked in the UK on the medical admission unit regularly saw the same patients week in week out. Some we knew would be discharged and back in again within 1 week. With my last job a few patients would try playing one nurse against the other but we always well documented what we did to warn the other nurse especially if we had an inkling that is what they would do

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Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

When I worked occupational medicine, it always amazed me the numbers of employees who seemed to think an on-the-job injury was like winning the lottery. They didn't really understand that they didn't really want the kind of injury that would get them a bazillion-buck settlement.

Then we'd have people who would come in with knee pain. They'd be furious when told it was arthritis. X-rays? Arthritis. "Well, it's from walking around on these concrete floors. I didn't have this when I started working here. Twenty years ago."

I kept waiting for a work-related pregnancy, and for demands for Clairol to cover up the gray because "I didn't have that when I started working here. Twenty years ago."

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Specializes in med-surg, psych, ER, school nurse-CRNP.
When I worked occupational medicine, it always amazed me the numbers of employees who seemed to think an on-the-job injury was like winning the lottery. They didn't really understand that they didn't really want the kind of injury that would get them a bazillion-buck settlement.

Then we'd have people who would come in with knee pain. They'd be furious when told it was arthritis. X-rays? Arthritis. "Well, it's from walking around on these concrete floors. I didn't have this when I started working here. Twenty years ago."

I kept waiting for a work-related pregnancy, and for demands for Clairol to cover up the gray because "I didn't have that when I started working here. Twenty years ago."

Oh, we had one about like that......wanted her maternity leave to start from the day she found out she was pregnant. Did not get her way, so she called the committeeman, and proceeded to sleep in medical until he came in. No complications, just did not want to be there. No note from her OB, just expected us to make it happen. When they finally pushed me too far as to why I would not grant Sickness and Accident for the term of her pregnancy, I snapped, "Because, the last time I checked, pregnancy was NOT considered an illness!"

Never heard another peep until she took maternity leave at 6 months.

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Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

Everybody who got pregnant wanted light duty; that was personal, not work-related, they didn't get it.

I kept waiting for someone to claim it was work-related- she got pregnant at work!!! (It would not have been outside the realm of possibility).

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