Things you'd LOVE to be able to tell patients, and get away with it.

[AngelfireRN]

Hi, my name is AngelfireRN, I'll be your nurse tonight.

I am not a waitress, nor am I your slave.

Yelling and hurling obscenities at me will not get you your pain meds any sooner than they are ordered. Nor will having your family member or entourage do the same.

Threatening lawsuits and having umpteen family members camp out in the halls or hold up the nurse's station will not get you preferential treatment.

Physically grabbing me as I go down the hall is NOT a good idea.

I do not give the orders, but I do have to follow/enforce them. This is something that you should take up with your doctor.

No, I will not call him again to ask him for more pain medicine. He has been called twice and has said no both times.

No, I will not give you his number so you can "straighten him out".

No, you are not my only patient, and I highly doubt that you are single-handedly paying my salary. On the off chance that you are, let's talk about a raise.

NO, NO, NO, I most empahatically will NOT come get you when it is time for your next pain shot while you are having a smoke break. I also will not bring it to you in the smoking room. (Have actually said that, I am allergic to cigarettes. I did it once, had an asthma attack, desatted to 83, and turned blue, according to the patient and my charge nurse, after the patient had to help me back to the floor).

No, I don't really care if your family has not eaten all day, they drove here by themselves, they are not sick, and no, I will not call for 6 guest trays. (This of course, is if the patient in question does not need all 6 family members present, and is not at death's door).

No, you may not have 3 six-packs of soda from the kitchen, there are other people that would like a snack, too.

No, they will not open up the kitchen up just for you, at 1 in the morning, because you don't like the snacks we have on the floor.

I could think of hundreds, but those will do for a start. I know it sounds mean, but this is why I got out of bedside nursing. When a hospital becomes the Hilton, I'm gone!

Have fun!

[gmkj]

I had a women who also used to fake seizures I finally had to say in a nice way. I am not sure whaT YOU ARE HAVING BUT IT COUldnt be a seizure dear,I know this because you wouldnt be able to talk through a seizure nor would you be able to stop and wring the call bell.Thats the funny part ahe would ACTUally tlak during it. I...dont....feel.....good......ring..........ring...she hasn't had one since.nor did she get the phenobarb she was hinting at.

[General E. Speaking, RN, RN]

With a megaphone in the large waiting area outside ICU: "Attention slobs! Pack up your coolers, bags of chips, 4 dozen kids, empty soda cans, blankets and pillows and get the (profanity) out."

We will call you for pick up when the patient is ready for discharge.

[General E. Speaking, RN, RN]

One more: "I'm sorry. Today is a NO FAMILY DAY. Please feel free to return tomorrow because I will be off."

[carolmaccas66, BSN, RN]

To the woman who's newly-diagnosed, demented mother I cared for last week:

It doesn't matter that you say 'all these meds are making mum confused, she wasn't confused b4 coming in HERE' (Mum was on Donepezil), and you don't even want her to have Panadol. Mum is on Panadol and other meds for pain that she has from other medical conditions. 'Stopping all these medications' will not stop her dementia. You do understand she won't get better? The Donepezil can slow the progression of dementia but won't stop it (explained this). She won't be 'going home soon', she will soon need 24 hour care and watching, she will need to go into a home. She will not be able to 'look after the grandkids' for you again while you are at work, at tennis, or whatever. Perhaps one way to look at the situation is it is now time for YOU to care for her, what do you think?

This woman's daughter was so far in denial re her Mum's dementia. Nothing we said could change her mind that it was all the meds that were 'making Mum a little confused'. Told her she had to speak to the doctor.

And, to make it worse, I found out later this woman's daughter used to be a nurse! Makes you wonder...

[sharpeimom]

i had a women who also used to fake seizures i finally had to say in a nice way. i am not sure what you are having but it couldnt be a seizure dear,i know this because you wouldnt be able to talk through a seizure nor would you be able to stop and wring the call bell.thats the funny part ahe would actually tlak during it. i...dont....feel.....good......ring..........ring...she hasn't had one since.nor did she get the phenobarb she was hinting at.

here we go again:mad:!

it is indeed possible to be able to speak and even carry on a conversation while having some types of seizures. i know this because i have had several different types of seizure since a congenital aneurysm

ruptured when i was thirteen months old. it is a commonly held fallacy even in the medical and nursing community that no conversation or speech is possible for someone in the thros of a seizure. during a tonic-clonic seizure, no speech is possible obviously, but in several other types, it is. i am currently seizure free on keppra and neurontin, but as a child on phenobarb liquid (yuck!) i was fully able to talk and follow a conversation during three types of seizure.

before i became disabled, i was a psych nurse, and i absolutely agree people do fake seizures for drugs and attention, and they were almost without exception, pains in the neck. please remember though that it is possible to speak during some seizure types.

[carolmaccas66, BSN, RN]

With a megaphone in the large waiting area outside ICU: "Attention slobs! Pack up your coolers, bags of chips, 4 dozen kids, empty soda cans, blankets and pillows and get the (profanity) out."

We will call you for pick up when the patient is ready for discharge.

I laughed so much when I read this! It would be great to do this like in the movies! And why is it when one patient comes to the ED/ER or ICU, the whole extended family seem to think it's a holiday camping ground?

[carolmaccas66, BSN, RN]

here we go again:mad:!

it is indeed possible to be able to speak and even carry on a conversation while having some types of seizures. i know this because i have had several different types of seizure since a congenital aneurysm

rupture when i was thirteen months old. it is a commonly held fallacy even in the medical and nursing community that no conversation or speech is possible for someone in the thros of a seizure. during a tonic-clonic seizure, no speech is possible obviously, but in several other types, it is. i am currently seizure free on keppra and neurontin, but as a child on phenobarb liquid (yuck!) i was fully able to talk and follow a conversation during three types of seizure.

before i became disabled, i was a psych nurse, and i absolutely agree people do fake seizures for drugs and attention, and they were almost without exception, pains in the neck. please remember though that it is possible to speak during some seizure types.

can you not work at all due to your seizures sharpeimom, or is your disability from something else? i too work psych a lot. sorry you are disabled, do you not work as a nurse anymore?

[rnlately]

Things I'd love to be able to tell patients AND families:

Dear Family Member:

I am not going to overmedicate pt for pain because YOU think YOU know better than the pt what her condition is. As long as said pt is alert and has all of her faculties about her she is well able to let me know when she is in pain. Do not call the ns every 2 hrs because pt has meds scheduled "as needed"; key words "AS NEEDED" not routine. I don't need to see your face glaring at me everytime I look up. Do not monopolize my time for pettiness; I do have 5 other pts that require my attention and perhaps are more medically unstable than your family member. Do not act like I am you maid. I am there to take care of the patient; not you. Do not continuously ask for sodas; remember you are the visitor, not the patient. There are patients on this floor that would like the opportunity to have a coke or crackers. If you are so hungry, there is a vending machine downstairs or around the corner; take your pick. Do not bring pizza for the patient when you know that one of her chief complaints is nausea. I'm not going to feel really good about having to give the patient Phenergan because of some of your foolishness. Last but not least, it's none of your business who the person is next door/across the hall, what she's here for, and how long she's been here. JUST GO HOME ALREADY!!! WE CAN MANAGE THE PT JUST FINE WITHOUT YOU AND YOUR PANHANDLING BEHAVIOR.

Dear Patient:

No I will not hold your "tallywhacker" (as you call it) in the urinal for you. If your hands are able to feed you and squeeze your call light then surely you can handle matters of urinary elimination. Don't get upset if I ask your friends, family, or whomever they may be to leave the room so that I can complete my assessment. If you want to show everyone you goods, show them on your own time and at your own place. I have a job to do and I refuse to wait until your company decides to leave at midnight for me to complete what should be a beginning of shift assessment at 1900. Save your off color, racist, and perverted jokes for someone else; I don't think they are cute and you will get the look of death from me (meaning that if looks could kill, you will probably drop dead). Stop asking me where I live and what type of car I drive; it's really none of your business and not to mention if I even get the impression that you are stalking me there will be no escape from the long arm of the law or the long arm of "country justice". Lastly, when I'm in your room taking care of you and I ask you "Is there anything else I can do for your?? I have time.", don't tell me "no" and then 10 minutes after I've left your room call and request some fresh ice.

[gmkj]

I am interested and will research this issue more. but in this case resident was definatly faking,seeing how her seizure stopped immediately and she never had one since.also had many other behavior issues. I also wish you the best.

[silverbat]

I had a pt who was having what appeared to me to be seizures almost continually. Even while asleep, she would would have seizure-like activity. I called the Doc, who said, no way, she has never had seizures and she isn't having them now. He came in to the hospital, wrote a huge note about how the FAKING patient had the nurse fooled, then left the hospital after doing nothing.

a little background.....80 yr old female with ESRD, liver issues, was on Demerol IM q 6 hrs scheduled.

Next day, pt went into grande mal seizures and was......... you guessed it............Demerol Toxic. I had brought the sched demerol to the Docs attention, but he disregarded it altogether when I talked to him. Pt went to CCU, then did go home after a prolonged stay, but went further into renal failure and passed not long after.

Sometimes even a Dr, can't tell when a seizure is a seizure... of course, THAT Doc, was a known jerk!

[amy14]

To the frequent drug seeking flyer:

Please stop pretending that you're dying from a MI by holding your breath till your face turns red. Pretending to have a heart attack will not get you the pain meds you requested, only a d/c order. I will not give you dilaudid even when you're crying and have snot running down your face. Quit frankly....you're making a fool of yourself. What I will do is stand by and wait until you can't hold your breath anymore and take a breath so that i can tell you the doctor has discharged you.

of course after i informed him he was being discharged he ripped out his IV, COMPLETELY trashed the room and ran out before i could get his paper work together.

[sharpeimom]

can you not work at all due to your seizures shar pei mom, or is your disability from something else? i too work psych a lot. sorry you are disabled, do you not work as a nurse anymore?

in november 2003, i had a severe stroke. i have recovered somewhat, but am almost totally dependent

upon my husband for many things now. i have a wheelchair, a motorized scooter, a hemi walker and a cane. i can also walk short distances holding on to things. what i use depends upon what i'm doing.

i've had hundreds of hours of pt and many hours of ot. our victorian-era house, which was built as a boarding school, has been adapted to accommodate my special needs. we've installed a stair chair, remodelled the bathroom off our bedroom so the shower is handicapped accessible, the john is higher and we've added bars at the sides. the downstairs bathroom also has a handicapped john and hand rails.

faucet handles (except in the bathroom with 150 year old fixtures) have been replaced with blade type handles because my fingers don't always cooperate. three years ago, i tore my right rotator cuff. i have a 9 cm tear which my neuro advises that i not have repaired because the annesthesia might cause problems. my right hand/arm was my "good" arm/hand. i was left handed prior to the stroke. that became the paralyzed side. of course.

throughout the whole adventure, my mind has remained as it was pre-stroke. i use lido patches plus

voltarin gel on my shoulder and most days, that combo works fairly well. my speech has been affected.

i have had much speech therapy, but it isn't good enough to have to speak professionally over the phone.

in a group, or one to one, you'd have no trouble understanding me however.

the most frustrating part sometimes, is people who don't know me assuming that i'm unable to communicate, am retarded, an empty shell. some of my favorites? "can she understand me if i speak

s-l-o-w-l-y?" "won't she hurt someone if you turn your back on her?" "how nice that you have her out in the fresh air today!" (answers phone) "may i speak to someone legally competent, please?" that day, i did say, "just who the xxxx do you think manages the finances in this family?"

more of an answer than you wanted, i suspect!!