Tragically idiotic

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Over my seven years in orthopedics, I run into a patient every now and then who has done something so stupid that I might be tempted to make fun of them...if only their action hadn't ruined the rest of their life. Numerous examples spring to mind -- the 24-year-old man who was playing "chicken" on a snowmobile and lost his right arm. The chronic alcoholic who decided it was a good idea to try operating a chainsaw while drunk, and came close to losing his arm. The young IV drug user who shot up with saliva rather than water, and now can't figure out why he might have endocarditis.

My (un)favorite was the lady whose friend told her that her PEG tube looked infected. Rather than come to the ED, she cut it off close to the skin with scissors. She gave herself an air embolus, which resulted in a stroke and the loss of half her body function. She's bedridden, dependent and aphasic, and only in her 50's.

I can't figure out why people do this to themselves. I'm sure the rest of you all have had patients like this more than once. How did you handle it?

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Just to clarify: I don't find any of the above situations funny at all. It's just that it makes me want to shake these patients and say, "Where was your brain?" ... but there's no point, because their lives are already wrecked. And it didn't have to be that way.

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Specializes in ICU.

I've had a lot of patients like that. One that comes to mind is a teenager who decided to get in an ATV race with his brother. He lost - to the tune of the ATV flipping over on top of him. He was a MASSIVE TBI, as well as had massive fractures everywhere else. After almost a month and a half on IP rehab (after everywhere else in the hospital, of course), he had finally managed to stand up and pivot with only 1 assist. As far as I know, he never got any verbal skills back at all. Honestly, it just makes me mad and frustrated. He was a bit of a sympathetic character (just a bit, he was so awful to us that he was mostly just aggravating), but we got another TBI around the same time who was a drunk driver and hit his car into a tree around 70 mph. I don't know about everyone else, but I didn't feel the slightest bit sorry for him and actually hated working with him - the TBI made him so violent that he punched his mother in the face once. If he'd do that to his own mother, imagine how he treated the nursing staff. I'll give you a hint - it wasn't pretty. It took several of us to hold him down to get a CBG because he thought we were trying to stab him with a knife and he'd fight for his "life" by punching, kicking, biting, screaming... I was not amused.

Let's just say I don't have any patients for TBIs so I'm getting out of rehab and just leave it there. I know it's not their fault, but their violence is a huge pet peeve of mine. I can't stand working with people who are ACTIVELY trying to harm me, whether they know what they're doing or not.

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Specializes in Cardiology.

We don't get the trauma pts where I work (trauma hosp down the street gets them) but we get a lot of addicts. Recently had a stretch of infected addicts, r/o endocarditis, on contact precautions, etc., of course wanting pain meds as soon as they were available. One I handled by getting her shipped off to CCU- I couldn't care for her with her sats in the 70s and take care of my other pts as well. The rest? Take a deep breath, be sympathetic to what brought them to the point of self-medicating, be thankful it isn't me, and give them the meds the MD deemed safe. Sometimes they just need someone in the room who isn't judging them.

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Specializes in Corrections, neurology, dialysis.

I had one the other day that was the worst case of enabling I have ever seen. Man in his mid 50s and Mom hovered over him. He is has diabetes and hypertension which led to renal failure on top of alcoholic cirrhosis. Mom told me he only eats food from McDonalds and has never eaten a vegetable in his life. Well, gee Mom, do you wonder how he wound up in this condition? We didn't address the alcoholism, but the writing was on the wall for me.

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How do you get an air embolism from a peg tube?

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How do you get an air embolism from a peg tube?

I'm curious as well.

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i agree

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How do you get an air embolism from a peg tube?

I was googling difference between American and Canadian peg tubes, turns out they are the same :)

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Lawnmowers. Stay away if drunk. Just sayin'...

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But then again, when I think of most every minor injury I've had, it was doing something stupid. Even ankle sprains, should have watched where I was going. I'm just lucky that I've stayed away from giant tools of destruction.

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Specializes in Emergency/Trauma/Critical Care Nursing.

40ish male patient decided to pull out an abscesses tooth with a pair of channel lock pliers instead of go to the dentist.... End up with a pocket of pus on his brain (forgot the name of it)

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