What do your ER patients families say or do that irks you?

sjt9721, BSN, RN · Jul 29, 2005

I had a patient that came in for chest pain. She had been there about an hour when a pizza was delivered to her. She said she was hungry and she didn't know how long she would be in the ER so she went ahead and ordered food. She was discharged about 2 minutes after her pizza came.

:bowingpur Okay, okay! You win! :rotfl:

CritterLover, BSN, RN · Jul 30, 2005

the butterfly one gets me, too. hear it all the time. never use a butterfly on them, since we don't stock them. i had an elderly lady come in about 5am one morning; she was scheduled to have a heart cath as an op but had chest pain on her way in, so she checked in to the er. told me i would have to use a butterfly on her. i gave her my standard response: a smile with an "i'm sorry, we don't have any butterfly needles here." so i used a straight needle. one stick, no "digging" required. i'm not saying she wasn't a hard stick, i think she probably was. but i didn't have trouble that morning. here's the thing: she got mad at me for getting her blood without difficulty!!!

personally, i don't think that a butterfly is always the answer. i often find it easier to use a straight needle. the tubing in a butterfly means the blood has further to travel to reach its destination (and potentially its anticoagulant). the advantages that i see is that you can see a flash in the tube; it is easier to manipulate a butterfly, especially when changing blood tubes, and it is easier to go in at a more shallow angle, since the hub of the vacutaner isn't in the way. size wise, its a wash. we have straight needles that come in the same sizes as butterfly needles.

often it is what your "phlebotomist" is used to. i work with a very good edt/emt iv who just can't get the venipuncture thing down. he's a great iv stick, but if he isn't threading a catheter, he just can't do it. i keep trying to tell him that a straight vp is easier than an iv, but he just says its becuase he isn't used to doing plain vps.

the other thing that kills me is the cab voucher request. the ed where i occasionally work is on the bus route; unfortunatly, the busses stop running shortly after dark. drives me nuts.

finally is the "what do you mean he's not going to get a bed tonight?!!!!" from the very irate family member. i'm sorry. i can't pull an empty bed upstairs out of my hind end. you are welcome to sign out against medical advice and take him to a different facilty; i can't force you to stay here. but if you choose to stay in this hospital, your only choice is to stay here in the er becuase there are no empty beds upstairs. this is a situation out of my control, and given that it is 2am, i seriously doubt there is anyone waiting to be discharged that will cause a bed to become free before morning. and in the unlikely case that it does happen, there are six people ahead of you in line for a bed. would you like a recliner?

txspadequeenRN, BSN, RN · Jul 30, 2005

WOOOOHOOOO LOLOLO I have actually said this........

*LOL* Oh yes, the ones that say, "You'll have to use a butterfly needle..."

elthia · Jul 31, 2005

:rotfl: :uhoh21: Comments made by and general behaviour of patients that irk me include (but are by NO means limited to):
- No. 1 pet hate is the the young dying swan/drama queen... doted on by their significant other/mother/father... PUHLEASE...! Vomiting once is not a medical emergency... nor is having diarrhoea... once....
I may be alone in the fact that if I have gastro I want to sh*t and vomit into my own toilet, shower in my own shower and crawl, almost dying into my own bed... /QUOTE
you are so right! i always wonder why people run to the er because of vomiting once or twice! i have puked all over my house, cleaned it up, medicated myself and crawled into bed, but the drama queen in the er wants everybody doting on her/him because of a little vomit. i always feel like a little vomiting never hurt anybody.
Yes, I work medical/oncology and I hate it when someone comes in for n/v and then throws a fit becuase they aren't getting a dinner tray.
However, I had a bad experience once where my episode of n/v was not taken seriously, (actually I think the nurse heard n/v and ignored everything else I told her). I was being treated for symptomatic acalculous cholecystitis my surgery was scheduled, but my surgeon told me that if I developed uncontrolled n/v or ran a temp of greater than 101, or developed a case of biliary colic that just wouldn't resolve in the normal amount of time to go to the ER IMMEDIATELY . I developed all three, while at work. My husband was called by a coworker, and off to the ER I go. (I don't recieve my medical care at the hospital I work at). I informed the triage nurse of my hx, my dx, my impending surgery, and my surgeon's name. I was triaged as n/v. I spent 7 hours in the waiting room on my husband's lap, curled up in a ball, with him rocking me back and forth, while I had a towel that I bit on to keep from screaming when the pain got too bad( I had had biliary colic for years,it would come and go, but I never had had an attack this bad before) . After 7 hours, someone finally took my vitals. The nurse was very apologetic, stated that "I am so sorry, someone misplaced your paperwork I didn't know you were out here". I informed her to "just call Dr. ---- and tell him I'm here with another gallbladder attack", 3 hours later, and I'm called back to the ER, placed in a bed and have labs drawn. The MD comes into my room and asks me how long I have been vomiting, for some reason my pancreatic enzymes are elevated, I might have gallstones, and I have a fever of 102, I might need surgery, he wants to consult with the surgeon on call. To which I reply, "I DON"T HAVE GALLSTONES, I HAVE ACALCULOUS CHOLECYSTITIS, AND I'M SUPPOSED TO HAVE SURGERY NEXT WEEK BUT I WAS TOLD TO COME IN IF I HAVE A SEVERE ATTACK OR N/V OR A TEMP, ."The MD asked who my surgeon was, then went and called him. within 15 minutes of the call I recieved demerol/phenergan, and IVF, rocephin IV and was admitted, it's now 4 am, I've been in the ER for 11 hours. My surgeon actually dictated my admission orders to the ER MD. I had surgery at 0700.
For some reason now, when I see a patient walking back on the floor after going outside to smoke and he says his pain is 10, I find it hard to believe him, to me pain of 10 is when you are praying that your gallbladder will rupture, you know it will give you peritonitis and could possibly kill you, but if a ruptured appendix is signalled by a sudden decrease of pain, then maybe if your gallbladder ruptures it will quit hurting for a little bit, and you dont' care about the other consequences.

**canoehead, BSN, RN** · Jul 31, 2005

Yes, there's another one for me- pain is 10/10 and the patient grins at you.

I did start saying by way of explanation that 10/10 would be screaming and crying, and it doesn't deter them in the least.

PennyLane, RN · Jul 31, 2005

Yes, there's another one for me- pain is 10/10 and the patient grins at you.

I get this ALL THE TIME.

Me: Can you rate your pain from 0-10 blah blah blah

Pt: It's a 10 out of 10. Then flashes me the cutest little "I'm in so much pain" smile, as they resume their phone conversation.

An hour later, after 2 mg of dilaudid. Pt is sleeping, totally out of it, you take their vitals, ask if pain is any better, after saying their name 3 times loudly, they roll over, pry their eyelids open a bit and say, "not really" or "a little bit" and promptly fall back asleep.

Disclaimer: I'm not talking about chronic pain patients here, or even someone in moderate distress upon arrival. I'm talking your healthy pts who come in for abd pain, ask for food right away, talk on their phones, laugh with friends--you know the type!

CCL"Babe", BSN, RN · Aug 1, 2005

My all time favorite..."I've got a present for you" as they point to a used bedpan or full urinal. My response - I'm sorry, I'm not allowed to take gifts from patients.

Another pet peeve..when the phrase "waiting on" comes in to play, as in - What took you so long to wait on me? I'm sorry, I didn't know I was a waitress, I thought I was a nurse.

MrsWampthang, BSN, RN · Aug 1, 2005

Well, they were breathing when I put them in the car....said in reference to a patient now slumped over and blue in the front seat.

I didn't call the ambulance because I didn't think I needed it....said by patient who can hardly breathe and is sweating profusely and grabbing their chest.

Caller on the phone asking "How long is the wait?" Well, let's put it this way, if you call your doctor on Monday (said on Friday night), you'll be seen sooner. (As a side note, waiting room at that time is completely empty and staff is sitting around chewing their nails waiting for the other shoe to drop and the ER gods to start spewing patients all over the place.)

Caller on phone calls and asks if ER doc can call them in a refill on the pain meds that they are already out of and just recieved in the ER three days prior.

Patient in triage "Well you have all my medical history, allergies and medication list in my records." Or "my doctor has a list of all my medications." (said at 2am on Saturday morning).

I didn't give my child any medication because I wanted you to see how high their temperature was. (said about child whose temp is now 104.5 orally)

Can you get me a coke? Can you get me another coke? (same patient 20 minutes later) I have to use the bedpan now. (same patient 10 minutes later) GRRRRRRRRRRR!!!!!!

I know I can think of more, but I'm too tired right now. Thanks for the laughs from others so far!

Pam

MrsWampthang, BSN, RN · Aug 1, 2005

As soon as I walk in to draw blood or start an IV patient says "I hate needles." Patient is 20 something with tattoos and body piercings galore!

Pam :rotfl:

caroladybelle, BSN, RN · Aug 1, 2005

Yes, there's another one for me- pain is 10/10 and the patient grins at you.

It's evil, but....a dream.

Oh, my pain is a ten on a ten pain scale.

Nurse takes a hammer and slams it down on patient's finger (or some other highly sensitive part of the anatomy). That was a "ten" pain.

Now, again what level was your pain at?

------------------------------------------------------------------------

And then I wake up from the dream, smile sweetly and go to work.

***********Please note that I am being facetious. I do not advocate violence against patients.....I am sure that there will be someone around here that will get highly offended over the fact that I am not taking pain issues seriously and that I am not deserving of the title "Nurse"...be rest assured that I do take patient pain issues seriously...I just wish that the patients actually took pain issues equally as seriously.***************

allnurses Guide · Aug 2, 2005

What irks me is the very large sign patients pass on the way in:

"customer satisfaction is our number one goal"

Gee, I thought it was Airway, Breathing, Circulation, Disability,..........

Where's Mick Jagger when you need him?

:Melody: You can't get no.......... :Melody:

Marie_LPN, RN, LPN, RN · Aug 2, 2005

"customer satisfaction is our number one goal"

What bugs me about that phrase is that a local grocery store has the same thing on their front door.