What HAVE you said to patients???

amortentia62442 · Apr 5, 2011

I had a pt that was a hemophiliac and was vomiting and stooling bright red blood. PRBC and FFP were both ordered, charge nurse and I were trying to get vitals and get the blood start, give report to the ICU to move him and keep calm. He continued to ask if I could get him some jello. I continued to explain that he was NPO, vomiting blood and the doctors would not want him eating anything right now. "but I haven't eaten in days, and I haven't thrown up in 45 minutes." I am usually pretty patient so I continue to explain to him that no he could not have jello. As I am trying to get vitals and check and hang the PRBC he asks again, I snapped and said "Look getting you jello is not the priority right now, hanging your blood is, so no I will not go call the Dr to ask if you can have jello." Him and his mother didn't seem too happy with me after that. But I got the blood hung and transferred him to the ICU.

TravelJinx · Apr 5, 2011

20 odd years ago I was in a teaching Hospital. We had an Elderly Lady came in with a nasty cellulitis in her lower leg from a cat bite. MD wrote orders to keep her on bed rest. I was taking care of between 9=11 Patients in private rooms and covering the IV's for the LVNs. So doing 1:1 Nursing wasn't an option. Pt of course was down at the end of the hall. (Aren't the confused ones always!)

Pt was a sundowner. Found her standing next to the bed with her IV pulled out. She was only wearing a tiny round little hat with a bit of a veil on her head, little fancy bolero type jacket, high heels and holding a little straw pill box purse. Which she beat me with while we got her back into bed - I don't remember how many of us it took. Put her in wrist restraints. When checked on her while later room was empty. I called Security and they found her wandering down in the closed Radiology Department - wearing the same 'outfit'. They thought at first it was a ghost because her skin was so pale - and of course they could see so much of it!

I called the Resident and got an order to put my little Houdini in a Geri Chair with the foot of the chair elevated on pillows across from the Nursing Station, so we could all keep an eye on her and keep her safe. (No sitters available.)

SOOOOO MD, who was known for loudly expressing himself, came in in the morning with a Group of Residents. When MD saw Pt up in the chair he started yelling 'for the Nurse who was responsible'. Something about what did I think I was doing and couldn't I understand an order as simple as bedrest. I calmly explained to him what had happened. He said that wasn't good enough I should've kept her on bedrest since that's what he'd ordered. SO since it was the end of a really bad / busy night I told him what I really thought.

I said "Well I thought about asking the Resident for an order to wheel her up to the 6th Floor and dump her off the roof because I figurered that was the only way to keep her in bed with her IV in place so I could give the IVAB as you ordered. But for some reason The Resident refused to give me that order so the Geri Chair with her leg elevated and wrist restraints to keep her IV in, while sitting where she'll be seen by Staff, was our compromise." MD's jaw dropped. He just starred at me for a minute than he turned and walked off the unit.

I was charting 10 minutes later when he walked up on the oppostie side of the desk and started turning the chart rack to get my attention. He said 'I was just wondering, why you didn't ask The Resident for an order to pith her?' Told him I was sorry but didn't know what that meant. He said 'You know in Biology class with the frogs you're going to dissect - little pins you use to hold them onto the board - that's pithing.'. I laughed! It was a good come back - even if he had to walk away to come up with it and possibly get help from his Residents! But that particular MD never tried to dress me down in front of a group again. Little Houdini eventually went back home minus the cellulitis. Don't know what happened to her cat.

RNTOBE_1970 · Apr 5, 2011

I worked in a LTAC about ten years ago. We had a young (30's) male patient that was a non compliant diabetic. He was in our facility for wound care to a nonhealing wound to his foot. He was always wandering throughout the facility, we would find him in the nurses' break room...he was always stunned when his blood sugar was well over 300. I had this patient for a few weeks and this was getting very old. I am usually very patient, and love to spend time educating my patients...but he drove me crazy. Blood sugar is sky high, he is going on and on about he doesn't understand why its so high. I tell him because he is non compliant. I tell him that he eats everything in sight. He gets ****** off and starts yelling at me " I am compliant!!!". I snap back, "oh yeah? If you are so compliant, why are you missing half of each foot??". He shut up and starting listening.

kool-aide, RN · Apr 5, 2011

I said this to a whiny ortho THR pt who would call myself and the nurse into his room REPEATEDLY for BS things like getting him a hot blanked and a *fresh* cup of ice after we had already taken care of his needs (ie: toileting, pain meds, etc.)

"Sir, I have 15 other pts besides you tonight, and your nurse has 5 other pts, do not over exaggerate, your call light has not been on for 30 minutes, it has been on for 5 minutes. The nurse and I have been in your room many times tonight to take care of you and have met and exceeded all of your needs. It's 0400 and you need to be asleep!

dee122381 · Apr 5, 2011

A male patient was continually getting "fresh" with the nurses. Upon reassessing his pain after administering pain medicine:

RN: Do you feel better?

pt: If you give me a kiss, I'll feel better.

RN: You need to start treating your nurses with some respect!

pt: I knew you could teach me...

RN: Obviously not, because you're not listening.

But apparently he did learn something after that, because there were no more "fresh" comments.

KyPinkRN · Apr 5, 2011

I once had a patient who was admitted to my unit with a balloon pump, pa line and quite a number of drips. Unfortunately the cath lab had sent him up to me with no warning and without calling any report. Of course there was a problem with the IABP on his arrival, and three other nurses and I were scrambling to fix the problem before we had to call the MDs and possibly shut down the pump and remove the line. The patient was NPO in case he had to go for emergency surgery. It was a huge clusterf**k, and through it all the patient was complaining that he'd had nothing to eat or drink all day. At first, as always, I explained his npo status and the rationale for it in the most polite way possible. But he just kept on and on about how he had not eaten. His complaining and my explaining (while trying to troubleshoot the iabp and lines and settle him in) went on for about ten minutes. Finally he yelled, "I'm ******* DYING of hunger here and none of you care!" I had absolutely had it and yelled back at him, "Sir, you might very well be dying, but NOT of HUNGER!" I thought the other nurses were going to choke when they heard that. I'm usually very patient, but that guy got on my last nerve. He and I got along pretty well after that, though.

Sometimes that's what it takes to get them to realize why we have to do things. I bet he got a "deer in the headlights" look on his face and did exactly what you asked after that.

EmilyCCRN · Apr 5, 2011

I was called in at 0300 one night for an anterior STEMI. As we were wheeling (i.e. running) the pt to the cath lab, he starts going off about how "I have insurance! Don't kill me because you don't think I can pay for this stuff. I know you guys don't try to save people if they can't pay! My insurance card is in my wallet! Let me get my wallet!" (he starts trying to sit up, pulling on his multiple IV lines, O2 tubing, etc. as we're flying down the hall). After repeatedy (and politely) trying to explain to the pt not to worry about money and that our only concern was taking care of him, I guess I got frustrated when he wouldn't shut up about his stupid insurance, not to mention the insulting comments about how we kill people who can't pay. Finally I said, "I don't give a sh!t about your insurance. We are trying to save your life here!" Not my finest moment, but it apparently worked. He shut up about his insurance after that and let us take care of him. He walked out the door 2 days later, hopefully with his insurance appropriately billed. :lol2:

Mommy&RN, BSN, RN · Apr 5, 2011

We have a frequent flyer (at least monthly), always with abdominal pain. The MD d/c'd all narcotics. She happened to be assigned to another RN this visit. She called out and I responded to the call light. I told her the MD discontinued all narcotics, and that we would not call and ask him to restart them. Her S/O tells me he will take her to the ER. I told them that I can get the AMA paperwork ready, but "if you are unhappy with your pain management, you may want to try a different facility.)

This woman told her MD that she bought drugs when her check came, then would return to the hospital when she was out of money. She has had so many scans of her belly that they won't do anymore because of how much radiation she has been exposed to.

She took the NSAID and didn't have any complaints the rest of the night.

CrunchRN, ADN, RN · Apr 5, 2011

People are AMAZING. Great thread!:smokin:

JulieCVICURN, BSN, RN · Apr 5, 2011

'You know in Biology class with the frogs you're going to dissect - little pins you use to hold them onto the board - that's pithing.

Pithing is actually the procedure that destroys the brain, not pinning down the frog. No biggie, but I'm a little leery of an MD who didn't know that!

I once told a patient who'd just had an MI and asked me (as a joke) if we had any Media channels that he didn't need to be rubbing one out right after having a heart attack. I thought it and it just shot out of my mouth before I could stop it. Luckily, he took it well.

You get to know what you can say to which patients and whether they're going to laugh or have you written up. He laughed. Thank goodness.

enchantmentdis, BSN, RN · Apr 5, 2011

To rude family member, who cussed me out while following me to my car: Follow me and i'll call the cops. Back off!!!!!

Esme12, ASN, BSN, RN · Apr 5, 2011

I once had a patient who was admitted to my unit with a balloon pump, pa line and quite a number of drips. Unfortunately the cath lab had sent him up to me with no warning and without calling any report. Of course there was a problem with the IABP on his arrival, and three other nurses and I were scrambling to fix the problem before we had to call the MDs and possibly shut down the pump and remove the line. The patient was NPO in case he had to go for emergency surgery. It was a huge clusterf**k, and through it all the patient was complaining that he'd had nothing to eat or drink all day. At first, as always, I explained his npo status and the rationale for it in the most polite way possible. But he just kept on and on about how he had not eaten. His complaining and my explaining (while trying to troubleshoot the iabp and lines and settle him in) went on for about ten minutes. Finally he yelled, "I'm ******* DYING of hunger here and none of you care!" I had absolutely had it and yelled back at him, "Sir, you might very well be dying, but NOT of HUNGER!" I thought the other nurses were going to choke when they heard that. I'm usually very patient, but that guy got on my last nerve. He and I got along pretty well after that, though.

:hhmth::hhmth::hhmth:

Being a life long critical care nurse that brought quite the visual for me!!!!!!!!!