What HAVE you said to patients???

carolmaccas66, BSN, RN · Apr 6, 2011

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.

We were always told the pith was the white stuff under the skin of the orange peel. We used to laugh when teachers said it cos it sounded like p**s! (we were all young and stupid then)

highlandlass1592, BSN, RN · Apr 6, 2011

the most memorable thing that i'd ever said was not to a patient, but to a visitor, who demanded to be let into a busy emergency department to see someone (who at that point in time wasn't allowed visitors) and was told that he could not be let it. he then shouted, "look at you, so full of yourself, on a power trip drunk with authority..."
before he could finish, i replied, "exactly, so i see that you understand perfectly then, that i would have no reservations whatsoever, in calling the police and having you arrested for criminal trespass, if you so much as even try to set foot past this door?"
he just stood there slack jawed for a few seconds before turning back into the waiting room, which coincidentally, also suddenly became as quiet as a morgue.
it was one of my finest nursing moments, lol...

:bowingpur:bowingpur:bowingpur:bowingpur:bowingpur:bowingpur:bowingpur:bowingpur

highlandlass1592, BSN, RN · Apr 6, 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.

:bowingpur:bowingpur:bowingpur:bowingpur:bowingpur

highlandlass1592, BSN, RN · Apr 6, 2011

One day many years ago in a very busy ICU the husband and boyfriend of a critical patient showed up at he same much to each others suprise. As they proceeded to fist fight and hit each other with furniture I took the CO2 fire extinguisher and sprayed them both.........as they looked at me in shock I informed them that I was far too busy to deal with their crap....as they both tried to plead their case......I informed them....."Frankly I don't care if you go outside and kill each other....as long as it is across the street and I don't have to fill out the paperwork!" They looked at each other and walked out talking to each other about how crazy that nurse was........

:bowingpur:bowingpur:bowingpur:bowingpur

Not_A_Hat_Person, RN · Apr 6, 2011

When I worked in Assisted Living, there was a power outage during a weekend shift. Just after the lights came back on, I got a page about a resident fall. I ran upstairs, carrying 3 lanterns.

When I arrived in the room, the Resident was on the floor, with an aide kneeling next to him. The resident's wife, a well-known witch (with a capital B) was screaming "Where were you?! I've been waiting 10 minutes! I pay $X000 a month for nursing care!" After a quick assessment of the resident, I asked his wife what happened. She responded "Why are you asking me? You're the nurse! I'm not a member of the health care team! I pay $X000 a month for nursing services!"

Finally, I responded "Ma'am, I'm trying to help your husband, but you're not giving me much to go on. I'm going to talk to my aide now." Then I turned and asked the aide what happened. The wife shut up, probably from shock.

During my brief tour of Nursinfg Home Hell, one of may patients was an extremely histrionic elderly woman. She got all of her meds via G-Tube, and if you didn't follow her directions exactly, she would throw screaming, crying fits. It was like working with a very large toddler.

She didn't like something I did. The tantrum started. I tried to explain what was going on. She kept crying and screaming, then put her hands over her ears. Fed up, I packed up whatever I was doing, said "I'm going to give you some space" and walked out.

Ibelieve13 · Apr 6, 2011

Lmao that is to. Funny. Grandma played bad cop good cop on you only in bad patient good patient form!! :nurse: :jester:

cb_rn · Apr 6, 2011

I hate it when families tell you not to give Mom morphine because she doesn't need it. Once we had this patient that just wouldn't leave - literally - every time a d/c order got written the daughter threw a fit until one of the docs would come up with some inane reason to keep her. Including a dermatology eval on a 90 year old for ... a hanging skin tag.

The daughter would call in the middle of the night to check on her mom. Ok, fine. So I go through a run down of every burp, fart, and snore that came out of mommy dearest, including the fact that I gave her morphine per the patient's request. Daughter goes bezerk, says she specifically told us not to give her mother that medication and asks how dumb can "we" be at the hospital. My reply?

"Miss So-andso, I went to school for several years to earn a license to assess patients. Your mother is ordered morphine on an as needed basis by her physician who went to school for several years to learn how to prescribe medication. She told me her leg was hurting and requested the medication. You don't have the authority to tell me not to give her prescribed medication that she is requesting. She is perfectly capable of making decisions about her healthcare. If you don't want her to have morphine you need to let her get discharged so that you can micromanage her care from home rather than waste your breath with me. Goodnight." Click.

LouisVRN, RN · Apr 6, 2011

"If you don't like the fact that we aren't giving you all the pain meds you have been prescribed outpatient by numerous physicians and then lied to our pain management doctor about, you are free to leave and take what you have at home."

MeTheRN, BSN, MSN, RN · Apr 6, 2011

To a BiPAP patient who was tachypneic and freaking out, even after I just pushed sedation meds:

"...that's fine, you don't have to calm down and breathe. I'll be happy to have you intubated."

To a patient berating me about being NPO and possibly having to go for emergency surgery:

"If you eat anything or even take so much as one sip of water, you will aspirate during surgery and suffocate to death and die on the OR table."

Sometimes you just need to be blunt.

MeTheRN, BSN, MSN, RN · Apr 6, 2011

To a BiPAP patient who was tachypneic and freaking out, even after I just pushed sedation meds:
"...that's fine, you don't have to calm down and breathe. I'll be happy to have you intubated."
To a patient berating me about being NPO and possibly having to go for emergency surgery:
"If you eat anything or even take so much as one sip of water, you will aspirate during surgery and suffocate to death and die on the OR table."
Sometimes you just need to be blunt.

FANTASTIC!

eriksoln, BSN, RN · Apr 6, 2011

Had a guy riding the high horse once about "protecting" his mother and insuring she got "the best of care". She was post OP, and the CNA went in to begin the post op vitals. The family, mainly the guy, started getting high and mighty with the CNA. The jest of what they said to her was that she was too young/immature to handle such detailed care as they expect. They went on to add that she seemed "too passive" and "not all that bright" to be doing a CNA's job. I overheard it and said not to worry about anymore vitals, I'd take care of doing them.

Two minutes later, they guy comes out and again begins expanding on why they don't want the CNA in his mother's room. "We want only the best for our mother and know how to get it." I explained to him I'd be handling the vitals and care myself for the rest of the night, hoping he'd be satisfied and go back in the room. Nope.

He then went on to explain to me how he is not completely happy with the care she received pre-op. "I don't see the nurses as often as I should. I don't know what they are doing but it can wait when my mother's care is involved. She comes first."

I gave him the "old man peering over his glasses" look and responded: "Well, sir, if you are in the habit of telling caretakers they are too young or stupid or immature when you see them in the room, I'm kinda understanding why you don't see them as often as you'd like."

He stared at me, not sure what to answer, and then started in with the "But its your job, so you have to do it regardless. Am I right? Aren't I? You have to go in."

My response: "Well, sir, you are the one out here telling me you don't see nurses as often as you'd like so, you tell me.............do we have to go in?"

I was expecting rage, to be fired from the assignment and to have to explain the whole thing to my manager the next day. Nope.

He apologised, went in the room, made all the family leave and came out to tell me "I'm leaving in ten minutes, no one will bother you guys anymore."

Me: :eek:

eriksoln, BSN, RN · Apr 6, 2011

Had one of those grandmothers who just relished being waited on one time. She was, one of those people that........the better they felt, the needier they got. She was being D/C'd in the AM so she was MILKING it while she could.

My explination of how it works:

"See, I am here 8 hours. I have 8 patients. Thats basically one hour each patient. But, when you take the time out for getting report, my half hour break, documentation and everything else, its reall more like 8 patients and 6 hours. So, you get me for 45 min. when the math is all said and done. But it gets even better! Cause close to 20-30 min. of that time is spent doing your meds. So, at best, you have me for 25 minutes during the day. Now........if you want those 25 minutes to be spent opening and closing your blinds and moving the tissue box from here to there and back here again........its your choice. But when your 25 minutes are up...........they are up. So, if you need a breathing treatment or walked to the BR..........you might have to wait for someone else, cause I'm giving everyone else their 25 minutes. Oh, and BTW, I just spent 10 minutes explaining this to you."

Call light never went on again all night, except for breathing treatments and to walk to the BR.