I am in my clinicals and I had this very interesting patient for a few days and he told me some stuff that i'm not sure if I should tell anyone but he claimed he does not take his medicine or insulin purposely which makes his diabetes go into DKA so he can have a stay in the hospital because he enjoys being here and loves the treatment and food. He is not a frequent flyer as this is his first time here
I know patients have a right to refuse medicine but is this something i should bring to anyone's attention.
Honestly, who wants to be in a hospital bed for days on end watching peoples court and hearing beeping sounds and have cords all over
He said he wants to make his glucose go over 1000 to see what happens. He says he is just curious
Specializes in Med/Surge, Psych, LTC, Home Health.
He needs a psych consult.
I had a patient once who was a frequent flyer, she was a young girl with a heart defect who was constantly being admitted with her PT/INR totally out of whack. It was pretty much determined that she was deliberately either not taking her Coumadin, or over taking it, so that she could go into the hospital and have lots of attention.
He is either serious and needs a psych consult or screwing with you since you're a student.. Either way, you need to protect yourself and tell the nurse/document what he said.
He is either serious and needs a psych consult or screwing with you since you're a student.. Either way, you need to protect yourself and tell the nurse/document what he said.
I also have direct experience with a patient who purposely lets themselves go into DKA so they get admitted for the drugs. This particular individual has been admitted 6 times since April of this year. I just wonder at what point do the providers stop prescribing the narcotic pain meds and give non-narcotics.
Patients like this really burn out the ICU staff because these patients are constantly on their call bell with 10/10 pain that the previous dose didn't help. These same patients also give us terrible surveys because we "didn't treat their pain" and gave "horrible service" when we couldn't drop what we were doing to bring them their sugar free soda and Dilaudid the exact second they rang the call bell. These same patients were also snoring 10 seconds before their cell phone alarm went off so they could request more pain meds. I can't chart an objective
I realize that we can't fix these people, and we are just supposed to take their word for it, but its disgusting that these individuals, with proven track records, continue to get their way. I will medicate regardless, even if I have to put it on a pump to go in over 2-5 minutes, but the point still remains.
Let him read the story of this little girl who had a blood sugar >1000 and see what he says. The girl ended up dying from complications related to her high blood sugar.
Let him read the story of this little girl who had a blood sugar >1000 and see what he says. The girl ended up dying from complications related to her high blood sugar.
I see this a lot, never been told straight up that they want to see how high the sugars can get though. Lots of malingering in the hospital system for one reason or another. I like the response from a prior poster regarding how being in the hospital is a lot better than their home life. I've seen an influx of homeless patients come in with uncontrolled whatever they have when it gets over 100 or below 30. They are hot/freezing and miserable being outside and let their disease process get out of hand at convenient times.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I see this a lot, never been told straight up that they want to see how high the sugars can get though. Lots of malingering in the hospital system for one reason or another. I like the response from a prior poster regarding how being in the hospital is a lot better than their home life. I've seen an influx of homeless patients come in with uncontrolled whatever they have when it gets over 100 or below 30. They are hot/freezing and miserable being outside and let their disease process get out of hand at convenient times.
Or their disease gets out of control because they are too hot, cold or miserable for self care.
Or their disease gets out of control because they are too hot, cold or miserable for self care.
Or they can't lay hands on critical medication or supplies, ie insulin (lantus retails for close to $300 for one vial) or syringes. Or the meds/supplies get stolen - you can't drink insulin, after all. Or the mental health issues that put them on the street escalate past the point where self-care is even possible.
Survival issues when you are homeless are very, very different from those faced by the rest of us.
Being homeless and broke doesn't help matters, but the individual about which I speak doesn't match either of those. They are on government insurance so no excuse for not having diabetes supplies, and they have a home. That's whats frustrating. They are willing to put their life on the line for narcotics and the doctors continue to oblige them. Mental health consult and all, nothing changes this particular patient.
NurseCard, ADN
2,850 Posts
He needs a psych consult.
I had a patient once who was a frequent flyer, she was a young girl with a heart defect who was constantly being admitted with her PT/INR totally out of whack. It was pretty much determined that she was deliberately either not taking her Coumadin, or over taking it, so that she could go into the hospital and have lots of attention.