You know it is going to be the admission from hell when.....

[deespoohbear]

You know it is going to be the admission from hell when....

1) Pt arrives and hands you a 4 page typed document that lists medications on page 1, allergies on page 2, diseases on page 3, and surgeries on page 4....(and the pages were filled from top to bottom with info)

2) The family arrives en masse and they haven't bathed in a coon's age.....

3) The POA tells you that they want their 95 y/o relative who has lived the past 15 years in a nursing home to be a full code. Never mind that the patient has Alzheimer's, Parkinson's, paralyzed on one side, ejection fraction of 10%, and so on and so on....they still want everything done to "save" the patient.....

4) The patient who has had several anti-emetics in the ER is still projectile vomiting as they are rolled off the elevator.....

I know there are others.....

[deespoohbear]

Originally posted by hapeewendy

I'm rather fond of the following admissions

"failure to thrive" "placement issues" "fatigue nyd" "falls"

yeah and ?????????????

what kind of medsurg miracle do you want me to pull from my hat to help cure that?

Wendy-May I ask what "fatigue nyd" stands for?

How about the admission that has the "primary caregiver" with them 24/7 telling the nursing staff on how to do their jobs....

My personal pet peeve with admissions is when you have the patient who is A&0 x3 (maybe a little hard of hearing, but in full control of their faculties) and the family has to answer the questions for them. Like, Mr. Smith...do you have a headache? And the daughter replies "yes, he does." Mr. Smith, do you have any numbness or tingling in your hands or feet? Daughter replies "yes, he does." And my personal favorite is when you ask the pt when was their last BM and the family answers that too. (On a patient who is able to ambulate themselves to the BR and care for their own hygiene). Makes me want to scream.... I have actually told some families that I am asking the patient and the patient seems to be able to answer appropiately.....usually quiets them down pretty quick....

[PRNnightnurse]

Originally posted by 3rdShiftGuy

When they are busted up in an MVA. Home meds include vicodin, soma, neurontin, valium, clonidine, ativan and haldol. Allergies include haldol and demorol.

The doc orders one percocet q6h prn. That's it.

AMEN!!!!!!!!! I work nights and I just love these kind of orders. I take evil delight in waking the doctor up to ask for more pain meds as the patient is screaming.

:roll

Jacki

[K O'Malley]

Yeah dawngloves, and I too love those admissions from ER--such as the "stable GI bleeder" who comes up on the gurney blue and gasping for air. OOps looks like he vomited and aspirated blood and then it goes downhill from there, down, down, down...

[hapeewendy]

fatigue nyd - what I'm suffering from right this very moment!

how lucky for you that youre not familiar with this type of admission !

It usually goes a lil somethin like this (hit it!):

pt feeling unwell and overly tired for a week or so , goes to emerg , does a lot of innovating explaining and imbelishing of symptoms , "oh I just cant move, I feel numb and tingly," and/or "no matter how long I sleep I cannot feel rested, I saw a tv program about sleep apnea and my cousins cousin has sleep apnea so im worried" etc

luckly for us all these admissions are rare but they usually involve the patient being a friend of a friend of the dr or someone on staff etc..

so yeah fatigue nyd ! heres the diagnosis - youre tired, get ur A$$ to bed!

in all seriuosness fatigue that is so debilitating should be taken seriously , I suffer from an illness in which fatigue is a HUGE part of the sypmtoms, if not THE major symptom, but really ,I've never seen a legit case of fatigue nyd , maybe someday!

[Stargazer]

Wendy--WHAT does the "nyd" stand for?

All I can think of is "fatigue New Year's Day"--which is, y'know, normal.

[mattsmom81]

Heroin OD in ER unresponsive and the ER nurse tells you "I'm Narcan'ing now and we'll be right up'.

Family members whose first words to you are 'I'm not leaving'...and they monopolize the situation as their unstable family member is crashing.

Postop heart rolls in and anesthesia remarks "Well, he was a little unstable a bit ago and he's all yours now" ...as he squirts in a few boluses from unlabeled 'mystery syringes' as he waves and runs out.

Patients and family who arrive immediately demanding to see 'the person in charge' and the supervisor has already alerted you she won't speak to them again.

Seems like the past 10 years the public has become so much more antagonistic...they are so often the problem not the patient.

[Stargazer]

Originally posted by mattsmom81

Heroin OD in ER unresponsive and the ER nurse tells you "I'm Narcan'ing now and we'll be right up'.

Now that's just mean!

Postop heart rolls in and anesthesia remarks "Well, he was a little unstable a bit ago and he's all yours now" ...as he squirts in a few boluses from unlabeled 'mystery syringes' as he waves and runs out.

This reminds me of the time that the open heart time apparently couldn't locate an ambu-bag anywhere in the OR (?) and decided, hey, it's just 50 feet down the hall to ICU, we'll just run him down there, he can go without being bagged for 30 seconds.

Except they got the bed number wrong and took him to the wrong side of ICU--the side where there WERE no empty rooms--and then had to turn around and go the opposite direction--yeah, the pt's sats were dropping just a tad by the time they finally made it into the correct room and we were able to start bagging him. Duh.

[zudy]

All the psych beds in the city, and indeed for 50 MILE RADIUS were full not long ago, so along with my usual ER pts I had 3 psych pts to hold until a miracle occurred. (Killer full moon) The first one told me not to get close to him, coz he knew I was going to implant a chip in his head. The second one was wearing a tiara and a candy necklace, the third said "So, when is breakfast served around her?" Inearly told her to go nibble on # 2's neck. At the end of 12 hours we these 3 PLUS all my reg pts (Yes, used guessed it, I AM NOT A PSYCH NURSE!!!!!!) # 1 pt reminded me for perhaps the hundredth time not to put a chip in his brain, I lost it and screamed, "Do I look like I have time to put a stupid chip in your brain!!!!! He looked thoughtful, and said "Well, no you don't." I have also taken care of Jesus,satan and Charley Pride, but not at the same time.

[NurseWeasel]

nyd = not yet determined, as in the cause ????

just a guess.

[hapeewendy]

fatigue - nyd = not yet diagnosed

:)

[Stargazer]

Ah--thank you. Maybe I'll be smarter after another cup of coffee. (Hey, a girl can dream, can't she?) :)

[hapeewendy]

youre plenty brilliant enough!

who would figure fatigue would need a diagnosis

I can see the nanda book now , well in my case anyway

fatigue related to lack of sleep caused by insane work schedule

fatigue related to lack of sleep secondary to partying ones ass off too much on a saturday night

ah well you get tha point!