Published
Whats your least favorite type of patient to take care of in the ER.....
Mine would have to be the drug over dose....had one on my last shift the treatment is pretty much the same What we normally get are the ones that havent done it right only taken enough to make them sleepy or beligerent so they dont end up intubated......Its pretty standard care....Large bore IV's monitor....foley....narcan/romazicon....charcoal...which always ends up all over the place........lol.....and sometimes NG tubes...they can be a real work out of your nursing skills....iv's, foley's, ng tubes...an of course restraints and the restraint paper work that goes with it.............Give me a lunger or MI any day.
One of my least favoriate patients...
The ones whose age (in months) equal the number of ER visits in their life. Oh and when asked who the PMD is, parents state the name of one of the ER docs. 3 yr olds should not qualify to be frequent flyers for insect bites, sniffles and "crying" for an hour. The parents though.... grrrrr.
Also, the fight-with-my-boyfriend-so-I-took-four-whole-xanax-cause-now-I-wanna-die. And is negative for Benzos. Besides,
why aren't you sleeping?
Ahh gotta love it.
Har har har. I love this thread.
:rotfl:
My least favorite are the ones with minor complaints and a condescending/demanding attitude. This is the nightmare scenario:
Young couple late 20s, childless, possible married but in a relationship nontheless. Out on the town for dinner and drinks. The girl gets good and drunk, but since she's been a partyer since her high school days she can handle her liquor; the dude gets less drunk but also can handle his liquor. The girl wrenches an ankle/faceplants/falls and hurts her wrist, whatever the case may be. Essentially an ESI level 3. They come in and it's a jammin' night in the ED, they get directed to Fast Track but have to wait in the lobby until space develops. Within 20 minutes the girl is complaining about waiting and the dude gets uppity about her having to wait "in the condition she's in". "She's been waiting and there's been people going back that don't look sick". You continually reinforce the concept of triage and try to be nice and explain how their stay will go. You point out she's gotten ice and Motrin/wound care.
They are not impressed. Dude gets on his cell phone. The girl continues to sneer at you when you walk by. More friends show up (also out to party and also a little tipsy). They begin asking. You respond but are brief in your response due to the pace and acuity of patients coming in. Dude shows back up, thrusts a cellphone in you face and says "her parents want to talk to you". You are barraged with the same questions the Dude asked you and has been asking you since they arrive. You end the phone call quickly and get back to work.
10 minutes later a guy you recognize as a rotating 1st year resident from some non-ER specialty shows up: a friend of the drunk couple. He starts asking you about the couple, what's the hold up, can't you just put them in fast track. You tell the resident if he values his life he'll get the flock outta your face and stop throwing his (miniscule) weight around..... on the inside. You tell him it ain't happening and his and their continued asking to speed things up are really bogging the process down, don't you remember what the ER rotaton was like for you?? Xray has been performed which gets them out of your hair for a brief respite.
Xray is back; the couple make it to a room in Fast Track. They've been here just over 1 hour. You herd out the 4 friends who want to follow in. The couple start sniping at each other; the Dude starts in on you again, what's the hold up, her xrays are done. At this point you want to throw the dude out of the ER but you know the girl will get more obnoxious. You finally drop a bomb: stop asking me every 5 minutes, graba chair and WAIT like the rest of the patients have to do. The subspecialty resident/friend is still milling around cozying up to the attending.
The attending finally goes in and sees the couple; they're giving him attitude over the wait and whatnot. He's seen the xrays and the diagnosis is minor; a splint will be needed and some wound care. The tech goes right in for wound care and the attending splits quickly. The girl is complaining to the tech, saying "nurse, can't you give me something more for the pain?". She's not being cooperative with the splint placement despite the repeated explanations that it has to be positioned properly for her injury to heal. She again asks for pain meds; you tell her she'll get a prescription for pain meds but she's been drinking so that precludes getting any narcs tonight. The Dude gets upset, asks you "why aren't you helping her pain". You ignore him and go and get their discharge instructions.
You go back to discharge her, making it as brief as possible. No use of affected extremity, wound care, follow up, etc. The Dude asks to see the charge nurse, "so I can complain about the b*llsh*t care we got". You tell the Dude quit the cussin' and you'll get the charge RN. He drops another one. You ask again to drop the cussin'. He finally complies. You leisurely walk toward the charge nurse desk to inform her about an opportunity for service recovery. You instead loop the ER and come back to the room they were in; the patients are gone. They are now out in the lobby, complaining to the triage tech, xray techs, everyone except security. You wait for him to drop one more cussbomb, which he does in about 30 seconds.
Ahh, sweet sweet relief. You page Security and let them know about the cussing guest in the lobby and let him handle it.... as you go back to your desk and enter a risk management report for verbally abusive guest.
That's a nightmare patient scenario for me. Sadly it was a very common occurrence.
-Craig
RN BSN and others.
brillohead, ADN, RN
1,781 Posts
Not my patient, obviously, but I think he'd have to qualify as a "least favorite" for some nurse somewhere:
Man saws off own foot to continue receiving unemployment benefits