Your least favorite patient.

brillohead, ADN, RN · Mar 30, 2012

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

It sounds like the plot of a boring "Saw" film, but it's apparently all too real. An unemployed Austrian man cut off his own foot with a mitre saw so he could continue receiving jobless benefits.
Hans Url, a 56-year-old from Mitterlabill, then took the foot and cooked it in the oven so doctors could not reattach it.
"The planning was meticulous," Franz Fasching, a police spokesman, told the Daily Mail. "(Url) waited until his wife and his adult son had left the house and he was alone. He then switched it on and sliced off his left foot above the ankle—throwing it in the fire so it would not be possible to reattach it before he called emergency services." He "then made his way to the garage where he called emergency services and waited for them to arrive."
Url was airlifted to a hospital in Graz, where he was put in an artificial coma so doctors could stabilize him. "The foot was too badly burned to reattach," a hospital spokesman said. "All we could do was seal the wound. He had lost a lot of blood—he almost died on the way to hospital."
According to the Austrian Times, Url had complained before the incident that he was too sick to work and "didn't like the work he was offered." The kicker: According to the paper, being footless does not necessarily qualify Url for unemployment compensation.
"He will be assessed once he is out of hospital, and we will see what work we can find for him," Hermann Gössinger, a spokesman for the employment benefits office, said.

SolaceRN · Mar 31, 2012

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.

CraigBSN02 · Apr 1, 2012

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.

NO50FRANNY · Apr 3, 2012

I usually don't give out chances, you are way more patient than me- you swear at me, I have you chucked.