911... what is your emergency?

So when you call 911, they will always ask you "what is your EMERGENCY?"

I'd like to know how a 40-something patient explains that her 'emergency' is that she had a "cough that started yesterday and was bothering her" with a straight face.

She was alert and oriented, ambulatory, and without mental deficiencies. Although I'm prone to not believe the last characteristic to be true.

But she called 911... she was dead serious... she took the ambulance in... and she would not leave when they wanted to discharge her. She made the ED docs life such hell that they finally admitted her.

And as you guessed it... she did not have medical insurance AND her cough was creating her so much pain that she needed some narcotics as soon as possible. LIKE NOW!!!

Mesh panties

So the other day a patients family member came out to the nursing unit and asked if we had underwear for the patients.

The nurse informed this "wife" that we only had one-size-fits-all mesh panties for the female patients on their menstrual cycle (to hold the sanitary napkin in place... duh). Ick... I know. Sorry.

So the "wife" went away for a while. Later she showed up again requesting these mesh panties. Well... we already explained what they were so we handed them over without question. (Although we were all very curious!)

Later in the shift the nurse entered the MALE patients room and found the patient lounging around in these mesh panties.

EEEWWWWW! and Why??

Dressing change hell

So you are covered in abscess's. Where did these abscess's come from?? You are using heroin and meth... and apparently you think the best route is "skin popping."

NOT my issue.

But you want treatment for these abscess's... cause I'm sure the are causing you pain and issues. Fine... welcome to our hospital. The doctors admit you, they treat you with antibiotics, and they even take you to minor surgery and clean some of these abscess's out.

You are a guest in this fine hospital of ours. We are feeding you, we are boarding you, we are giving you medicine's finest antibiotics to rid you of these pests, we are giving you pain medicine for the discomfort you must feel after years of "skin popping" that you applied upon yourself, and we are changing your abscess's dressings so that you might heal. SO PLEASE DO NOT SCREAM BLOODY MURDER TO THE NURSE WHEN THEY ARE DOING THESE THINGS FOR YOU.

And... going AMA so that you can go get your "fix" so that you can "handle" your dressing changes will not be tolerated. We will NOT save your bed for 5 hours, so that when you return we can give you MORE drugs and then try to "treat" your condition.

Cause NOW... I DON'T GIVE A SHIT. If you want those "pesty" abscess's off... I'll just take your arms off completely. Try smoking your meth or shooting up your heroin without arms.

Take a picture, please... I'd like to see it.

Tattoo's and IV's

If there is one thing that I get a lot of experience in, it is starting IV lines. I often get called by nurses on my unit to start an IV, difficult or otherwise. Sometimes we are forced to put and IV in a foot... not our first choice, but if their veins are shot in their arms... we go for the feet. I've done it all.

I actually like putting IV lines in, but I don't just put them in for fun. I really only try if I think I have a good chance at getting the line in.

But a few pet peeves about putting lines into patients...

One... please don't tell me where to put the IV. I will a) think you are an IV drug user, if you know where to put it. and b) I will NOT put the IV where you "like" it best, I will PUT it were my nursing judgment tells me the best place is.

Two... if you are covered in tattoo's, don't tell me you are afraid of needles. Because I won't understand. And yes, I've gotten a tattoo or two. So don't play that card. I won't get it and I really won't try to... suck it up.

Three... If you have a tattoo, don't explain to me that a certain IV line might RUIN your tattoo. Because when we can't get a line in you to give you your Dilaudid and Ativan... guess you got to choose... the IV or the tattoo. Cause you can't have both.

And FOUR... the most obnoxious one on the list. I really don't want to start the IV between your tattoo'd ladies nipple and the snake tongue. So while I like starting IV's, this still seems a little over the line for me.
*In my head... tourniquet, check; gloves, check; IV setup, check; needle, check; alcohol, check; landmark... OMG... nipple and tongue.*

F this.

Many unknown

We admitted an elderly patient last night with a left hip fracture.

Many issues came to light with this particular admit...

First... the patient had been walking around on this fractured hip for over a week. The patient claims that they saw their naturopathic physician after a fall last week. The doc told them that all they needed to do was rest and take Tylenol if absolutely necessary. As you can see, the patient turned back to western medicine and brought themselves to the hospital when the pain was just too much to take.

Second... to get the patients pain under control we had to use Morphine, Valium, and Dilaudid. How the heck did the patient get by at home??

Third... my favorite, the allergy list. One form said "many unknown." WTF does that mean?? Another form said "almost all medications." I think the naturopathic physician filled the patients head with some really good ideas. Honestly... if you tell us you are allergic to almost all medications... guess we can't give them to you. Unless you, as the patient, cannot tell me when you had a certain medication and what your reaction to it was... guess we are going to test the medication out. You just took three narcs... trial and error??

**This is not meant to sway any opinions regarding naturopathic medicice or slander naturopathic medicine in any way. It is just a story. As a healthcare provider I respect all people and their practice and/ or beliefs. It is simply unfortunate that this patient lived in pain for over a week.**

Riddle me this...

Your medical history includes hypertension (high blood pressure) and a brain aneurysm. You deny using recreational drugs, alcohol, or tobacco. You don't have a history of pain, acute or chronic.

So tell me... why do you have METHADONE listed as one of your home medications??

A what??

We admitted a patient who was severely assaulted. Someone really took out some anger on this poor patient.

So what was the patient assaulted with?? A hanger, a shoe, and a peanut butter jar.

WTF? For one, I didn't think a hanger could be so dangerous. Two, a peanut butter jar? Really? And three, why do we know this?? Or care?

People never cease to amaze me.