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Post by Deleted on Mar 30, 2016 19:15:07 GMT
I so feel your pain! Even now, after not being an ED nurse for many years, I still get nervous whenever I see a full moon and thank my lucky stars that I now have a much less stressful day job! OMG!!! The full moon the other night? Black cloud, shit magnet, horrible day. We had about 24 inpatient holds in our ER, we started our shift at 0645 with a level 1 trauma, we had two heart alerts, one stroke alert, by 10am, then a pt in 4pt restraints, and ended with a level 1 trauma at 1835. That was just ONE of our pods with 12 beds. I don't even know what happened in our other 75 beds. m That just makes me cringe. So sorry you had a bad (sounds like an understatement!) night!
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Post by mcscrapper on Mar 30, 2016 20:34:30 GMT
justkat I wish I could like that post x1000. The 10/10 pain thing is really bugging me lately. EVERYONE thinks their pain is a 10 and I know this stuff is subjective but when you say that and you have no other clinical symptoms and you are walking and talking and eating everything in sight, I have a hard time believing you. Now, the guy with an open knee cap fracture or bilateral forearm fractures, or the guy with a dehissed wound post knee replacement and the hardware is sticking out and there is about 2-3 units of his blood in the floor....THAT guy is a 10. Funny, the knee replacement guy said, "nah, I'd say I'm about a 3, 3.5." He looked like crap and his BP was like 70/shitty, HR 130. I was like, "Dude. You are totally a 10!" Other things we don't want to hear: "I've been out of my meds and need a refill. I'm out of my percocet, my phenergan, oh and my soma." "I've been out of my psych meds for about 2-3 weeks." "I'm allergic to norco, percocet, fentanyl, dilaudid, zofran, reglan, compazine..." Yeah, I'll bet you are. Or when we ask about the pt's medical history and they say "Nothing" but their med list populates.... Imdur, plavix, amiodarone, lisinopril, HCTZ, metformin...... I beg to differ.
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Post by refugeepea on Mar 30, 2016 20:38:08 GMT
I don't think they like to hear me say we are going to need 3 people to hold my son down.
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Post by elaine on Mar 30, 2016 21:09:20 GMT
As a physician I agree with you on the ER/ED stuff. We get an idiot who makes one of these comments about how quiet it is and you can hear everyone gasp. That's the night we'll have 3 mass casualties and multiple GSWs from the brand new gang war that just started. I hate when patients tell me they have a years worth of vitals in a spreadsheet they've created from their Fitbit. Uumm ok what the hell am I supposed to do with this?! And why do you have it? Another is telling me your pain is a 10. Really? A 10? It's not that I'm skeptical but when you went outside to smoke and then went to the vending machine 6 times it really didn't look like a 10. When I did a peds rotation: I had one woman come in for a well baby check. I explained to her nicely that she shouldn't give her baby chocolate milk (could see the bottle). She laughed and said "oh no that's silly I'd never do that. This (holding up bottle) is coffee with lots of milk. He really likes it". Telling me I'm too young/too pretty/boobs too big/smell too good etc etc to be a doctor. Telling me your sexy nurse/sexy doctor fantasy as I'm trying to examine you. And yes it's happened more than once. (sigh) Telling me you don't need follow up to remove stitches or a cast because you can do it yourself. Yeah, no you can't. Well ok yes technically you can but you shouldn't. I can use a blowtorch to light a match but should I? I can remove a sore tooth with a rusty pair of pliers but should I? I'm not an MD, but I work in a surgical office. When you remove your own stitches, because you think it's time, and then run into problems, it is not our fault. When the doctor says to come back for 4 week post op follow up, and the clinic time happens to be 4 weeks and 3 days, I'm not trying to screw up your care. Surgeons do not see people 5 days a week, 8 hours a day. Trust me, I want the best for you and am fitting you in where you need to be - screaming at me won't help. And this one.. stop calling me because the patient portal isn't updated for OTHER offices. I am not tech support. Well, from the patient side of things - I had recent eye surgeries in Michigan. They removed the one stitch from eyelid number 1 when they did surgery on the other eye the following week. A couple of days later I returned home to the DC area. One week later I went to the Walter Reed ER to have the other stitch removed. It was amazing work - a one inch incision in the fold of my eyelid, but only one stitch. Anyhow, it took them three and 1/2 freaking hours of my sitting in a room before they finally decided they could take it out. Literally, 3 different doctors came in to look at it and each asked why I didn't go back to Michigan to have it removed. After calling and consulting with the ophthalmology department in the main hospital, they decided that since it had been 12 days the stitch needed to come out or it would cause problems. When they finally came at me with scissors and pliers it was out in 30 seconds. It made me wonder about doing it myself next time, since 3.5 hours to remove one stitch is excessive.
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Post by berty on Mar 30, 2016 21:46:35 GMT
For the LOVE....please don't ever say, "It sure is quiet in here today," while sitting in the ER. You are also not allowed to say, "Y'all look kinda slow for a Friday." We are never, EVER slow in the ER. Ever. "You just need to go ahead and call the IV team. No one can ever get an IV on me." Dude! I AM the IV team. If I can't get it in your arm on the first shot, I'm going for your neck. Now zip it and remember, *I* get to chose the needle size. "What is taking so long? I've seen X amount of people go back before me and I know I'm sicker than they are." Me thinking: Oh really? And where did you go to medical school? What I actually say: "Sir, I cannot discuss other patients' medical histories with you or why he is here. The fact that you aren't being rushed back means you aren't dying." "I haven't eaten in six days." Blood sugar reads 350. "My pain is a 10/10" while pt is texting and walking back and forth to the vending machines, or outside to smoke, and drove themselves to the hospital. Want to really make an ER nurse mad? Tell 'em your pain is a "20" Just don't ever say "quiet, slow, or not busy" while in the ED. Baaaaaadddd juju. meredith I so feel your pain! Even now, after not being an ED nurse for many years, I still get nervous whenever I see a full moon and thank my lucky stars that I now have a much less stressful day job! My mom has been retired for decades and still to this day every time there's a full moon she says, " a lot of babies are going to be born tonight."
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Post by anonrefugee on Mar 30, 2016 22:00:27 GMT
That annoys me and I'm not a medical professional.
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eleezybeth
Pearl Clutcher
Posts: 2,784
Jun 28, 2014 20:42:01 GMT
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Post by eleezybeth on Mar 30, 2016 22:11:12 GMT
I cover mental health emergencies in the ER. My biggest pet peeve ever is when a parent brings their "suicidal" child in. They throw a fit when we have to hospitalize them because they just "wanted someone to talk to them." Nope, sorry, your job is to talk to them, my job is safety first and if you could have done that you wouldn't have brought them to me.
As for the needles... I have a thyroid disorder. I give a shit ton of blood. You want to make your job easy? Follow the track marks. You want to be a renegade? Use my left arm, stick me three times, end up following the track marks. Every. Single. Time. I let you try, do your thing, you are the boss... I get it but then we get to have a chat about how you can listen to the patient--after all that's my committee.
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Post by freecharlie on Mar 30, 2016 22:19:34 GMT
The 10/10 pain thing is really bugging me lately. EVERYONE thinks their pain is a 10 and I know this stuff is subjective but when you say that and you have no other clinical symptoms and you are walking and talking and eating everything in sight, I have a hard time believing you. Now, the guy with an open knee cap fracture or bilateral forearm fractures, or the guy with a dehissed wound post knee replacement and the hardware is sticking out and there is about 2-3 units of his blood in the floor....THAT guy is a 10. Funny, the knee replacement guy said, "nah, I'd say I'm about a 3, 3.5." He looked like crap and his BP was like 70/shitty, HR 130. I was like, "Dude. You are totally a 10!" I'm one of those people who goes for the middle number because I figure a 10 is when my arm has been ripped off. I think I undershoot. I don't think they like to hear me say we are going to need 3 people to hold my son down DS had to be hospitalized for an asthma attack and dehydration when he was around 4. It took them forever to get the IV in and it hurt him. They had to use the restraints and pin him to the bed to get the IV out when it was time, he was so terrified. Until he was 10 I would have to completely restrain the kid for a shot. It often took 2-3 people to immobilize him. He's pretty much gotten over it now since he has had allergy shots for a couple of years, but it was a nightmare.
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raindancer
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Jun 26, 2014 20:10:29 GMT
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Post by raindancer on Mar 30, 2016 22:27:16 GMT
I told my lab tech I was a bad blood draw please use a butterfly. Close my eyes and pretend I'm anywhere else. After three sticks said lab tech says, I guess I'll try a butterfly. Grrr. I, too, am a bad stick. I hate even mentioning it because it seems like many phlebotomists take the comment as a thrown gauntlet. I screwed either way. My husband has this problem, and when he is dehydrated it's worse and he is always dehydrated at the er because he goes for small bowel obstructions and has been vomiting. They always patronize him, bruise the shit out his arms and then agree he is a hard stick. 2 weeks ago they couldn't get a new IV with an ultrasound and four people from the IV team. Finally they quit and he is still bruised. An anastesiologist had to do it. I understand that medical professionals feel like everyone says that, but it really sucks to watch my husband I. Pain because they have some damn pride issue
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Post by Darcy Collins on Mar 30, 2016 22:31:41 GMT
I get your vent - but as yet another bad stick - just remember the patient is probably offering that little tidbit after a few bad experiences. I actually don't think I'm a "hard" stick - just a bit more challenging than normal. But two nurses and 15+ attempts at an iv during active labor will make one a bit bitter. Especially when it took the good vampire about 2 seconds. Now I warn for a normal draw and wouldn't hesitate to ask for someone more experienced if I needed an iv.
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Post by lisacharlotte on Mar 30, 2016 22:33:16 GMT
The 10/10 pain thing is really bugging me lately. EVERYONE thinks their pain is a 10 and I know this stuff is subjective but when you say that and you have no other clinical symptoms and you are walking and talking and eating everything in sight, I have a hard time believing you. Now, the guy with an open knee cap fracture or bilateral forearm fractures, or the guy with a dehissed wound post knee replacement and the hardware is sticking out and there is about 2-3 units of his blood in the floor....THAT guy is a 10. Funny, the knee replacement guy said, "nah, I'd say I'm about a 3, 3.5." He looked like crap and his BP was like 70/shitty, HR 130. I was like, "Dude. You are totally a 10!" I'm one of those people who goes for the middle number because I figure a 10 is when my arm has been ripped off. I think I undershoot. I don't think they like to hear me say we are going to need 3 people to hold my son down DS had to be hospitalized for an asthma attack and dehydration when he was around 4. It took them forever to get the IV in and it hurt him. They had to use the restraints and pin him to the bed to get the IV out when it was time, he was so terrified. Until he was 10 I would have to completely restrain the kid for a shot. It often took 2-3 people to immobilize him. He's pretty much gotten over it now since he has had allergy shots for a couple of years, but it was a nightmare.[/quote] This was my kid. Once there was blood everywhere. Funny, he joined the army (infantry) and they had to practice giving each other IVs.
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Post by Heart on Mar 30, 2016 22:51:54 GMT
My husband is an incredibly hard stick. even with the IV finder, his veins roll, drop or clamp once a needle gets near them. He went in for surgery recently and it took longer to get his IV started than his procedure did. We warned them repeatedly that he's hard to get a needle into but it literally took 7 people and over 30 tries. They wound up using an infant needle on his knuckle.
Both my husband and son have a tendency for a vein to blow once a needle is in, beyond being hard to get a needle in. You bet your butt I am going to warn you and in my son's case, DEMAND a trauma/er tech because he FIGHTS. insinuating that I don't know what's best for my family is rude and jerky
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Post by pmm on Mar 31, 2016 1:32:06 GMT
I'm a respiratory therapist. My favorite is when a patient tells me they are allergic to albuterol. Then when I go through their home respiratory medications they tell me "I have a ProAir inhaler". I politely tell them that is a brand name for albuterol. Then they want to argue about it. Good grief!
I also hear "my veins roll" when I go in to draw arterial blood. They don't even let me get out of my mouth what it is I'm gonna do before they start going on and on about their roll-y veins. Takes me much longer to explain it than if they would have let me finish my sentence in the first place.
I always have a long discussion about the lab before I even look at my options...which there are only four, the other two we reserve for people that are dead or going to be dead despite our best efforts.
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flute4peace
Drama Llama
Posts: 6,757
Jul 3, 2014 14:38:35 GMT
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Post by flute4peace on Mar 31, 2016 1:58:12 GMT
For the LOVE....please don't ever say, "It sure is quiet in here today," while sitting in the ER. You are also not allowed to say, "Y'all look kinda slow for a Friday." We are never, EVER slow in the ER. Ever.
"You just need to go ahead and call the IV team. No one can ever get an IV on me." Dude! I AM the IV team. If I can't get it in your arm on the first shot, I'm going for your neck. Now zip it and remember, *I* get to chose the needle size. "What is taking so long? I've seen X amount of people go back before me and I know I'm sicker than they are." Me thinking: Oh really? And where did you go to medical school? What I actually say: "Sir, I cannot discuss other patients' medical histories with you or why he is here. The fact that you aren't being rushed back means you aren't dying." "I haven't eaten in six days." Blood sugar reads 350. "My pain is a 10/10" while pt is texting and walking back and forth to the vending machines, or outside to smoke, and drove themselves to the hospital. Want to really make an ER nurse mad? Tell 'em your pain is a "20" Just don't ever say "quiet, slow, or not busy" while in the ED. Baaaaaadddd juju. **EDIT** In my comment about IVs...I mean to include, "At least let me try before assuming I'm not going to get you on the first try." I usually DO get those harder sticks on the first try, I might add. meredith Oh my dear goodness no, NEVER EVER say the Q word. EV-ER. I work a bit with emergency services, enough to know that if something big happens, someone in the county has said it.
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flute4peace
Drama Llama
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Jul 3, 2014 14:38:35 GMT
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Post by flute4peace on Mar 31, 2016 1:59:18 GMT
I told my lab tech I was a bad blood draw please use a butterfly. Close my eyes and pretend I'm anywhere else. After three sticks said lab tech says, I guess I'll try a butterfly. Grrr. I always say they're not getting near me with a regular needle. I'll sit there all day waiting for that butterfly.
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flute4peace
Drama Llama
Posts: 6,757
Jul 3, 2014 14:38:35 GMT
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Post by flute4peace on Mar 31, 2016 2:06:44 GMT
I agree with everything you wrote, except for the part about the IVs. I've had chemo and now everyone has trouble drawing blood from me, so you'd better believe that I'm going to mention that and also mention that smaller is better (needle-wise). As for the "it's awfully quiet in here tonight" comment.... I know it's just a superstition but seriously I've seen its effects in real life. I was on call one night and called to the ER for someone. A family member said how quiet it was and ten minutes later there was a multi-car accident on the interstate right down the road. Another time a brand new chaplain said it, and boom an ambulance arrived witha heart attack and suddenly the waiting room filled up. I felt responsible for that one because I was the one showing that new chaplain around. oy. -- You'll never get me to admit that those were just coincidences. Yep. I was on the phone with a deputy one night when he said it. Before I could even finish chewing him out for saying it, tones went off. (turned out to be a nothing-berger so we had a good laugh)
One of our part-time city officers said it one morning, and we ended up with a month's worth of serious calls in about an hour and a half.
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Post by scrapsuzy on Mar 31, 2016 3:17:35 GMT
How about this patient doozy? "I can't stop throwing up. It is been constant all day." As said patient stands in front of me in full-glam make-up, eyes-poppin', lips smackin', hair perfectly in place, let's go out on a Saturday night.
I don't know about you, but when *I* can't stop throwing up, I can barely brush my hair or go anywhere. But hey, to each their own, right?
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Post by lorieann13 on Mar 31, 2016 3:47:03 GMT
justkat I wish I could like that post x1000. The 10/10 pain thing is really bugging me lately. EVERYONE thinks their pain is a 10 and I know this stuff is subjective but when you say that and you have no other clinical symptoms and you are walking and talking and eating everything in sight, I have a hard time believing you. Now, the guy with an open knee cap fracture or bilateral forearm fractures, or the guy with a dehissed wound post knee replacement and the hardware is sticking out and there is about 2-3 units of his blood in the floor....THAT guy is a 10. Funny, the knee replacement guy said, "nah, I'd say I'm about a 3, 3.5." He looked like crap and his BP was like 70/shitty, HR 130. I was like, "Dude. You are totally a 10!" Other things we don't want to hear: "I've been out of my meds and need a refill. I'm out of my percocet, my phenergan, oh and my soma." "I've been out of my psych meds for about 2-3 weeks." "I'm allergic to norco, percocet, fentanyl, dilaudid, zofran, reglan, compazine..." Yeah, I'll bet you are. Or when we ask about the pt's medical history and they say "Nothing" but their med list populates.... Imdur, plavix, amiodarone, lisinopril, HCTZ, metformin...... I beg to differ. Why does that bother you? Guess what I am allergic to reglan, morphine, vanco (red mans syndrome), demerol, stadol, codine, and every other pain main underbthe sun that is a narc. I can take regular tylenol and regular motrin (max 800mg).
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Post by lorieann13 on Mar 31, 2016 3:51:54 GMT
I don't think they like to hear me say we are going to need 3 people to hold my son down. My son needs 4. One on the legs, one on the upper body to hold the burrito wrap, one hold his shoulder, and one to hold his arm/elbow. A simple movement and his veins roll. He has ptsd from his many picu and acute care stays as well as having had a CVL and several surgeries. So he knows what is coming when he sees the white pab coat
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Deleted
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Post by Deleted on Mar 31, 2016 13:18:55 GMT
You might be the IV team, but I am the owner of this body and I am going to tell you something even if you might find insulting if it might spare me some pain. It would never occur to me that a medical professional would retaliate to receiving such information by deliberately choosing a tool that would cause unnecessary pain.I don't hesitate to tell a nurse or phlebotomist that I have bad veins with a tendency to roll. I also don't allow the same person to stick me more than 3 times. If you can't get the vein, and keep it, in 3 tries, you're out; call in the relief vampire. I came to this conclusion after a phlebotomist stuck me 14 times while I was in labor and never got a usable vein. My OB ran him off when he came in and saw me crying with band aids all over me. My DH is needle phobic and getting a simple blood draw can be hell for him. I can not tell you the number of times I have said to the person coming in to draw blood that he is needle phobic, please keep the needles covered and don't discuss them with him only to have that person decide that they have the right to demand that he get over it or that he look at how TINY the needle is or that he know that they are "going to stick him until the job is done." No, you're not - his body, he decides when you stop. There are many reasons that I love Kaiser, but their sensitivity training for their phlebotomists is definitely one of them. Kaiser has DH's file flagged for his needle phobia. When he goes in to have blood drawn, they have all the needles covered and they ask him if there is anything they can do to make this easier for him - would he like to lie down, stand up, face away from them - whatever works for him they are willing to do. No one touches him until he puts his arm out, no grabbing his hand and pulling on him. They ask if he wants to know when they're going to "begin" , i.e. stick him, or if he prefers they just do it quietly. His favorite lady told him to breathe out as she began and it would confuse his nerves and lessen his body's response. True or not, he believes it and it gives him a measure of control during the process. Before his stroke, I had to almost wrestle him down to get him in the car to go get blood drawn; since his stroke, he will go to one of the 2 Kaiser facilities we frequent for a blood draw ON HIS OWN with no arguing. My mom was the intake person for my home town's ER for several years. She said she could not believe the number of people who used the ER as a dr's office. The hospital opened a clinic and the ER nurses were told to direct patients towards the clinic if the initial interview showed the illness was not an emergency. The clinic had a fee upfront and the ER didn't, so many patients would refuse to go to the clinic. The nurses were told they were to call security when that happened. When news of this new policy got around, people who couldn't afford the clinic fee just started waiting until the clinic closed at 2 am to go into the ER. Marcy I agree with your "owner of this body" comment. Medical professionals may know more about people in general but we know what works for us. After several nightmare IV pokes over the years, one requiring the helicopter transport team to come in to do it in her hospital room, my daughter knows exactly what works for her. They are not offended but seem thankful to get it in one or two tries instead of one person trying and then another and then another until she is covered in band-aids.
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Post by lbp on Mar 31, 2016 13:40:03 GMT
I am an easy stick as I am very "veiny" however if you mess it up once, I will be on the floor the second time. I have no idea why I faint if I am stuck more than once. I get very hot and out I go. I do let them know that, and usually get an eye roll then they just have to deal with my passing out. The smarter ones know to recline me before the stick.
I also sometimes have to go to the emergency room because of my migraines. I go maybe once every 2-3 years and get tired of nurses treating me like I am a druggie. I know there are lots of people who go just to get pain killers. I am not one of them and don't like being treated as such.
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Deleted
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Sept 28, 2024 20:49:46 GMT
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Post by Deleted on Mar 31, 2016 14:02:30 GMT
My husband is an incredibly hard stick. even with the IV finder, his veins roll, drop or clamp once a needle gets near them. He went in for surgery recently and it took longer to get his IV started than his procedure did. We warned them repeatedly that he's hard to get a needle into but it literally took 7 people and over 30 tries. They wound up using an infant needle on his knuckle. Both my husband and son have a tendency for a vein to blow once a needle is in, beyond being hard to get a needle in. You bet your butt I am going to warn you and in my son's case, DEMAND a trauma/er tech because he FIGHTS. insinuating that I don't know what's best for my family is rude and jerky Your DH sounds like my daughter!! Seven people and 30 tries... that poor man. After one of my daughter's surgeries they told me "we had to use preemie needles!".. she was 17 at the time. I have not had nearly as many pokes as her but the last one I had, the nurse tried a couple times and called for an anesthesiologist. The first IV I ever had was in an emergency and all I can remember was two people, one on each arm, racing to get one in. I was pretty out of it, but it seemed as if they were making a contest of it.
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Deleted
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Post by Deleted on Mar 31, 2016 14:04:50 GMT
I don't think they like to hear me say we are going to need 3 people to hold my son down. My son needs 4. One on the legs, one on the upper body to hold the burrito wrap, one hold his shoulder, and one to hold his arm/elbow. A simple movement and his veins roll. He has ptsd from his many picu and acute care stays as well as having had a CVL and several surgeries. So he knows what is coming when he sees the white pab coat That is so sad..
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Post by refugeepea on Mar 31, 2016 14:15:07 GMT
I don't think they like to hear me say we are going to need 3 people to hold my son down. My son needs 4. One on the legs, one on the upper body to hold the burrito wrap, one hold his shoulder, and one to hold his arm/elbow. A simple movement and his veins roll. He has ptsd from his many picu and acute care stays as well as having had a CVL and several surgeries. So he knows what is coming when he sees the white pab coat He's only 7, but he's tall and fast. I can see me upping the number of people needed in the future.
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Post by pjaye on Mar 31, 2016 14:19:20 GMT
I have not had nearly as many pokes as her but the last one I had, the nurse tried a couple times and called for an anesthesiologist The trouble is that often when the nurse does believe the patient but the various doctors won't listen to the nurse. I admitted a lady one time who had been vomiting for several days, she was very overweight, had diabetes AND also told me that they always have trouble getting IVs in on her. So I called in the anaesthetist. He asked me how many times I'd tried and I said "none" then he proceeded to get shitty with me because I was calling him before I'd even tried. I pointed out all of the various reasons to him again and that I had looked at her arms carefully and couldn't even see enough to warrant a single attempt and said that I didn't think it was a good use of anyone's time or effort for me to stick her several times when I already knew I wouldn't be able to get it and in the process might potentially ruin a vein that he could have got. He came down later still complaining...he was on his 5th attempt when my shift finished and I went home...so I didn't get the chance to give him the "I told you so" look. So sometimes it's attitudes like these from those who are more experienced that guilt some nurses into trying when they already know it's not going to be successful. The 'I didn't try" isn't something well accepted in nursing, and is treated as a weakness even when there's a very good reason for it. I think sometimes the 'system' forgets that there are real people at the end of every nurse "trying".
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Deleted
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Post by Deleted on Mar 31, 2016 14:25:42 GMT
You know what I hate the most is when I medicate a patient and one of her her visitors says "hey can I get some of that". I know they are just trying to be cute and I always respond with a polite smile, but it drives me bananas. I panic when a patient says they think something bad is about to happen to them or when they say they think they are going to die. They are often correct. In OB, I hate it when parents want their free car seat. There is no free car seat people and I would love to just smack whoever is passing that rumor around town. Um. Our hospital does give away free car seats. A tire company sponsors it. A nursing teacher said that if a patient said that they were not going to make through surgery. Cancel the surgery, because 90% of the time the patient won't.
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Post by pjaye on Mar 31, 2016 14:35:53 GMT
When a patients says to me 'I have a very high pain tolerance" - that mostly means I'm going to be running to the drug supply for them all shift long. Same with "I'm a very good patient". you know that their finger is going to be on the bell more than anyone else's. People who feel the need to prepare you by telling you how little trouble they are going be already know that's not true...but somehow they still think that by saying it, you won't notice their constant demands.
The other times you know you're in for it is when your perfectly lovely, normal, rational patient of 5 minutes ago says "what are you going to do with that snake under my bed" or "I heard you talking about me and I won't drink that poison and I'm calling the police". Then you know your well planned & organised shift is going straight to hell and you'll be making phone calls and getting sedative orders all night at best...at worse you'll be holding down an irrational. screaming patient who is trying to escape because everyone wants to kill her.
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raindancer
Pearl Clutcher
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Jun 26, 2014 20:10:29 GMT
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Post by raindancer on Mar 31, 2016 14:54:41 GMT
justkat I wish I could like that post x1000. The 10/10 pain thing is really bugging me lately. EVERYONE thinks their pain is a 10 and I know this stuff is subjective but when you say that and you have no other clinical symptoms and you are walking and talking and eating everything in sight, I have a hard time believing you. Now, the guy with an open knee cap fracture or bilateral forearm fractures, or the guy with a dehissed wound post knee replacement and the hardware is sticking out and there is about 2-3 units of his blood in the floor....THAT guy is a 10. Funny, the knee replacement guy said, "nah, I'd say I'm about a 3, 3.5." He looked like crap and his BP was like 70/shitty, HR 130. I was like, "Dude. You are totally a 10!" Other things we don't want to hear: "I've been out of my meds and need a refill. I'm out of my percocet, my phenergan, oh and my soma." "I've been out of my psych meds for about 2-3 weeks." "I'm allergic to norco, percocet, fentanyl, dilaudid, zofran, reglan, compazine..." Yeah, I'll bet you are. Or when we ask about the pt's medical history and they say "Nothing" but their med list populates.... Imdur, plavix, amiodarone, lisinopril, HCTZ, metformin...... I beg to differ. Why does that bother you? Guess what I am allergic to reglan, morphine, vanco (red mans syndrome), demerol, stadol, codine, and every other pain main underbthe sun that is a narc. I can take regular tylenol and regular motrin (max 800mg). Yeah. We had a nurse who didn't believe my dh about being allergic to percocet. And she asked very condescendingly "What happens", um...hives, difficulty breathing, etc. "Oh" she stammered. He also reacts to demerol, becoming violently ill. But if he says he has a bad reaction people insist he try again, since it's not a "true allergy". What the hell difference does it make if he gets hives or starts violently vomiting? It makes him miserable. So he now states it as a known allergy because otherwise he gets ignored. So yeah. He might not have an allergy, but if you are going to be shitheads to people then you force their hand.
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raindancer
Pearl Clutcher
Posts: 3,095
Jun 26, 2014 20:10:29 GMT
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Post by raindancer on Mar 31, 2016 14:57:10 GMT
You know what I hate the most is when I medicate a patient and one of her her visitors says "hey can I get some of that". I know they are just trying to be cute and I always respond with a polite smile, but it drives me bananas. I panic when a patient says they think something bad is about to happen to them or when they say they think they are going to die. They are often correct. In OB, I hate it when parents want their free car seat. There is no free car seat people and I would love to just smack whoever is passing that rumor around town. Um. Our hospital does give away free car seats. A tire company sponsors it. A nursing teacher said that if a patient said that they were not going to make through surgery. Cancel the surgery, because 90% of the time the patient won't. I know one of the hospitals in Tucson does as well. Anyone who needs one can get one. They also have 2 health fairs per year and they give out free booster seats to anyone with a child under 4'9" and they give out free bike helmets as well.
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Post by pjaye on Mar 31, 2016 15:10:08 GMT
What the hell difference does it make if he gets hives or starts violently vomiting? It makes him miserable There is a big difference. Lots of people vomit with narcotics, it's a side effect of the drug and not an allergy and you don't want to limit your analgesic options unless there is a true allergy. The difference is that with the vomiting side effect that the right anti-emetic may well prevent it. Vomiting is not life threatening. Anaphylaxis is. So yes a big difference, "feeling miserable" vs potentially dying. I had a certain narcotic at home with a bad tooth abscess and one tablet had me over the toilet vomiting for the next 4 hours. Several months later in hospital for something else they mentioned giving me that same drug again, so I just said "I vomited for 4 hours last time I had it" the anaesthetist then gave me an anti-emetic (I didn't even ask/care what it was) and I was totally fine, no nausea or vomiting at all. Just telling the truth and telling medical professionals what happens means they can make better decisions on if/how to give some drugs, there's no need to make thing up that just pisses people off...as you've clearly already discovered.
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