Sometimes patients will arrive in the ER triage and you know they are not really sick, and they have an agenda.  Unfortunately many times it is to acquire drugs.  Sometimes the same person will come over and over again for the same reason, but with a different ailment each time.

Sometimes these people require confrontation by a physician to get them to realize their efforts are not going to work, but other times it is just too funny and there really is nothing that can be done. If you come to an emergency room with a specific complaint you WILL be worked up and treated for what is found related to that complaint.  If nothing is found, all your testing is normal, then you will not be treated.

The following is just a funny (or maybe not) video someone on YouTube put together to typify these kinds of folks that visit ER’s habitually.

You Just Never Know What Patients Are Going to Do Next

Technorati Tags: Drug Seeking, ER, nursing, patient care, Seiures

[2] Comments

This story is going to be hard to believe as true. But I am telling you it is!! So just read with a bit tolerance. And remember there is nothing more entertaining than the truth of human nature.

I was a new graduate and a little gullible, admittedly so. I was in my first job after graduation. And I was ready to make a difference. I wanted to help everyone. I believed anything… I cared.

In the small town that I trained there was a federal prison that was contracted with my hospital for patient care. I was on duty the night they brought in a male prisoner onto my unit with complaints of abdominal pain. Needless to say I was a little intimidated.

But he was a patient first, a prisoner second. I was determined to give him the care he needed. Of course they did all the usual tests and it was discerned that he was constipated. Worse yet, he was impacted with hard stool and the treatment was to manually disimpact him. All the medical people reading this, knows what that entails. Everyone else, I had to stick my finger up his rectum and pull out the hard feces….really.

I couldn’t believe it either…

But I was young, new and out to save humanity. I had a job to do and I was going to do it.

So I went into the patient. He was a very large tattooed bear of a man. Did I mention he was huge? Really scary. And unusually quiet. He did not respond to any attempts on my part to engage him in conversation. This was really okay with me since I was actually quite frightened.

I explained to the patient what it was I needed to do for him. He accepted the information and said for me to go ahead and do it. I proceeded to perform the procedure and received the shock of my life and to this day, 40 years later, has not been matched by any other experience.

I pulled from his bottom a hundred dollar bill!! And after that, more money… twenties, tens, fives and more hundreds. One bill after another, I was shocked. I didn’t know what to do. Should I tell him?

Well of course, he had to know they were there, so I told him what I had found. He asked me how much I had found so far, I quickly added it up and he said to keep going, I hadn’t gotten it all yet.

Really? Are you kidding me?

So I kept going…

To the tune of $5,460! Yep! More than $5,000. And you know what? He was a really nice man.

He told me why he had to go to prison. He had killed his wife’s lover. It was considered a crime of passion and he was probably able to be rehabilitated. And he was a model prisoner. (Which I learned from the guard that was outside his hospital room door the entire time he was in the hospital). He was more talkative now, He wanted to know what I was going to do with the money. I explained it was his money, I was going to give it back to him. But I strongly recommended he not put it back where I had found it, since his abdominal pain that had now been relieved would return. Also he was potentially going to rupture his bowel and the complications could include death. He agreed a new plan was needed.

I rinsed all the money in the bathroom sink and dried it with the paper towels and rolled it all up in a money roll and gave it back to him. He was very grateful and very sweet about it. He promised he would find a new place to keep his money.

I never said anything to the guard. In my mind, it was none of his business.

However, I just had to ask my patient why he had the money in his butt. He bashfully answered and said he didn’t have anywhere else to hide it and he was so big and mean looking that none of the little hoodlums would be brave or strong enough to try to sodomize him.

Well… I asked!

Technorati Tags: constipation, nursing outcomes, nursing patients, patient care

[10] Comments

Back in the early eighties, it came strongly into focus about patient rights. It was decided by the Joint Commission, now known as JACHO (the accrediting council for hospitals) that it was no longer allowed to physically restrain patients.

You see it used to be a safety practice for confused patients if they were in danger of harming themselves or others we would put what was called a Posey jacket or wrist restraints on there person to keep them safe. A Posey jacket was a little front and back jacket with strings that could be tied to the bottom of the bed. Usually this was enough but sometimes they had to have their wrists restrained because they could get themselves undone with just the jacket. We called these patients Houdini.

Of course, we would include the family in the decision regarding patient rights and ask them to come sit with the patient to prevent this from being necessary. Sometimes they were willing, other times they would give permission for the restraints.

Don’t get me wrong, it was actually quite humane, patients that were confused were constantly pulling out their IV’s or falling out of bed, or pulling out their urinary catheters. All these things are dangerous and painful. So it was all good.

Well, it was to be no more, no restraints! Patient rights ruled over patient safety.

Well this one evening, I had a little 85 year old Alzheimer’s patient that was very very confused and disoriented. I had her bed in the lowest position, but she kept getting out of bed. She was very much in danger of getting hurt, I worried so much about her. Then I got an idea…

I asked her what she used to do when she was younger, she said she took care of her home and family. Well that is all I needed to hear. I told her I also had a family and home to take care of and that I was overwhelmed with how much I had to do and I wondered if she had time, would she like to help me. She was eager to help me.

I left her room and returned with a big box of towels and washcloths and pillow cases, all jumbled up. I told her it was just out of the dryer and needed to get folded. Her face was joyful. She had a purpose. She had something to do. She was somebody again.

She meticulously folded each and every piece and stacked them all up. It took her an hour. She was so proud when she offered her completed project to me. I thanked her profusely, kissed her cheek, went outside the room and messed it all up again.

I stayed gone for a few minutes to give her a little time to recoup and then I brought the next “load” in for her to fold. She looked at me and started folding. She did an excellent job. She finished again in about an hour.

I came in a third time with another “load” and her face looked a little troubled. Then she pushed the basket back to me and said “Honey, I’ve tried to help you, but you are going to have to learn to take care of your own home. I am not always going to be here for you. You need to stand on your own two feet now.” It was great! I tried hard not to smile, really I did. She then told me she was exhausted and she was going to bed.

She went to bed for the entire night, slept like a baby and was never restrained. From then on we just kept her busy with chores and never had to restrain her again. Her patient rights remain intact! What a memory.

Technorati Tags: medical patient, patient health, patient mental, patient rights, patient safety, patient treatment, patients rights, rights

[6] Comments

Hello, my name is Susan, I am a registered nurse with a large variety of nursing experiences. I have been nursing for forty years. I have a sub-specialty in orthopedics, cardiology and alcohol and drug withdrawal and rehabilitation. I have also worked in most fields of nursing, and I am currently working in emergency medicine.

I love nursing. I have had the most amazing career in all different fields of nursing. I have met so many people. Wonderful dynamic and talented physicians, excellent technicians, memorable patients and so many friends along the way that I feel truly blessed

Many different emotions come into play when I think back over the years. Some memories are beautiful and very endearing while others are outrageous and some even make me feel the anger I felt at the time. Some are very humorous and cause me to laugh right out loud with the memory. Some other memories are even shocking and a bit disturbing.

No matter what, people are people and it takes all kinds to make the world go round. And most of those people, sooner or later, turn up in the hospital with one complaint or another. And that’s when I have been able to meet so many different people with all types of problems.

Some we were able to help, others may have had little hope, while some had nothing physically wrong but were dealing with different psych or substance abuse problems. But they are still all people deserving of respectful and loving care.

The purpose of this blog is to share these memories. A kind of tribute to the many people and events that have occurred in my career. Now I do want to give a mild warning here. I will be honest with how things occurred. Sometimes things could be a bit crude, or graphic, or even bloody. Or maybe you might not agree with some of the choices I made. But I will still record them here as honestly as memory serves me. Also none of the names mentioned in this blog will ever be the person’s actual name. I will also change other non relevant details to make the event less recognizable so as to protect the anonymity of the people involved.

I also want to impart any knowledge about diseases, conditions and health and wellness. My experience will help you learn about the things that could potentially  affect us. Hopefully will you will live long healthy lives and if anything I tell you helps in that journey, I will be continuing in my role of nurse and caregiver and it will make me happy for us both.

All the stories, tales and quips will be true life and as accurate as memory serves. All the medical information will be researched and as accurate as possible, but nothing on this website should be utilized as medical treatment or  in lieu of your physician and his care. This is not a clinic or hospital or advice center. Just information and entertainment.  So settle back and enjoy memories of forty years of nursing.

Technorati Tags: emergency nursing, Nurse, nurses, nursing care, nursing job, nursing patient care, nursing skills, professional nursing

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