So, obviously drug seekers are a big cause of frustration and wasted resources in ERs, but I think the number one thing that I deal with that tests my patience the greatest is the douchebags with no medical training that want to micromanage how you do your work. I had people like this recently who were seriously so ridiculous that they wanted to argue with everything we did down to the dosages and types of medications. Might I add, the suggestions in question- yeah, most likely would have been lethal. For a condition that is pretty black and white on how to treat. Rationale was given and was recieved with many a scoff. Efficient care was met with suspicion and hostility. I seriously have no idea what the hell these people's problem was. But, one of our doctors has suggested a solution that I think will please everyone.
He suggests that we can go ahead and just make all of our medicines and medical supplies available to everyone. You want 15 mgs of Dilaudid at once? Cool, go buy it and make it happen! You think you and your layperson family can manage your care better than all these dumbshits down at the ER? Go to the store and get all the supplies and meds you need, and see how it works at home. If it turns out to be harder than you think, you can always come see us, and maybe you'll appreciate the fact that we went to school for this for a reason and let us do our damn jobs. Hey, you can even pay by the hour to rent one our stretchers. You can pay another fee to have Pyxis access and you can pay us by IV set for every start attempt you make. At any time, you can opt to STFU and let us take over.
Look, I realize this is ridiculous, but I'm really curious how many people would call our bluff if we gave them the chance. I bet the attitude would change after about an hour. We'd just have to stock up on Dilaudid.
You are seriously a genius. This would most definitely solve many of our woes, and I fully support the idea!
ReplyDeleteI wish I could take credit. This is actually the same doctor that came up with the drug, admission and work excuse menu. I'm campaigning for him as new ER director.
ReplyDeleteWe get the same sort of stuff in offices, too.
ReplyDeleteI had a patient the other day who called back after she left the office because she (or her significant other) wasn't happy with the dose of her pain medication. She wanted it increased from 7.5 mg to 30 mg.
Duh, NO!
I've said before, my office is not a drive through.
You might be surprised. I know quite a few of these buggers who are better at hitting a vein than I am, and wouldn't be at all concerned about an actual IV, as long as 'the D medication' gets to its home in the vein.
ReplyDeleteI had a complaint from a patient who was upset that she didn't get a neb right away when she arrived in the ER. Well, you were there for foot pain, and your lungs were clear, that's why? The only reason she got a neb later was the temper tantrum she threw over why we were ignoring her asthma?
ReplyDeleteSounds like a plan! I'd like to see some of my patients deliver their own babies and do all their post partum care at home.
ReplyDelete15mg oral or IV? Cuz in the land of hardcore drugs all the hardcore time (pacific northwest, surprisingly [to me]), we give out oral as if it were Skittles.
ReplyDeleteSwitch to engineering. No layperson ever gives you crap on your decisions because everyone just assumes all engineers are brilliant.
ReplyDeleteOOOh, I like it.
ReplyDelete-whitecap nurse
LOL. If only I could find a job that pays as much as nursing....I'd quit in a minute!
ReplyDeleteI want to see the drug excuse/work note menu in another post!! Brilliant.
ReplyDeleteAlso, I let a guy start his own IV once. He'd been shooting up since before I was born, and I was pretty impressed with his skillz. He, in turn, told me it was much harder than just shooting up, since he'd never tried to thread a catheter. ;) We parted with a weird mutual respect.
I work in long-term care, and we get patients in their 50s who come in and do that once they find out they are not getting the dosage of pain medication they got in the hospital. Of COURSE IV Dilaudid is stronger than the Oxycodone your doctor ordered for you here! You are now in rehab, which means you are getting better, or supposed to be getting better, than you were in the hospital. Right? Amazing. I am a new follower.
ReplyDelete@emily-here is the post with the menu http://newnurseinthehood.blogspot.com/2010/10/bullies.html.
ReplyDeleteAlso, that is INSANITY and completely awesome. That's always what I say I'm going to do on my last day at work when someone tries to tell me my business.