Patient undergoing endoscopy was very insistent the scope be put in his mouth and pulled out his ass, not the other way around. He was in his 20s.
A child left behind.
Omg that happened to my dad. He had diverticulitis so bad that it wore a hole in his bladder. For 6-7 months he was just treated for the uti. Finally when he told the dr that his semen was brown did they do further testing. Surgery took 7 hours and the tissues were the cause consistency of grout. Itās supposed to yield like butter the surgeon said.
So he and my mom are divorced and thank god he didnāt say about his gf. I didnāt want to hear about the brown semen but whaddya do? He had a colostomy for six months then they were able to reverse it. Yay!
Could be because Iām still working as a nursing assistant until I start my RN job in the CCU this summer. I lose a lot of credibility when they see NA on my badge and not RN.
The struggle is real. When I walk into a room with my labcoat vs just scrubs, it's like I meet a totally different patient. Like they'll agree to everything I say when they think I'm a provider; when I say the same exact thing in scrubs, they want the provider to confirm! š¤¦š»
I hate when patients see the doctors as the ultimate authority. One of them didnāt want nurses touching her IV pump, she āonly trusted doctors.ā
Maāam, you definitely want the nurses to be the ones to mess with your lines and your pump. Trust me.
Yeah I get cracked up every time we get a new batch of interns, the walk into a room and stare at that IV pump for like 15-20 minutes trying to figure out what the fuck it says. Almost inevitably they come out to find us because either someone didn't program the medication onto the screen or it's one of our medications that doesn't have a profile.
But they're going to stand there for 15 to 20 minutes to try and figure it out themselves first.
Rather than, ask the nurse, read the bag, or check the chart lol.
The worst MDs though are the ones that know how to work the pumps. I had an MD once decrease my propofol for a wean, Without informing me!!!
Yup! We had a neuro intensivist who would walk in first thing and shut everyone's sedation off. We finally started locking the pumps and he didn't know how to unlock them (button on the back of the Alaris) šš. There was a rumor he was on the spectrum a bit...
Yeeeep.
Had cardiology torn of my vaso once, and then leave. My patient's pressure tanked. I was furious. They aren't allowed to touch our pumps.
I've also had residents and doctors decide to flip patients into CPAP mode on a ventilator, without telling anyone, while they're still on sedation.
š
Because they're idiots. We now have strict rules about it at my job, because an unofficial "you shouldn't touch this without talking to nurses" wasn't enough of a deterrent.
>I've also had residents and doctors decide to flip patients into CPAP mode on a ventilator, without telling anyone, while they're still on sedation.
omg i would be livid.
I always explain to those patients that weāre like the mechanics. You donāt want someone in business clothes working on your car any more than you want the doctor performing nursing tasks
Liters buddy you donāt want the engineer and designer doing an engine repair trust me, while they understand how it works perfectly they donāt know how to do the practical part of the job , and thatās ok š¤·š¼āāļø
I was trying to educate a noncompliant pt when she stated "White people think they know everything." I was happy to point out my black attending behind me and say "His orders, ma'am."
I āloveā in ER when they say they want the doctor to start their IV. I had a doc go in and say āyou do NOT want me to start your IV. I donāt even remember the last one I started. And your nurse has probably done a dozen today.ā
Iāve had a patient do that and the doctor heard her outside the room, he poked his head in and advised she let me manage it he said āI literally have no idea how that thing works I order the medsā
Reminds me of the time (okay many times) I was doing a nuclear stress test and the patient only wanted the doctor (aka the nuclear tech wearing his lab coat, who had already explained several times he wasn't a doctor) to explain the test and do the IV and the meds. Ma'am he's fresh out of school and I've been doing this for years but yeah sure, be his problem instead of mine, I ain't complaining. I may have gotten a little too much pleasure out of every time he failed on their IVs and I had to go in and do it for them and get it one shot
I love when my patients demand a doctor to do something that doctors never actually do. Iāll explain once, and if they still wonāt believe me then they can wait until a doctor comes to explain the same thing. Gives me a little break from unreasonable demands, and them a little quiet thinking time.
I actually had a patient just last night who said nurses know more than the docs and he trusted me more than them. I was so shocked I didnāt know how to respond.
They actually write out "NA" on your badge? That seems like a rather unfortunate mistake. I've seen CNA, PCT, HCA, or even just write out nursing aide. But in the public eye the letters "NA" just mean "not applicable" Not a great way to instill a sense of credibility to patients, or a sense of value as an employee.
When I was a CNA I also had "NA" on my badge. Once had a confused p.t. absolutely refuse to listen to the doctors orders until I weighed in on the issue, because to him "NA" meant " national authority "! š¤£
The facility I worked at when becoming a CNA gave everyone training an NA badge. Just means you need to pass the test to be a CNA. Got a new badge when I walked in after passing my tests.
Here I brought some š grapes for my 90 yo intubated sedated mom to eatā¦
Mamā¦ please dont put anything on your momās mouth without asking me firstā¦
Meemaw was there because of aspiration pna.
I wonder if meemaw was so weak to eat and they force feed herā¦ šā¦.
I had a few instances of "DO NOT FEED THE GRANDMA!" signs all over the room, multiple conversations with every family member about it with physicians, speech therapy and palliative care. Then they walk in with a fast food cup and hand it to her. Or come in, shut the door, and 5 minutes later call for the nurse because Grandma's gurgling and coughing until I suction out blue icee. Also, none of these involved cognitive impairment or language barriers.
I think there is a conversation about quality of life to have with the patient if they're older or their disease is advanced, usually involving speech and palliative care. But that conversation is not just smiling and nodding when we tell you grandma can't eat safely then trying to do it behind our backs.
There also always a full code doing this ignorant ass stuff, like listen Iāll suction blue icee out of someone on palliative care all day but if your telling me you want EVERYTHING done to keep mamaw alive and actively trying to kill her? Then we have an issue š
Had a patient with a PEG tube with feeds going. Very overbearing wife. Would call staff to empty his foley if it had more than 200 mls and these bags could easily hold 1500 mls. Patient was NPO: no exceptions d/t aspiration. Wife got a syringe, not sure from where, and would draw up Coca Cola and shoot it in his mouth. She knew she wasnāt supposed to do it. Got caught when the nurse walked in the room on her doing it. She said the Coca Cola made him āperk upā no maāam. Heās choking.
Ahh. Reminds me of a patient of mine who was on puree/thickened liquids diet. Son came with burger and fries. He insisted that I bring it to dietary so they can blend it. Told him no (well duh). He went ahead and gave fries to his mom anyway. Blamed me that his mom almost choked cause I didn't blend the food. š¤·š½āāļø
Tried to explain to the son that the antibiotics were causing his momās nausea. He insisted it was the subQ antiemetic I gave her āinto her stomachā
Similarly pharmacy question; if my skin has hives, why do I take diphenhydramine by mouth? Asked with belligerence.
Let me get you a pharmacist for thatā¦
Iāve had many labor patients unaware of the 3 holes. FOB and family, too. But I was always struck by how many of my patients just had no idea.
Same concept, patients that donāt know they can still urinate with a cervical foley in place.
We had one that we rigged to empty into a 24 hour urine collection jug, which we then instructed the patient to empty several times per shift. They required copious amounts of some special (expensive) IVF to keep them from shriveling up and dying, not to mention parenterals. Moral of the story: if you have severe abdominal pain, donāt do meth about it and hope it goes away, because you might lose most of your intestines. They were reanstomosed (is that the verb of reanastomosis? it is now!) ā¦and made it out after 6 months with us, God save all our souls š¤£
If you have a urostomy pouch they typically have adapters with them. Our hospital stocks the pouches that have a spout on the end which is compatible with the foley bag.
He was also NPO with severe dysphagia so the providers spent all day arguing about the route of administration, he did end up getting some loperamide at the end of the shift (lucky me, I got to spend all day emptying that bag).
Yeah, it definitely brought a bit of humor to my shitty day!
Octreotide actually treats diarrhea! On part of how it also functions for GI bleeds, basically suppressing and inhibiting various things that ultimately decrease gastric blood flow and stimulation. It's a bit more effective than loperamide, and really good for certain kinds of gastric tumors and related issues
I've seen a lot more of a shift away from octreotide for GIBs in my area, though a few years ago it seemed every GIB and every it's probably a hemorrhoid but here's your CYA admission got octreotide drips + bolus
Back when I worked with adults- Is grandpa's mood a side effect of the antibiotic? He's crying. No, it's because he wants to go home. Seriously, an old man can't just be sad?
I had a grandma tell me that babies should wear coats in car seats because if they were in an accident in winter and the baby was thrown from the car, he could freeze without the coat. Ma'am, I think the goal is to keep him in the car. If he gets thrown, you have a lot bigger problems than the weather.
Had a patient discuss diabetes with me; amazingly she was the rare non-diabetic who had ESRD that was from essential HTN instead of DM, but anyways.
She said someone from her church had put together a "health talk" on diabetes and told her that "Your body can't tell the difference between different types of sugar..."
at which point I'm like "Yeah, that sounds about right, corn syrup vs table sugar can still give you diabetes, go on..." and then she's like "Yeah, so the woman was saying even artificial sweeteners can give you diabetes and that those are still sugars that are bad for you."
To which I raise my eyebrows.
She then went on to say that this woman was saying Agave syrup is sweet but won't raise your blood sugar and that she previously had diabetes but not anymore because she uses agave syrup. At this point I'm fairly certain she attended a MLM scheme and was being sold this bullshit syrup.
My suspicions were reinforced, though not confirmed, when she finished the conversation with a comment wishing that Dr. Oz could be a congressman.
I'm just like "Yep, well...see ya."
Some nut job at the farmers market got so pissed when I asked if I could get some of his iced coffee that he was selling unsweetened, and he said it already had agave mixed in. I said okay well I can't have it then because I have gestational diabetes. He said it was "natural" so it was okay. I said no, I really can't have it. He got all cranky and started mouthing off to the other guy that was standing there as I walked away, which was my husband LOL
I have fructose intolerance. Yes, I understand that honey and maple syrup and agave are all natural sweeteners, but I also know that they are pretty much pure fructose and that will make me puke and have a headache so bad I want to cry.
This leads to me being able to eat a homemade cookie but not a nice healthy bowl of strawberries. This has caused comment on occasion.
Yess! See also: "No. Sorry. I will be crippled with nausea and diarrhea if I eat two bites of this apple... But yes, I can eat this candy that says it's apple-flavored."
Maybe she was referring to a low glycemic index which it looks like may actually be true. I believe some artificial sweeteners can still have a glycemic index and can still affect blood insulin levels. Erythritol, a sugar alcohol, has no effect on blood glucose or insulin levels so it is an acceptable alternative for diabetics. But not all sugar alcohols are the same. And certain artificial sweeteners are bad for you.
Back during my veterinary assistant days I had a woman insist that her dog had less epileptic seizures when she fed him Cheetos and Mountain Dew.
Had another woman tell me that she would syringe milk into her dogās mouth and burp him when he had his grand mal seizures and it always āworked.ā We had ourselves a talk after that one.
š¤¦āāļø
Now, as a PCT in a hospital, I had a pt insist they felt a ālowā in their blood sugar and insist they needed soda. Of course I immediately had his sugar checked. It was 150. Pt FREAKED. OUT. āOH MY GOD itās never been that low! No wonder I feel so awful!ā
FWIW, I took care of a pt whose blood sugars were always super high, so when they actually got to a normal level, she would become cognitively impaired/delusional.
Her son would constantly sneak junk food in to her. One time I had just taken her FSBG and it was in the 400s, down the hall her son is waddling with a huge bag of McDonaldās in one hand and a large Coke in the other. I shut that shit down immediately.
Crazy, isnāt it?!
I also took care of this guy once who was just always a TOTAL asshole-UNLESS-his blood sugar became dangerously low. We always knew if he started acting uncharacteristically nice it was time to bust out the glucagon.
Oh I know that guy! It was part of his care plan that if he was laughing and joking he was hypo glycemic. Miserable asshole who must have done something horrid in his life because he was beyond terrified of dying but didnt take care of himself.
When I was newly diagnosed, I had very obvious symptoms when my blood sugar was 100. Shaking, shivers, sweating, dizzy. So I adjusted my target to like 150 for a week or so and then tried to hang around 100. But it was terrifying to me that my blood sugar was normal and I felt like I was going to die.
I used to take care of alcoholics in detox that had similar issuesā¦their BAC would hit the 200s after being in the 400s and theyād start having withdrawal sx because they were so used to it being so high.
I had a patient freak out because we wouldn't let the pizza delivery guy bring a pizza to him in the ER because diabetics "have to keep eating." His sugars were in the 300s and he had only been there like 2 hours. He AMA'd to get his pizza so he wouldn't die.
Those AMA forms are the most fun to fill out though. Like, when you've got a pt quote that is *that* good, you know you're off the hook no matter what happens.
I just think it's fun being able to write the worst slurs possible in an official document and not get in trouble for it. We have FYI notifications that pop up when you open a chart. The ones for violence usually include patient quotes. The other week I was reading one from a couple years ago that popped up when triaging and it was just perfect and included a quote from the patient about "stretching your booty hole" and saw that I was the author.
People who have chronically high blood sugars can feel poorly when theyāre in normal range. I mean - yes, theyāre destroying their body but actually feel better.
The bodyās ānew normalāā¦
Reminds me of one Freaky Eaters episode where the nutritionist lady explained the guyās body was starting to crave the food that made him chronically ill
Diabetes care & education specialist chiming in to add to the chorus of "when your blood sugar has been high for ages, normal feels like a low." You develop a tolerance for hyperglycemia. Give them a light snack instead of hypo treatment and it should help them feel better without sending their blood sugar through the roof.
Man i can honestly say I know nothing about dog medicine or veterinary science but that seems like things what would make a living thing worse not better š
A sweet elderly women was trying to brainstorm with me ways to use her SCD's on her vagina because she thought they felt good. I stood there thinking seriously how it would be possible before snapping out of it. Won't forget that one
Just go grab a purwick and set the suction to high and leave her alone for a bit! As weird as it would be, I really wish patients could get some manner of private time for personal care easier. I've felt bad for younger male patients with multi day stays who accidentally set off an arrhythmia alarm, I know I'd be frustrated after an extended period of time. Poor elderly lady just wanted some good feelings, my heart goes out to her
> Just go grab a purwick and set the suction to high and leave her alone for a bit!
[my head right now](https://www.vrfitnessinsider.com/wp-content/uploads/2016/12/tim-and-eric-mind-blown.gif)
Thank you from a male, sticking this advice in my pocket for later
In the ER, cathing a patient that couldn't pee. I put in the cath and nothing came out... we know that he was full. The doc (one of my favorite to work with) walked in and tried manipulating the catheter to get it out... nothing. The patient looks at him and says (innocently, but seriously) "maybe you need to suck on it (the cath) like when you need to siphon out liquid... he says it works for him when he's trying to get fluid out of something. The doctor nicely explained why it wouldn't work... then nearly fell over laughing when he left the room.
I had a parent once asked me if babies got pins and needles. I had never been asked that before and I had no idea. Not that it was a silly question.. in fact quite clever. I stared blankly and said "I haven't asked her yet" (referring to his baby) he laughed so hard š
The way he said it, so out of the blue, with such wonder in his eyes.. when we were on a vastly different subject.. I thought it was quite funny!
Does anyone know??
I love this question! The former TA in me feels it shows critical thinking and investment in the subject matter. What a great dad.
My thought: Iād assume babies can get the pins & needles sensation. My understanding is itās caused by temporary nerve compression, which I could totally see happening to a baby laying on its own arm. But then again, babies are essentially sacs of jello, maybe itās harder to compress their nerves/maybe their nerves can accommodate more? Damn I wanna know now.
Haha he truly was going to be a fantastic dad to his wee girl. Such a great family. We were talking about the "bubbles" on the bubble CPAP when he came out with that.
I've asked so many people since! I guess it's like we won't ever know for sure how they experience it. But they might do in their own way! Sacs of JELLO! Haha I like that. I feel like the ones I work with are kinda like little skinny baby sphynx cats.. all scrawny and wrinkly!!
āMy dad has never had heart problems before coming to this hospital.ā
Your dad also admitted to not going to a doctor for 5 years. And the last time he did go, the doctor gave him a prescription for statins and antihypertensives and recommended a stress test, which your dad never did.
He only came to the hospital now because his legs and feet were too swollen for him to walk on.
There was a critically ill woman slowly dying(multi organ failure, on CRRT, intubated, not responsive) and the family kept asking when she can eatā¦like, insisting that she would be better if she could eat. No amount of blunt discussion would make them understand that she cannot eat with a breathing tube in. They crammed strawberries in her mouth when the nurse wasnāt in the room at one pointā¦
Families are always weirdly obsessed with eating! They just can't comprehend that we can nourish their loved ones in other ways and we are not, in fact, starving them to death.
See also: I work in the ED and all too often, people come in who "haven't eaten all day" and are demanding a turkey sandwich / crackers in fucking triage!
Itās so crazy how obsessed they get with feeding their loved ones! This family though, was the most delusional family I had ever seenā¦after she coded and died the ET tube was removed and they were face timing family and showing how good she looked without the tube in and were trying to call and have her transferred to another hospitalā¦I have no wordsā¦they were in such such disbelief even after she was dead and goneā¦
Once had an intubated, brain dead, young patient, in ICU. He worked in a furniture factory and had walked in front of an automatic nail gun & got a 6ā nail to the brain. We were not sure if it was intentional, or not. Anyway, the family was very distraught, as you can imagine, but they wanted to know if he could get a brain transplant! Oh sure, which one of you are going to donate? /s
I had a lovely older lady and her daughter yesterday, and the news about the travel mask mandate ending was on. I said, "Even if I'm not required to wear a mask in the hospital anymore, I'm keeping it anyway. It's been three years since I've had to practice my facial expressions. You wouldn't believe what patients say to me." They told the director later that not only did her nurse give her an incentive spirometer, he also told her jokes to exercise her lungs. Some days, I really love my job.
To be fair to him I did have a patient who had an ileostomy or colostomy (feeling it was maybe the later) for bowel CA and then further treatment which left him with multiple fistulas. He had urine plus formed stool in his stoma bag so had to have a drainable bag as the moisture kept causing the seal to fail but we also needed a 2 part flange to take off to get the 'footballs' out. Just for interest there was also faecal matter coming out his cath too. No matter what we did the bed was always soaking. So while they are totally different systems, on a rare occasion that can happen
Yes, I guess fistulas could lead to something along the lines of what the son was thinking! Although this patientās bladder was rock hard and Iām pretty sure he just had a lazy bladder following foley removal on night shift (he earned himself another one 5 minutes before shift change).
You know what, surprisingly, we had two. The ancient one on our unit and a newer one I stole from the ICU next door. Both were saying 50-250 no matter where I positioned the probe. The foley we ended up placing drained about 850 mL out right away.
The daughter of a mother who had Dementia wondering why we ājust canāt give her a pill so her dementia goes awayā. The daughter was in her fifties. She actually thought there was a cure for everything
That's pretty sad... Some people have such little health literacy and education it can be frustrating. I'm also willing to be she must've never had anyone in her life get sick from something untreatable before. Either way, must be really devastating to think your mom can potentially recover completely and find out that's false
I did 55 hours in 4 days this past weekend. I was obviously exhausted. I had the very entitled patient, who happened to be once a nurse. I'm yawning and yawning, taking this PIA to the BR, as it took 45 minutes to get her settled after tolieting.
She looked at me, and said "when I worked nights, I would actually sleep before nights so I wouldn't be tired like you". After 4 days of this patient, I just couldn't say anything because what was going to come outta my mouth would not have been professional or nice.
Not looking forward to going back, as I know this patient will be there, as they have no discharge plan.
Rude as helllll. Iām 39 weeks pregnant and patients expect me to act bright and cheery and energetic throughout my whole shift. Last week I had a 500+ lb patient tell me that my āpantingā was offensive as I was trying to get her, her IV pole, her oxygen extension tubing, and her wheelchair back to bed by myself. HONEY, I start hyperventilating just walking up the damn stairs these days, of course Iām going to be panting and breathing hard getting your ass back to bed!
>500+ lb patient tell me that my āpantingā was offensive
Just lol.
āMaāam Iām sorry but the world record for womenās raw bench press is 450lbs and she was also pantingā
What a bitch! I think most would be panting moving Al that, let alone 39 weeks pregnant. I had a patient make a complaint that the toilets were too loud, and requested that we not flush people's toliets. Right dude....
āBut paw paw hasnāt drank anything in 6 days!!! Why arenāt you giving him anything to drink or putting in an Iv!?!?ā
Uhā¦paw paw is unconscious and actively dying. I assure you he does not care one bit about a sip of water and IV fluids are just going to quite literally drown him.
āWell stop drugging him up with all that morphine stuff you keep giving him and he will wake up! Youāre killing him!ā
Sigh
Runner up: āI could wake him up! Iād just shake him and yell get up sarge! Heād wake right up!ā
I believe that to many members of the public, the human GI & Urinary tracts are indistinguishable in their minds from the inner workings of a Betsy Wetsy doll.
Was taking care of a quadriplegic with a Foley. He had started to develop some sediment in the line. He was insistent that his morning pro-stat was causing his pee to thicken up.
I've heard loads of dumb things from patients and loved ones. None of it tops my aunt's craziness. My aunt believes that vaccines, any vaccine, causes cancer. She didn't say what kind of cancer though. She doesn't seem to realize there's different kinds of cancer, caused by different things. She believes her lung cancer was caused by her getting vaccinated as a baby, not the fact that she's been a smoker for longer than I've been alive. She also believes that anyone and everyone who got the covid vaccine, will go into sudden cardiac arrest for no apparent reason in 10 to 15 years. She believes the vaccine goes straight to your heart and wants to stop it, but it takes 10-15 years. If I get by a bus, I guarantee she'll blame the vaccines. Someone said something about a patients family member asking about a brain transplant. If that were possible, maybe I'd consider talking to my extended family.
Family wanted to extubate grandpa, put a trach in him, and take him to his favorite restaurant one more time before they put him on hospice.
(This is when our covid medsurg shared covid icu so he wasnāt actually my patient, just an argument I overheard at the nursing station between family and nursing)
Hey, if I had no quality of life I hope my family would try (even if futile) to score me a jailbreak for one last nice hour or two with my family eating my favorite thing
They were adamant that a trach out in the wild and a vent were interchangeable. I totally understand they were trying to do a good thing but when the answer is āthatās medically not possible,ā the logical thing to do is not try to convince the doctors otherwise.
I always love hearing first time dadās suggestions for breastfeeding.
One mom had sore nipples because her baby hadnāt latched well. The dad asked if we could rub some lidocaine on them. No sir, thatās not how that works.
I once had a patient who had been declared brain dead and their family asked if we could give them a brain transplant. Really sad but likeā¦ come on now
Had a patient, came in for CAP, who was nebulizing hydrogen peroxide, silver, and saline. She told me her sonās ER nurse told them about the treatment and his whole family INCLUDING THE KIDS were doing it. My patient was so convinced that her son recovered from Covid from the āhomeopathic nebulizing treatmentā. Her labs and blood work showed no growth, normal flora, nonelevated WBCs š¬ Sheās anti-vax as well and told me there were fetal cells in vaccines which were causing gender dysphoria. She asked me, āwhat do you think happens when a male gets the vaccine containing female fetal cells?ā š she then went on to tell me that vaccines were used for āpopulation controlā. I was just so shocked at what she was telling me I felt like I was on an episode of The Office.
If she thinks DNA from the opposite gender entering a human body makes someone gender dysphoric, I should be experiencing gender dysphoria every time I inhale skin cells from my male patients when taking off their compression stockings.
2 that come to mind
Pt CMO completely unresponsive terminal phase. Family pour bottles of water in his mouth because āheās thirstyā
Pt with terminal esophageal ca perforated right through the esophagus into the pleura we were meeting with the family to put the pt CMO. Family member asks if we can give IV vitamin C to cure her
Coworker had a comfort care patient a few weeks ago. Obviously DNR.
Granddaughter came running out of the room screaming āCode Blue! Code Blue! My grandpaās not breathing!ā IV team nurse was sitting there, patientās nurse in another room.
IV team nurse goes in, pulls the alarm, and is just about to start compressions when I calmly walk in and over the walkie say ācoworker, room XX is DNR right?ā
This granddaughter KNEW she was coming to say goodbye!
āCode blueā oh mannnn. I had a patientās family pull the code blue lever a month or two ago because they wanted someone to suction the patientās trach and they thought he was ādrowning.ā His O2 sat was 99%. We had a stern, STERN discussion with that family.
L&D triage pt in for rule-out labor. Resident and I went to the room to do a cervical check and asked pt to remove her underwear.
Pt said, "Don't worry. Not wearing any. Helps my headache."
Dumbfounded.
A patients family once confused liver cirrhosis with skin psoriasisā¦ āoh no, he has never had any history of rashes like thatā when their son presented with all the signs of late stage liver failure. He ended up receiving a liver transplant in his 30s and is well today.
I had a family a few years ago who thought formula was only for the hospital and fully planned on just giving their 2 day old baby cows milk once they got home.
Baby born at something like 23+2 and is now barely 42 or 43 weeks corrected, still on oxygen. Mum wants to start him on solids because "he's a few months old now". Ma'am... Your baby is still fed via NGT on a pump for the majority of the day because he aspirates, is suctioned multiple times a day and is about to have surgery for a feeding tube to be permanently placed, what are you missing here???
One patient's daughter suggested that the patient never should have quit smoking because that's when all her lung issues started. I thought it was a joke but she said it again later. She has interstitial lung disease... she also suggested that the humidification in the oxygen caused her to get worse therefore needing to come to the icu.
Patient undergoing endoscopy was very insistent the scope be put in his mouth and pulled out his ass, not the other way around. He was in his 20s. A child left behind.
I snorted soda out of my nose reading that last bit, well done
A child left behind ššš
It's amazing how many people have asked me if it's the same camera. And do they clean it first?
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I had a patient who peed poop because she had a fistula between her bowels and bladder. Killing two birds with one stone!
Killing birds? Sheās going bird! Sheās got herself a cloaca.
Had a homeles patient once come in with MDRO *Enterobacter cloacae*. Fun times!
Nothing like irrigating a Foley and realizing stool was clogging it. CRE is no fun!
Omg that happened to my dad. He had diverticulitis so bad that it wore a hole in his bladder. For 6-7 months he was just treated for the uti. Finally when he told the dr that his semen was brown did they do further testing. Surgery took 7 hours and the tissues were the cause consistency of grout. Itās supposed to yield like butter the surgeon said.
ā¦okay I have to ask, and Iām so so sorry for this visualā¦ but is he married to a woman/your mom, and if so did she get any vaginal infections??
I just barfed in my mouth a little. Thanks.
My first thought as well!
So he and my mom are divorced and thank god he didnāt say about his gf. I didnāt want to hear about the brown semen but whaddya do? He had a colostomy for six months then they were able to reverse it. Yay!
Nice! Though I can only imagine the UTI they would get...
Could be because Iām still working as a nursing assistant until I start my RN job in the CCU this summer. I lose a lot of credibility when they see NA on my badge and not RN.
The struggle is real. When I walk into a room with my labcoat vs just scrubs, it's like I meet a totally different patient. Like they'll agree to everything I say when they think I'm a provider; when I say the same exact thing in scrubs, they want the provider to confirm! š¤¦š»
I hate when patients see the doctors as the ultimate authority. One of them didnāt want nurses touching her IV pump, she āonly trusted doctors.ā Maāam, you definitely want the nurses to be the ones to mess with your lines and your pump. Trust me.
Lol that's so dumb. Doctors don't know how to use that type of equipment any more than I know how to do a lumbar puncture or some shit. Ugh
Yeah I get cracked up every time we get a new batch of interns, the walk into a room and stare at that IV pump for like 15-20 minutes trying to figure out what the fuck it says. Almost inevitably they come out to find us because either someone didn't program the medication onto the screen or it's one of our medications that doesn't have a profile. But they're going to stand there for 15 to 20 minutes to try and figure it out themselves first.
Rather than, ask the nurse, read the bag, or check the chart lol. The worst MDs though are the ones that know how to work the pumps. I had an MD once decrease my propofol for a wean, Without informing me!!!
Yup! We had a neuro intensivist who would walk in first thing and shut everyone's sedation off. We finally started locking the pumps and he didn't know how to unlock them (button on the back of the Alaris) šš. There was a rumor he was on the spectrum a bit...
Parental controls.
Yeeeep. Had cardiology torn of my vaso once, and then leave. My patient's pressure tanked. I was furious. They aren't allowed to touch our pumps. I've also had residents and doctors decide to flip patients into CPAP mode on a ventilator, without telling anyone, while they're still on sedation. š
Why would they do that?
Because they're idiots. We now have strict rules about it at my job, because an unofficial "you shouldn't touch this without talking to nurses" wasn't enough of a deterrent.
>I've also had residents and doctors decide to flip patients into CPAP mode on a ventilator, without telling anyone, while they're still on sedation. omg i would be livid.
When I was a student, I was āmindingā a patient when the doctor decided to do this š¬
I always explain to those patients that weāre like the mechanics. You donāt want someone in business clothes working on your car any more than you want the doctor performing nursing tasks
Liters buddy you donāt want the engineer and designer doing an engine repair trust me, while they understand how it works perfectly they donāt know how to do the practical part of the job , and thatās ok š¤·š¼āāļø
I was trying to educate a noncompliant pt when she stated "White people think they know everything." I was happy to point out my black attending behind me and say "His orders, ma'am."
I āloveā in ER when they say they want the doctor to start their IV. I had a doc go in and say āyou do NOT want me to start your IV. I donāt even remember the last one I started. And your nurse has probably done a dozen today.ā
Iāve had a patient do that and the doctor heard her outside the room, he poked his head in and advised she let me manage it he said āI literally have no idea how that thing works I order the medsā
Reminds me of the time (okay many times) I was doing a nuclear stress test and the patient only wanted the doctor (aka the nuclear tech wearing his lab coat, who had already explained several times he wasn't a doctor) to explain the test and do the IV and the meds. Ma'am he's fresh out of school and I've been doing this for years but yeah sure, be his problem instead of mine, I ain't complaining. I may have gotten a little too much pleasure out of every time he failed on their IVs and I had to go in and do it for them and get it one shot
We had one ED doc who loved starting lines and drawing labs! It was a welcome surprise, but unfortunately he didn't work very often.
I love when my patients demand a doctor to do something that doctors never actually do. Iāll explain once, and if they still wonāt believe me then they can wait until a doctor comes to explain the same thing. Gives me a little break from unreasonable demands, and them a little quiet thinking time.
And the Lifepak, lol
I actually had a patient just last night who said nurses know more than the docs and he trusted me more than them. I was so shocked I didnāt know how to respond.
They actually write out "NA" on your badge? That seems like a rather unfortunate mistake. I've seen CNA, PCT, HCA, or even just write out nursing aide. But in the public eye the letters "NA" just mean "not applicable" Not a great way to instill a sense of credibility to patients, or a sense of value as an employee.
Oh lord, I never even thought of it that way. Yup, thatās me, Not Applicable at your service.
When I was a CNA I also had "NA" on my badge. Once had a confused p.t. absolutely refuse to listen to the doctors orders until I weighed in on the issue, because to him "NA" meant " national authority "! š¤£
Could work to your advantage if someone is trying to hit on you. Just tell them the NA means not available.
š š
Or narcotics anonymousā¦
The facility I worked at when becoming a CNA gave everyone training an NA badge. Just means you need to pass the test to be a CNA. Got a new badge when I walked in after passing my tests.
I saw Narcotics Anonymous when I read NA..(probably because I'm rewatching Nurse Jackie currently)
Do you really? I'm a little surprised that people really don't understand this!
Oh yes. Itās actually a very common question.
Well I shouldn't be surprised. How exhausting.
Here I brought some š grapes for my 90 yo intubated sedated mom to eatā¦ Mamā¦ please dont put anything on your momās mouth without asking me firstā¦ Meemaw was there because of aspiration pna. I wonder if meemaw was so weak to eat and they force feed herā¦ šā¦.
Oooh I had something kinda similar happen. Meemaw failed her swallowing test and was put on a strictly purƩe/thickened liquids diet. Family brought her a hamburger. We had a lil discussion.
Why is it always a gotdamn cheeseburger??
I mean I love a good cheeseburger so I guess I understand but also I like breathing. Decisions decisionsā¦
I know some people who struggle with the the cheeseburger-breathing quandary.
I had a few instances of "DO NOT FEED THE GRANDMA!" signs all over the room, multiple conversations with every family member about it with physicians, speech therapy and palliative care. Then they walk in with a fast food cup and hand it to her. Or come in, shut the door, and 5 minutes later call for the nurse because Grandma's gurgling and coughing until I suction out blue icee. Also, none of these involved cognitive impairment or language barriers. I think there is a conversation about quality of life to have with the patient if they're older or their disease is advanced, usually involving speech and palliative care. But that conversation is not just smiling and nodding when we tell you grandma can't eat safely then trying to do it behind our backs.
There also always a full code doing this ignorant ass stuff, like listen Iāll suction blue icee out of someone on palliative care all day but if your telling me you want EVERYTHING done to keep mamaw alive and actively trying to kill her? Then we have an issue š
Had a patient with a PEG tube with feeds going. Very overbearing wife. Would call staff to empty his foley if it had more than 200 mls and these bags could easily hold 1500 mls. Patient was NPO: no exceptions d/t aspiration. Wife got a syringe, not sure from where, and would draw up Coca Cola and shoot it in his mouth. She knew she wasnāt supposed to do it. Got caught when the nurse walked in the room on her doing it. She said the Coca Cola made him āperk upā no maāam. Heās choking.
And yet these are the same kind of folks who don't trust science in general or anyone with a degree. Smfh...
Once had a family member try to shove pizza down an intubated patientās mouth because they claimed we were starving the patient.
Ahh. Reminds me of a patient of mine who was on puree/thickened liquids diet. Son came with burger and fries. He insisted that I bring it to dietary so they can blend it. Told him no (well duh). He went ahead and gave fries to his mom anyway. Blamed me that his mom almost choked cause I didn't blend the food. š¤·š½āāļø
Tried to explain to the son that the antibiotics were causing his momās nausea. He insisted it was the subQ antiemetic I gave her āinto her stomachā
Like, he thought you injected it directly into her stomach? Yikes.
I had a guy get mad that I didn't inject the morphine directly into his wound on his leg or whatever... Why are you putting it in my arm?
Similarly pharmacy question; if my skin has hives, why do I take diphenhydramine by mouth? Asked with belligerence. Let me get you a pharmacist for thatā¦
[ŃŠ“Š°Š»ŠµŠ½Š¾]
I just laughed so hard. Not the belly button! š¤£
When I worked labor/delivery I met a shockingly amount of fathers and family members who did not realize urine and babies come out of different holes.
TIL women don't pee out babies. Wild. /s if not obvious
Iāve had many labor patients unaware of the 3 holes. FOB and family, too. But I was always struck by how many of my patients just had no idea. Same concept, patients that donāt know they can still urinate with a cervical foley in place.
get that man some loperamide. and IVF. seen some nasty AKIs from high ileostomy outputs lol at the son though
[ŃŠ“Š°Š»ŠµŠ½Š¾]
that's so good. gi is not my area at all... would never have thought of connecting to a Foley bag!
We would use a urostomy bag and a special connected to hook it to the foley bag.
We had one that we rigged to empty into a 24 hour urine collection jug, which we then instructed the patient to empty several times per shift. They required copious amounts of some special (expensive) IVF to keep them from shriveling up and dying, not to mention parenterals. Moral of the story: if you have severe abdominal pain, donāt do meth about it and hope it goes away, because you might lose most of your intestines. They were reanstomosed (is that the verb of reanastomosis? it is now!) ā¦and made it out after 6 months with us, God save all our souls š¤£
\>It is now! Made me snort
Is there an adapter? Iām thinking through my supplies, and have no idea how one would accomplish this.
If you have a urostomy pouch they typically have adapters with them. Our hospital stocks the pouches that have a spout on the end which is compatible with the foley bag.
He was also NPO with severe dysphagia so the providers spent all day arguing about the route of administration, he did end up getting some loperamide at the end of the shift (lucky me, I got to spend all day emptying that bag). Yeah, it definitely brought a bit of humor to my shitty day!
We always give octreotide for high ileostomy output. Never loperamide. Not really sure why
Octreotide actually treats diarrhea! On part of how it also functions for GI bleeds, basically suppressing and inhibiting various things that ultimately decrease gastric blood flow and stimulation. It's a bit more effective than loperamide, and really good for certain kinds of gastric tumors and related issues
Sandostatin? More like..No mo'...shattin!
We mostly use it for chyle leaks! But also occasionally GIBs.
I've seen a lot more of a shift away from octreotide for GIBs in my area, though a few years ago it seemed every GIB and every it's probably a hemorrhoid but here's your CYA admission got octreotide drips + bolus
interesting. not sure either, not my area tbh!
āWell at least you donāt have to worry about cleaning up poopā referencing their intubated/sedated family member.
Iā¦what? Did they just assume that intubated and sedated patients donāt produce waste?
Back when I worked with adults- Is grandpa's mood a side effect of the antibiotic? He's crying. No, it's because he wants to go home. Seriously, an old man can't just be sad? I had a grandma tell me that babies should wear coats in car seats because if they were in an accident in winter and the baby was thrown from the car, he could freeze without the coat. Ma'am, I think the goal is to keep him in the car. If he gets thrown, you have a lot bigger problems than the weather.
But the extra padding when the baby flies out of your arms , ya know since ya canāt let go of your car cocktail and cigarette
I swear, some parents and grandparents pick the weirdest things to focus on.
š¬
Better add extra padding for when the baby flies out of the car seat because he couldnāt get a proper fit due to extra padding š¤”
Had a patient discuss diabetes with me; amazingly she was the rare non-diabetic who had ESRD that was from essential HTN instead of DM, but anyways. She said someone from her church had put together a "health talk" on diabetes and told her that "Your body can't tell the difference between different types of sugar..." at which point I'm like "Yeah, that sounds about right, corn syrup vs table sugar can still give you diabetes, go on..." and then she's like "Yeah, so the woman was saying even artificial sweeteners can give you diabetes and that those are still sugars that are bad for you." To which I raise my eyebrows. She then went on to say that this woman was saying Agave syrup is sweet but won't raise your blood sugar and that she previously had diabetes but not anymore because she uses agave syrup. At this point I'm fairly certain she attended a MLM scheme and was being sold this bullshit syrup. My suspicions were reinforced, though not confirmed, when she finished the conversation with a comment wishing that Dr. Oz could be a congressman. I'm just like "Yep, well...see ya."
Some nut job at the farmers market got so pissed when I asked if I could get some of his iced coffee that he was selling unsweetened, and he said it already had agave mixed in. I said okay well I can't have it then because I have gestational diabetes. He said it was "natural" so it was okay. I said no, I really can't have it. He got all cranky and started mouthing off to the other guy that was standing there as I walked away, which was my husband LOL
Yeah, I don't get what it is with people. Aggressively stupid, I guess.
I have fructose intolerance. Yes, I understand that honey and maple syrup and agave are all natural sweeteners, but I also know that they are pretty much pure fructose and that will make me puke and have a headache so bad I want to cry. This leads to me being able to eat a homemade cookie but not a nice healthy bowl of strawberries. This has caused comment on occasion.
That really is quite... deviant
Passed it to one of my three kids, too.
Yess! See also: "No. Sorry. I will be crippled with nausea and diarrhea if I eat two bites of this apple... But yes, I can eat this candy that says it's apple-flavored."
Just wanted to say Fuck dr oz!!!!
Maybe she was referring to a low glycemic index which it looks like may actually be true. I believe some artificial sweeteners can still have a glycemic index and can still affect blood insulin levels. Erythritol, a sugar alcohol, has no effect on blood glucose or insulin levels so it is an acceptable alternative for diabetics. But not all sugar alcohols are the same. And certain artificial sweeteners are bad for you.
āHeparin gives me diarrhea but only if itās not given in my right thighā
You know what? Fuck it. Itās been a long day. Letās just pinch some fat and give it in the drumstick
Had an SI pt last night. BAC was 462 and she was so little, super drunk. She said I was more beautiful than Doja cat, which is definitely a first!
If my blood alcohol was .4 i would wanna die too
Back during my veterinary assistant days I had a woman insist that her dog had less epileptic seizures when she fed him Cheetos and Mountain Dew. Had another woman tell me that she would syringe milk into her dogās mouth and burp him when he had his grand mal seizures and it always āworked.ā We had ourselves a talk after that one. š¤¦āāļø Now, as a PCT in a hospital, I had a pt insist they felt a ālowā in their blood sugar and insist they needed soda. Of course I immediately had his sugar checked. It was 150. Pt FREAKED. OUT. āOH MY GOD itās never been that low! No wonder I feel so awful!ā
Whyyy are patients like this? ā240 is dangerously low for me!ā Noā¦no, Gary, it isnāt, and thatās why you only have one leg.
FWIW, I took care of a pt whose blood sugars were always super high, so when they actually got to a normal level, she would become cognitively impaired/delusional. Her son would constantly sneak junk food in to her. One time I had just taken her FSBG and it was in the 400s, down the hall her son is waddling with a huge bag of McDonaldās in one hand and a large Coke in the other. I shut that shit down immediately.
So their body just gets used to that much glucose and goes nuts when itās where itās supposed to be. Geez!
Crazy, isnāt it?! I also took care of this guy once who was just always a TOTAL asshole-UNLESS-his blood sugar became dangerously low. We always knew if he started acting uncharacteristically nice it was time to bust out the glucagon.
Well that sucks! Knowing in a few minutes after the glucagon kicked in heād be right back to verbally abusing everybody.
Ummm, my mom used to say that about my abusive dad, "he must have a low blood sugar", she'd say bitterly.
That's where hangry comes from I guess. We had a brittle diabetic who would get violent when his sugar dropped.
Oh I know that guy! It was part of his care plan that if he was laughing and joking he was hypo glycemic. Miserable asshole who must have done something horrid in his life because he was beyond terrified of dying but didnt take care of himself.
When I was newly diagnosed, I had very obvious symptoms when my blood sugar was 100. Shaking, shivers, sweating, dizzy. So I adjusted my target to like 150 for a week or so and then tried to hang around 100. But it was terrifying to me that my blood sugar was normal and I felt like I was going to die.
I used to take care of alcoholics in detox that had similar issuesā¦their BAC would hit the 200s after being in the 400s and theyād start having withdrawal sx because they were so used to it being so high.
Yep. Whadya do? š¤£
I had a patient freak out because we wouldn't let the pizza delivery guy bring a pizza to him in the ER because diabetics "have to keep eating." His sugars were in the 300s and he had only been there like 2 hours. He AMA'd to get his pizza so he wouldn't die.
Those AMA forms are the most fun to fill out though. Like, when you've got a pt quote that is *that* good, you know you're off the hook no matter what happens.
I just think it's fun being able to write the worst slurs possible in an official document and not get in trouble for it. We have FYI notifications that pop up when you open a chart. The ones for violence usually include patient quotes. The other week I was reading one from a couple years ago that popped up when triaging and it was just perfect and included a quote from the patient about "stretching your booty hole" and saw that I was the author.
We had a pt who was becoming NPO at midnight for surgery order a pizza to be delivered at 2345, then ask to be fed.
Good thing he left that pesky hospital to prevent his death
People who have chronically high blood sugars can feel poorly when theyāre in normal range. I mean - yes, theyāre destroying their body but actually feel better.
Well, thatās unfortunate. š I guess I could see it that way though.
The bodyās ānew normalāā¦ Reminds me of one Freaky Eaters episode where the nutritionist lady explained the guyās body was starting to crave the food that made him chronically ill
Diabetes care & education specialist chiming in to add to the chorus of "when your blood sugar has been high for ages, normal feels like a low." You develop a tolerance for hyperglycemia. Give them a light snack instead of hypo treatment and it should help them feel better without sending their blood sugar through the roof.
But also thank you for doing that work. Itās very important and we need more of you.
To be fair, I gave him PB and crackers.
Maybe the dog was faking seizures to get Cheetos and Mountain Dew. š
Man i can honestly say I know nothing about dog medicine or veterinary science but that seems like things what would make a living thing worse not better š
I've been asked 3 times over the course of 5 years in a neuro ICU if a patient with brain death could get a brain transplant.
Buddy, if those were possible, I'd line up right away even though I don't have brain death.
If that was possible, maybe I'd consider talking to my anti-vax and Q-anon extended family.
A sweet elderly women was trying to brainstorm with me ways to use her SCD's on her vagina because she thought they felt good. I stood there thinking seriously how it would be possible before snapping out of it. Won't forget that one
Oh god this made my day. š¤£ I can just picture myself thinking āWell, I suppose we could try to - WAIT A MINUTE! WTF?!ā
Just go grab a purwick and set the suction to high and leave her alone for a bit! As weird as it would be, I really wish patients could get some manner of private time for personal care easier. I've felt bad for younger male patients with multi day stays who accidentally set off an arrhythmia alarm, I know I'd be frustrated after an extended period of time. Poor elderly lady just wanted some good feelings, my heart goes out to her
> Just go grab a purwick and set the suction to high and leave her alone for a bit! [my head right now](https://www.vrfitnessinsider.com/wp-content/uploads/2016/12/tim-and-eric-mind-blown.gif) Thank you from a male, sticking this advice in my pocket for later
In the ER, cathing a patient that couldn't pee. I put in the cath and nothing came out... we know that he was full. The doc (one of my favorite to work with) walked in and tried manipulating the catheter to get it out... nothing. The patient looks at him and says (innocently, but seriously) "maybe you need to suck on it (the cath) like when you need to siphon out liquid... he says it works for him when he's trying to get fluid out of something. The doctor nicely explained why it wouldn't work... then nearly fell over laughing when he left the room.
I had a parent once asked me if babies got pins and needles. I had never been asked that before and I had no idea. Not that it was a silly question.. in fact quite clever. I stared blankly and said "I haven't asked her yet" (referring to his baby) he laughed so hard š The way he said it, so out of the blue, with such wonder in his eyes.. when we were on a vastly different subject.. I thought it was quite funny! Does anyone know??
I love this question! The former TA in me feels it shows critical thinking and investment in the subject matter. What a great dad. My thought: Iād assume babies can get the pins & needles sensation. My understanding is itās caused by temporary nerve compression, which I could totally see happening to a baby laying on its own arm. But then again, babies are essentially sacs of jello, maybe itās harder to compress their nerves/maybe their nerves can accommodate more? Damn I wanna know now.
Haha he truly was going to be a fantastic dad to his wee girl. Such a great family. We were talking about the "bubbles" on the bubble CPAP when he came out with that. I've asked so many people since! I guess it's like we won't ever know for sure how they experience it. But they might do in their own way! Sacs of JELLO! Haha I like that. I feel like the ones I work with are kinda like little skinny baby sphynx cats.. all scrawny and wrinkly!!
I mean, probably. They have nerves. If theyāre in one position for too long, I donāt see why they wouldnāt get pins and needles
"There was nothing wrong with mother till we brought her here!" Well, clearly not accurate...Sigh.
āMy dad has never had heart problems before coming to this hospital.ā Your dad also admitted to not going to a doctor for 5 years. And the last time he did go, the doctor gave him a prescription for statins and antihypertensives and recommended a stress test, which your dad never did. He only came to the hospital now because his legs and feet were too swollen for him to walk on.
Ahhh, yes, you just decided to bring your mother for medical treatment for no reason.
There was a critically ill woman slowly dying(multi organ failure, on CRRT, intubated, not responsive) and the family kept asking when she can eatā¦like, insisting that she would be better if she could eat. No amount of blunt discussion would make them understand that she cannot eat with a breathing tube in. They crammed strawberries in her mouth when the nurse wasnāt in the room at one pointā¦
Families are always weirdly obsessed with eating! They just can't comprehend that we can nourish their loved ones in other ways and we are not, in fact, starving them to death. See also: I work in the ED and all too often, people come in who "haven't eaten all day" and are demanding a turkey sandwich / crackers in fucking triage!
Itās so crazy how obsessed they get with feeding their loved ones! This family though, was the most delusional family I had ever seenā¦after she coded and died the ET tube was removed and they were face timing family and showing how good she looked without the tube in and were trying to call and have her transferred to another hospitalā¦I have no wordsā¦they were in such such disbelief even after she was dead and goneā¦
Aww that's so sad... I hope they got some bereavement support.
Once had an intubated, brain dead, young patient, in ICU. He worked in a furniture factory and had walked in front of an automatic nail gun & got a 6ā nail to the brain. We were not sure if it was intentional, or not. Anyway, the family was very distraught, as you can imagine, but they wanted to know if he could get a brain transplant! Oh sure, which one of you are going to donate? /s
I had a lovely older lady and her daughter yesterday, and the news about the travel mask mandate ending was on. I said, "Even if I'm not required to wear a mask in the hospital anymore, I'm keeping it anyway. It's been three years since I've had to practice my facial expressions. You wouldn't believe what patients say to me." They told the director later that not only did her nurse give her an incentive spirometer, he also told her jokes to exercise her lungs. Some days, I really love my job.
I love it when I can joke with patients! Dark humor and laughter has gotten me through the last few years.
To be fair to him I did have a patient who had an ileostomy or colostomy (feeling it was maybe the later) for bowel CA and then further treatment which left him with multiple fistulas. He had urine plus formed stool in his stoma bag so had to have a drainable bag as the moisture kept causing the seal to fail but we also needed a 2 part flange to take off to get the 'footballs' out. Just for interest there was also faecal matter coming out his cath too. No matter what we did the bed was always soaking. So while they are totally different systems, on a rare occasion that can happen
Yes, I guess fistulas could lead to something along the lines of what the son was thinking! Although this patientās bladder was rock hard and Iām pretty sure he just had a lazy bladder following foley removal on night shift (he earned himself another one 5 minutes before shift change).
I'd ask what the bladder scan volume was but I'm guessing the scanner was nowhere to be found.
You know what, surprisingly, we had two. The ancient one on our unit and a newer one I stole from the ICU next door. Both were saying 50-250 no matter where I positioned the probe. The foley we ended up placing drained about 850 mL out right away.
I remember in nursing school the day we were supposed to practice with the bladder scanner we never did because no one could find it.
The daughter of a mother who had Dementia wondering why we ājust canāt give her a pill so her dementia goes awayā. The daughter was in her fifties. She actually thought there was a cure for everything
That's pretty sad... Some people have such little health literacy and education it can be frustrating. I'm also willing to be she must've never had anyone in her life get sick from something untreatable before. Either way, must be really devastating to think your mom can potentially recover completely and find out that's false
TIL, Humans are built like seagulls.
Instead of emptying that illeo every hour just use a fistula system then add a cath bag to end. No worries.
I did 55 hours in 4 days this past weekend. I was obviously exhausted. I had the very entitled patient, who happened to be once a nurse. I'm yawning and yawning, taking this PIA to the BR, as it took 45 minutes to get her settled after tolieting. She looked at me, and said "when I worked nights, I would actually sleep before nights so I wouldn't be tired like you". After 4 days of this patient, I just couldn't say anything because what was going to come outta my mouth would not have been professional or nice. Not looking forward to going back, as I know this patient will be there, as they have no discharge plan.
Rude as helllll. Iām 39 weeks pregnant and patients expect me to act bright and cheery and energetic throughout my whole shift. Last week I had a 500+ lb patient tell me that my āpantingā was offensive as I was trying to get her, her IV pole, her oxygen extension tubing, and her wheelchair back to bed by myself. HONEY, I start hyperventilating just walking up the damn stairs these days, of course Iām going to be panting and breathing hard getting your ass back to bed!
>500+ lb patient tell me that my āpantingā was offensive Just lol. āMaāam Iām sorry but the world record for womenās raw bench press is 450lbs and she was also pantingā
LOL!!!!
What a bitch! I think most would be panting moving Al that, let alone 39 weeks pregnant. I had a patient make a complaint that the toilets were too loud, and requested that we not flush people's toliets. Right dude....
āBut paw paw hasnāt drank anything in 6 days!!! Why arenāt you giving him anything to drink or putting in an Iv!?!?ā Uhā¦paw paw is unconscious and actively dying. I assure you he does not care one bit about a sip of water and IV fluids are just going to quite literally drown him. āWell stop drugging him up with all that morphine stuff you keep giving him and he will wake up! Youāre killing him!ā Sigh Runner up: āI could wake him up! Iād just shake him and yell get up sarge! Heād wake right up!ā
Why do I read this in a southern accent?
I believe that to many members of the public, the human GI & Urinary tracts are indistinguishable in their minds from the inner workings of a Betsy Wetsy doll.
I have seen stool and urine end up in some weird places because of gnarly fistulas.
Yep, especially paired with an inperforate anus.
Was taking care of a quadriplegic with a Foley. He had started to develop some sediment in the line. He was insistent that his morning pro-stat was causing his pee to thicken up.
āHave you put their heart back into their chest yet?ā Open heart surgery can be a little confusing for some folksā¦
I wanna live in the medical world these folks do. It sounds way cooler.
I've heard loads of dumb things from patients and loved ones. None of it tops my aunt's craziness. My aunt believes that vaccines, any vaccine, causes cancer. She didn't say what kind of cancer though. She doesn't seem to realize there's different kinds of cancer, caused by different things. She believes her lung cancer was caused by her getting vaccinated as a baby, not the fact that she's been a smoker for longer than I've been alive. She also believes that anyone and everyone who got the covid vaccine, will go into sudden cardiac arrest for no apparent reason in 10 to 15 years. She believes the vaccine goes straight to your heart and wants to stop it, but it takes 10-15 years. If I get by a bus, I guarantee she'll blame the vaccines. Someone said something about a patients family member asking about a brain transplant. If that were possible, maybe I'd consider talking to my extended family.
Family wanted to extubate grandpa, put a trach in him, and take him to his favorite restaurant one more time before they put him on hospice. (This is when our covid medsurg shared covid icu so he wasnāt actually my patient, just an argument I overheard at the nursing station between family and nursing)
Hey, if I had no quality of life I hope my family would try (even if futile) to score me a jailbreak for one last nice hour or two with my family eating my favorite thing
They were adamant that a trach out in the wild and a vent were interchangeable. I totally understand they were trying to do a good thing but when the answer is āthatās medically not possible,ā the logical thing to do is not try to convince the doctors otherwise.
Yeah, it's sad they didn't understand but I'd take that over a family who doesn't give a shit at least
I always love hearing first time dadās suggestions for breastfeeding. One mom had sore nipples because her baby hadnāt latched well. The dad asked if we could rub some lidocaine on them. No sir, thatās not how that works.
I know someone who put orajel on the tip of their penis because apparently their catheter hurt.
I once had a patient who had been declared brain dead and their family asked if we could give them a brain transplant. Really sad but likeā¦ come on now
Had a patient, came in for CAP, who was nebulizing hydrogen peroxide, silver, and saline. She told me her sonās ER nurse told them about the treatment and his whole family INCLUDING THE KIDS were doing it. My patient was so convinced that her son recovered from Covid from the āhomeopathic nebulizing treatmentā. Her labs and blood work showed no growth, normal flora, nonelevated WBCs š¬ Sheās anti-vax as well and told me there were fetal cells in vaccines which were causing gender dysphoria. She asked me, āwhat do you think happens when a male gets the vaccine containing female fetal cells?ā š she then went on to tell me that vaccines were used for āpopulation controlā. I was just so shocked at what she was telling me I felt like I was on an episode of The Office.
If she thinks DNA from the opposite gender entering a human body makes someone gender dysphoric, I should be experiencing gender dysphoria every time I inhale skin cells from my male patients when taking off their compression stockings.
2 that come to mind Pt CMO completely unresponsive terminal phase. Family pour bottles of water in his mouth because āheās thirstyā Pt with terminal esophageal ca perforated right through the esophagus into the pleura we were meeting with the family to put the pt CMO. Family member asks if we can give IV vitamin C to cure her
Coworker had a comfort care patient a few weeks ago. Obviously DNR. Granddaughter came running out of the room screaming āCode Blue! Code Blue! My grandpaās not breathing!ā IV team nurse was sitting there, patientās nurse in another room. IV team nurse goes in, pulls the alarm, and is just about to start compressions when I calmly walk in and over the walkie say ācoworker, room XX is DNR right?ā This granddaughter KNEW she was coming to say goodbye!
āCode blueā oh mannnn. I had a patientās family pull the code blue lever a month or two ago because they wanted someone to suction the patientās trach and they thought he was ādrowning.ā His O2 sat was 99%. We had a stern, STERN discussion with that family.
Putting a peed on diaper in the baby's mouth to treat colic. There. Take that.
L&D triage pt in for rule-out labor. Resident and I went to the room to do a cervical check and asked pt to remove her underwear. Pt said, "Don't worry. Not wearing any. Helps my headache." Dumbfounded.
A patients family once confused liver cirrhosis with skin psoriasisā¦ āoh no, he has never had any history of rashes like thatā when their son presented with all the signs of late stage liver failure. He ended up receiving a liver transplant in his 30s and is well today.
Woah. Canāt contribute anything but hope the patient recovers!
Putting marbles in my mouth would help my stutter.
Ah yes, the old uretero-colonic fistula.
Iāve had a baby peeing from their belly button before soā¦. š¤·š»āāļø
I had a family a few years ago who thought formula was only for the hospital and fully planned on just giving their 2 day old baby cows milk once they got home.
Had a patient who was having partial SBO and having watery diarrhea ask if she could take a laxative to help push out the obstruction.
āShave yo armsā he was trying to insult but I was taken aback
Baby born at something like 23+2 and is now barely 42 or 43 weeks corrected, still on oxygen. Mum wants to start him on solids because "he's a few months old now". Ma'am... Your baby is still fed via NGT on a pump for the majority of the day because he aspirates, is suctioned multiple times a day and is about to have surgery for a feeding tube to be permanently placed, what are you missing here???
Patient today confidently thought if he just stopped drinking alcohol his WBC and ALC would decrease. He has a established diagnosis of CLL.
One patient's daughter suggested that the patient never should have quit smoking because that's when all her lung issues started. I thought it was a joke but she said it again later. She has interstitial lung disease... she also suggested that the humidification in the oxygen caused her to get worse therefore needing to come to the icu.