Sunday, January 13, 2013

dilaudid ala carte

You know what I just love? Those people who come in thinking that they are going to dictate what happens.  You know, the kind of person who requests what medication they want and how they want it.  They tell you what tests they want. They even tell you they want to be admitted and don't plan on going home.

Well, guess what folks? This isn't a cafeteria with different don't get a menu to choose from here.  You do what the doc decides.

Entitlement comes from all levels of society.  From the poor, who expect that you are going to arrange for a cab home to the upper middle class folks who think they can dictate how the visit is going to go. Espeically  irritating are those who say they know somebody in the administration or they know a doctor who works here. So what.

This happens a lot in triage, where people become irate because their doctor didn't call us to say they were coming. . I have seen people treat the triage nurse like shit calling them a liar, when told their doctor didn't call.   They think they will get in ahead of everybody else.  Not. they


Mal said...

Be fair. Some people know their own health problems, and can tell you what tests, medications and procedures they are likely to need. They're not all entitled, some are just trying to help you, get the care they need, and get out of the ER.
These are, however, not the ones asking for Dilaudid.
I'm one of them. 'Liability issues mean I need to get checked out here, because I passed out in your hospital and some moron called the crash team, but you're wasting your time. I have POSHT and hypoglycemia, and I had a syncopal episode, my foot twitches are a medication side effect from Venlafaxine, and not a seisure. Test my blood glucose, and my blood pressure sitting and standing, give me some paracetamol for the bruises, and some glucose for the shakiness, a drink of water in case I'm a little dehydrated, and I'll be good to go.'
Listen to me, and this will take five minutes, don't, and I'm checking out AMA and screw your liability issues, because you're going to take five hours to confirm what we both already know, which is that I really don't need to be here.

Anonymous said...

I do this too. People with chronic health problems, or decent medical knowledge often do know what's wrong with them, and what they need.

I went through this several times with my gallbladder in my early 20s. I was having complications and my liver wasn't doing its job, and I was having episodes of jaundice, severe pain and vomiting, so I ended up going to the ER a few times. If people listened to me, I got IV fluids painkillers, liver function tests, and was admitted for observation until things settled down. If they didn't listen, I got the exact same thing - after ultasound, CT, surgical consult, repeated examinations for Murphy's sign, and many, many bloodtests.

girlvet said...

Sorry guys, its up to the doctor what you get. Of course, the information you tell them may help determine what that is.

Nurse Lily said...

I'm with you on this one. I've seen it time and time again. Allergic to morphine, "don't even try the benadryl cocktail with me", etc. Somehow the only thing that works is "a minimum of 4 of dilaudid". Really, now...very interesting. You know, that hangnail DOES look pretty Hard not to get jaded.

hoodnurse said...

One of the NPs I used to work with would always say "she thinks this is Burger King and she can have it her way. Too bad it's the ER."

Christy Ryman said...

I'm one of those, too, to an extent. I get really bad migraines, and it's hard enough to get drs and nurses to take me seriously what with you guys assuming everyone's a drug seeker. When I do end up in the ER, which is only a couple times a year, I always ask the dr what they suggest. But I also tell them if they've suggested a drug that gives me particularly bad side effects, or I ask for the nausea med I know works best. It's frustrating to lay there in pounding pain while I humor the dr and let them try the meds they want to and after they don't work I can finally ask for what I know what works.

Anonymous said...

There is a difference between providing information to a doctor/nurse and telling them what to do. If you are telling a dr what test to run and what meds to give, then obviously, you do not need to be in an emergency room! Plain and simple. The reason you are there is you have an ailment and wish for it to be treated. Let the people with a degree do what they know to do.